2 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 8
Cataract Surgeons Giving Anesthesia?
Insurer say anesthetists aren't needed for most cataract cases.
Anesthesia Alert
JoEllen McBride, PhD | Associate Editor
A
major health insur-
er wants to deny
coverage of anes-
thesiology services
during cataract sur-
gery, saying the surgeon can han-
dle sedation and emulsification on
his own.
Think your eye docs would
mind much if they had to adminis-
ter IV sedatives and look up from
the microscope during the case to
monitor vital signs? Of course they
would (as would your patients!), but they might have to if Anthem
delivers on its promise to eliminate coverage for an anesthesiologist
or a nurse anesthetist during what it calls "routine" cataract surgeries.
"You want your ophthalmologist focusing only on the surgery at
hand and not the patient's anesthesia issues," says Steven Gayer, MD,
MBA, chief of surgery and anesthesia at Bascom Palmer Eye Institute
in Miami, Fla. "I would hate to be the surgeon who has a case of a
vocal local: trying to talk a patient down with no one in the room to
help."
In a clinical guideline (osmag.net/fR2uCB) released in February,
Anthem states that ophthalmologists can administer and monitor seda-
tion without jeopardizing patient safety. The guideline also says that
monitored anesthesia care is medically necessary only under certain
circumstances: if the patient is younger than 18 years old, or is unable
• SURGERY AND SEDATION Anthem says it's safe for a cataract surgeon to monitor how well
the patient is doing under anesthesia while he's looking through an operating microscope.
Pamela
Bevelhymer,
RN,
BSN,
CNOR