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CMS Asks Surgeons to Delay Non-Essential Surgeries and Treatments during COVID-19 Emergency

CMS announced in a Press Release and in separate Guidance that “all elective surgeries, non-essential medical, surgical, and dental procedures be delayed during the 2019 Novel Coronavirus (COVID-19) outbreak” should be postponed.

In the Guidance, CMS stresses the following:

Decisions remain the responsibility of local healthcare delivery systems, including state and local health officials, and those surgeons who have direct responsibility to their patients. However, in analyzing the risk and benefit of any planned procedure, not only must the clinical situation be evaluated, but resource conservation must also be considered. These recommendations are meant to be refined over the duration of the crisis based on feedback from subject matter experts. At all times, the supply of personal protective equipment (PPE), hospital and intensive care unit beds, and ventilators should be considered, even in areas that are not currently dealing with COVID-19 infections

The recommendations provide a framework for hospitals and clinicians to implement immediately during the COVID-19 response. The recommendations outline factors that should be considered for postponing elective surgeries, and non-essential medical, surgical, and dental procedures. Those factors include patient risk factors, availability of beds, staff and PPE, and the urgency of the procedure. This will help providers to focus on addressing more urgent cases and preserve resources needed for the COVID-19 response …

In the guidance, CMS lists “tiers” of surgeries as a consideration for delaying surgery.  Tier 1a (those that are for low acuity surgery/healthy patient and therefore the most likely to be re-scheduled) includes cataract surgery.

They also stress that, since this is an evolving situation, other measures might be recommended later.

We are happy to assist you with claims issues and other topics related to eye care during this public health emergency.  Check back often for updated News Items related to billing, documentation, and operations related to your practices during COVID-19.

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