During the December 2013 meeting of the Texas Medical Board, new rules related to office based level I anesthesia were adopted. Use of local anesthesia that exceeds 50% of the recommended safe dose is now level II and requires additional patient monitoring. However, Mohs micrographic surgery is exempted under the new rule.
CHAPTER 192. OFFICE BASED ANESTHESIA
22 TAC §192.1
The amendment adds language providing that except as provided by §192.2(b)(9), the administration of certain local anesthesia, peripheral nerve blocks, or both in a total dosage amount that exceeds 50 percent of the recommended maximum safe dosage per outpatient visit is a level II service, in accordance with SB 978 (83rd Reg. Session).
22 TAC §192.2
The amendment revises language in subsection (b)(1) providing that rules under Chapter 192 do not apply to outpatient settings in which only local anesthesia, peripheral nerve blocks, or both are used in a total dosage amount that does not exceed 50 percent of the recommended maximum safe dosage per outpatient visit, in accordance with SB 978 (83rd Reg. Session). Additionally, new subsection (b)(9) is added, providing that the rules under Chapter 192 do not apply to the performance of Mohs micrographic surgery.