New Speech-Language Pathology Rule: Supervision of videostroboscopy and nasopharyngoscopy no longer required

But Dr. Rosen said the differentiation between functional and diagnostic work when it comes to the two procedures is “smoke and mirrors.” For example, “instead of saying the patient has a cyst, the speech-language pathologist will say, ‘there is a lesion on the vocal fold’ or ‘there is an irregularity to the edges of the vocal fold,’” he said. “There are these code words that people have developed, but in practice speech-language pathologists are truly doing diagnostic procedures.”

He sees the process that occurred with CMS as a missed opportunity to engage in a dialogue that would result in ensuring optimal care for patients. In Dr. Rosen’s view, “that means, specifically, that otolaryngologists are involved, not just MDs, and that there is an appropriate window during which there is a personal review of the examination by the otolaryngologist. If the MD is not in the room, I think that’s okay, but it has to be an otolaryngologist that reviews the results, probably within 72 hours.”

The AAO-HNS plans to reiterate to CMS its position “that the decision to remove the supervision level completely is not desirable and that the supervision level of direct would be the correct level to assign to the two procedures,” according to an item in the Academy’s “The News.” ENT TODAY