Ohio Administrative Code › Title 4731 - State Medical Board › Chapter 4731-25 - Office Based Surgery › Section 4731-25-01 - Definition of terms

Current through all regulations passed and filed through July 1, 2024
As used in this chapter of the Administrative Code:
(A) "Anesthesia services" means
			 administration of any drug or combination of drugs with the purpose of creating
			 deep sedation/analgesia, regional anesthesia or general anesthesia. Anesthesia
			 services shall not include the administration of topical or local anesthesia or
			 moderate sedation/analgesia;
(B)
			 "Certified copy of a patient record" means a copy of the patient record with a
			 separate statement, signed by the person making the copy and notarized,
			 attesting that the copy is a "true and accurate copy of the complete patient
			 record";
(C) "Deep
			 sedation/analgesia" means a drug-induced depression of consciousness during
			 which patients cannot be easily aroused but respond purposefully following
			 repeated or painful stimulation. The ability to independently maintain
			 ventilatory function may be impaired. Patients may require assistance in
			 maintaining a patent airway and spontaneous ventilation may be inadequate.
			 Cardiovascular function is usually maintained;
(D) "General anesthesia" means a drug-induced
			 loss of consciousness during which patients are not arousable, even by painful
			 stimulation. The ability to independently maintain ventilatory function is
			 often impaired. Patients often require assistance in maintaining a patent
			 airway, and positive pressure ventilation may be required because of depressed
			 spontaneous ventilation or drug-induced depression of neuromuscular function.
			 Cardiovascular function may be impaired;
(E) "Local anesthesia" means the injection of
			 a drug or combination of drugs to stop or prevent a painful sensation in a
			 circumscribed area of the body where a painful procedure is to be performed.
			 Local anesthesia includes local infiltration anesthesia, digital blocks and
			 pudendal blocks. Local anesthesia does not involve any systemic sedation;
(F) "Minimal sedation
			 (anxiolysis)" means a drug-induced state during which patients respond normally
			 to verbal commands. Although cognitive function and coordination may be
			 impaired, ventilatory and cardiovascular functions are unaffected. "Minimal
			 sedation" shall not include sedation achieved through intravenous
			 administration of drugs;
(G)
			 "Minor surgery" means surgery that can safely and comfortably be performed
			 under topical or local anesthesia without more than minimal oral or
			 intramuscular preoperative sedation. Minor surgery includes, but is not limited
			 to, surgery of the skin, subcutaneous tissue and other adjacent tissue, the
			 incision and drainage of superficial abscesses, limited endoscopies such as
			 proctoscopies, arthrocentesis and closed reduction of simple fractures or small
			 joint dislocations;
(H) "Moderate
			 sedation/analgesia" means a drug-induced depression of consciousness during
			 which patients respond purposefully to verbal commands, either alone or
			 accompanied by light tactile stimulation. Reflex withdrawal from a painful
			 stimulus is not a purposeful response. No interventions are required to
			 maintain a patent airway, and spontaneous ventilation is adequate.
			 Cardiovascular function is maintained;
(I) "Office setting" means an office or
			 portion thereof which is utilized to provide medical and/or surgical services
			 to the physician's own patients. Office setting does
			 not include an office or portion thereof licensed as
								 an ambulatory surgical
			 facility by the department of health pursuant to
			 division (E)(1) of section
			 3702.30 of the Revised
			 Code, a hospital registered with the department of
			 health pursuant to section
			 3701.07 of the Revised Code, or
			 an emergency department located within such a hospital;
(J) "Regional anesthesia" means the
			 administration of a drug or combination of drugs to interrupt nerve impulses
			 without loss of consciousness and includes epidural, caudal, spinal, axillary,
			 stellate ganglion blocks, regional blocks (such as axillary, bier, retobulbar,
			 peribulbar, interscalene, subarachnoid, supraclavicular, and infraclavicular),
			 and brachial anesthesia. Regional anesthesia does not include digital or
			 pudendal blocks;
(K) "Special
			 procedure" means a diagnostic or therapeutic procedure which is not surgery
			 which requires entering the body with instruments in a potentially painful
			 manner, or which requires the patient to be immobile, and which requires the
			 provision of anesthesia services. Special procedures include, but are not
			 limited to, diagnostic or therapeutic endoscopy that explores existing channels
			 and involves no transverse of a body wall; invasive radiologic procedures;
			 pediatric magnetic resonance imaging; manipulation under anesthesia; or
			 endoscopic examination with the use of general anesthesia;
(L) "Surgery" means the excision or
			 resection, partial or complete, destruction, incision or other structural
			 alteration of human tissue by any means, including through the use of lasers,
			 performed upon the body of a living human being for the purposes of preserving
			 health, diagnosing or curing disease, repairing injury, correcting deformity or
			 defects, prolonging life, relieving suffering, or for aesthetic, reconstructive
			 or cosmetic purposes, to include, but not be limited to: incision or curettage
			 of tissue or an organ; suture or other repair of tissue or organ, including a
			 closed or an open reduction of a fracture; extraction of tissue, including
			 premature extraction of the products of conception from the uterus; and,
			 insertion of natural or artificial implants. Surgery shall not include the
			 suturing of minor lacerations;
(M)
			 "Topical anesthesia" means the application of a drug or combination of drugs
			 directly or by spray to the skin or mucous membranes which is intended to
			 produce a transient and reversible loss of sensation to a circumscribed area.
(N) "Tumescent local anesthesia"
			 means subcutaneous infiltration of high volumes of crystalloid fluid containing
			 low concentrations of lidocaine and epinephrine. For purposes of this chapter
			 of the Administrative Code, "tumescent local anesthesia" shall be considered
			 "local anesthesia" as that term is defined in paragraph (E) of this rule.
Effective:
				8/31/2011
R.C. 119.032 review dates:
				05/20/2011 and
				08/31/2016
Promulgated Under:
				119.03
Statutory Authority: 4731.05
Rule Amplifies:
				4731.22
Prior Effective Dates: 1/1/04