On March 29th, 2020, the Texas Medical Board (TMB) clarified that certain elective surgeries and procedures may be performed if the ordering physician has determined that such case is Urgentor Elective Urgent or Emergent. Further, the TMB stated proper documentation is the key to justifying any determination by the ordering physician that an elective case qualifies in one of these three categories.
Should you choose to proceed with ordering an Urgent, Elective Urgent, or Emergent surgery or procedure, be sure to very clearly state the reasoning and facts in the patient’s medical record. Here are some excerpts from the TMB’s FAQ document:
What should I do if I determine an elective surgery is necessary and will not violate Executive Order GA 09 or TMB rules?
Documentation is key. It is very important that the medical record clearly reflects why the elective surgery or procedure was urgent and necessary to prevent serious adverse medical consequences or death. This documentation could include information on the patient’s medical history, prescriptions, lab results, imaging, or other relevant factors used to make the determination of the urgent necessity of the elective surgery or procedure.
“Urgent or Elective Urgent” means a surgery or procedure is scheduled where there is a risk of patient deterioration or disease progression that is likely to occur if the procedure or surgery is not undertaken immediately and/or the surgery or procedure is significantly delayed.
The TMB provided these 10 Tips to assist you in determining whether the patient qualifies for an Urgent, Elective Urgent or Emergent procedure:
GA 09 and the TMB rules allow providers to use their judgment in determining whether a surgery or procedure will prevent serious adverse medical consequences or death;
If you normally could or would wait a few weeks to provide the surgery or procedure being considered for a specific patient based on the patient’s unique circumstances, then that might help you decide what to do;
If you normally could not or would not wait a few weeks to provide the surgery or procedure being considered for a specific patient based on the patient’s unique circumstances, then that might help you decide what to do;
If you do proceed with a surgery or procedure during this time, then be sure to clearly document why you made that decision;
Referencing legitimate literature and guidelines, such as the CDC, CMS, or specialty guidelines will be very helpful;
TMB cannot put anyone in jail;
The decision to hold a temporary suspension or restriction hearing will meet the same standard as before the COVID-19 disaster;
TMB understands the importance of having as many safe licensees available as possible during this time;
The TMB Board Members include 12 physicians that also must navigate these times, the Executive Order, and the rules while providing safe patient care; and
TMB is and will continue to be understanding that these are unprecedented times.
Click here for updated FAQs issued by the TMB on March 29, 2020 with respect to performing Non-Urgent, Elective Surgeries and Procedures during the COVID-19 pandemic.