Ohio Administrative Code › Title 4731 - State Medical Board › Chapter 4731-25 - Office Based Surgery › Section 4731-25-02 - General provisions

Current through all regulations passed and filed through July 1, 2024
(A)
			 Anesthesia services in the office setting shall be provided only by physicians
			 and osteopathic physicians licensed pursuant to Chapter 4731. of the Revised
			 Code; podiatric physicians licensed pursuant to Chapter 4731. of the Revised
			 Code and practicing within the scope of practice for podiatric physicians; and
			 certified registered nurse anesthetists licensed pursuant to Chapter 4723. of
			 the Revised Code and practicing within the scope of practice for certified
			 registered nurse anesthetists; and only in accordance with Chapter 4731-25 of
			 the Administrative Code.
(B)
			 Nothing in this chapter of the Administrative Code shall be interpreted to
			 permit a podiatric physician to perform surgery or special procedures in an
			 office setting using general anesthesia.
(C) Nothing in this chapter of the
			 Administrative Code shall be interpreted to prohibit a registered nurse with
			 the appropriate education and training from carrying out a physician's order to
			 maintain a patient within an intensive care unit of a hospital at the level of
			 sedation determined by the physician to be appropriate and necessary for that
			 patient's care, so long as the patient remains within the intensive care unit
			 with appropriate monitoring and so long as the physician's order is written in
			 compliance with all applicable laws.
(D) A physician or podiatric physician shall
			 not perform on more than one patient at the same time special procedures or
			 surgery using moderate sedation/analgesia or anesthesia services.
(E) A certified registered nurse anesthetist
			 providing moderate sedation/analgesia or anesthesia services in the office
			 setting shall be under the direction of a podiatric physician acting within the
			 podiatric physician's scope of practice in accordance with section
			 4731.51 of the Revised Code or a
			 physician, and, when administering anesthesia, the certified registered nurse
			 anesthetist shall be in the immediate presence of the podiatric physician or
			 physician. For purposes of this chapter of the Administrative Code, a physician
			 shall not be considered to have supervised the administration and monitoring of
			 moderate sedation/analgesia or anesthesia services if the moderate
			 sedation/analgesia or anesthesia services were administered and monitored by a
			 physician anesthesiologist.
(F)
			 "Surgery" shall not be interpreted so as to prohibit a registered nurse from
			 performing tasks that are within the scope of practice of the registered nurse,
			 so long as the registered nurse's activities are in accordance with Chapter
			 4723. of the Revised Code.
(G) This
			 chapter of the Administrative Code shall not apply to surgeries or special
			 procedures in which the level of anesthesia is limited to minimal sedation as
			 that term is defined in this chapter of the Administrative Code, or which use
			 only local or topical anesthetic agents, and which are performed in an office
			 setting except that liposuction procedures performed under tumescent local
			 anesthesia shall be subject to the provisions of rule
			 4731-25-05 of the Administrative
			 Code.
(H) Special procedures or
			 surgery utilizing moderate sedation/analgesia or anesthesia services shall be
			 performed in the office setting only on patients who are evaluated as level P1
			 or P2 according to the American society of anesthesiologists physical status
			 classification system current at the effective date of this rule.
(I)
								A special
			 procedure or surgery that is prohibited by rule of the Administrative Code or
			 law of the Revised Code to be performed in a hospital or ambulatory surgical
			 facility shall not be performed in an office setting.