General Surgery Coding Alert

Protect back-office staff, too.

For employee safety and compliance purposes in your general surgery practice, you should be aware of recent COVID-19- related advisory guidance from the Occupational Safety and Health Administration (OSHA).

Update: In response to the “Executive Order on Protecting Worker Health and Safety” signed by President Biden, OSHA issued the new guidance document, “Protecting Workers: Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplace.”

Key: Although your practice may be carefully following CDC guidance for those encountering patients, you should also be aware of risks associated with issues related to employees in non-patient care areas.

Grasp OSHA Guidance

OSHA notes that its recommendations in the guidance are “advisory.” However, don’t be surprised to see them turn mandatory soon.

“If OSHA moves forward with issuing an emergency temporary standard (ETS), we expect that many of the recommendations in this guidance will become part of the ETS,” say attorneys Mark Duvall, Jayni Lanham, and Deepti Gage with law firm Beveridge & Diamond in online analysis.

Context: Biden’s executive order requires OSHA to “consider whether any emergency temporary standards [ETS] on COVID-19, including with respect to masks in the workplace, are necessary, and if such standards are determined to be necessary, issue them by March 15, 2021.”

Update: OSHA has confirmed that an ETS is pending, but with the March 15 deadline past, a spokesperson for the administration said the agency will need additional time.

Use the guidance: Before you have an ETS, the current OSHA guidance can serve to help you consider COVID-19 risks, inform staff, and lead to a safer workplace.

Consider asking yourself these OSHA-inspired questions as you plan on how to train staff, manage COVID-19 cases among employees, and communicate the protocols — and the dangers — of the virus:

• Are your policies aligned with federal health, privacy, and workplace standards?
• Do you have “reasonable accommodations” to protect older or disabled employees, who are at a higher risk of getting sick?
• Have you instituted a comprehensive training program that instructs employees on the most recent mandates related to masks, personal protective equipment (PPE), barriers, ventilation, cleaning, and disinfecting?
• Do you have screening, isolation, and reporting policies in place, as well as and protocols encouraging sick employees to stay home without fear of repercussions?
• Is your IT enabled to track and report staff cases of COVID-19 while protecting privacy?
• Do you have a plan in place that promotes COVID-19 vaccination while not infringing on workers’ rights or choices to not get inoculated?

Report Internal COVID-19 Cases

In the agency’s enforcement guidance, OSHA outlines when workplaces need to report COVID-19 cases as a work-related illness:

1. The case is a confirmed case of COVID-19 (see CDC guidance on persons under investigation and presumptive positive and laboratory-confirmed cases of COVID-19);

2. The case is work-related; and

3. The case involves one or more of the general recording criteria OSHA requires, such as days away from work, significant illness diagnosed by a healthcare provider, medical treatment beyond first aid, or death.

Join the Great Mask Debate

Although current CDC recommendations say that most healthcare personnel only need surgical masks, many experts across the scientific and public health spectrum disagree. More than a dozen prominent scientists wrote a letter asking the agency to update its mask guidance to acknowledge the ease with which the SARS-CoV-2 is transmitted through the air.

“CDC continues to recommend surgical masks for most healthcare workers and limits the use of NIOSH-certified respirators only to direct patient care or aerosol generating procedures with COVID-19 patients. It is now well-documented that healthcare workers in non-COVID-19 patient care and support positions are also at high risk of infection and should be wearing respirators,” the signatories say.

CDC responds: “For reasons supported by science, comfort, costs, and practicality, CDC does not recommend the use of N95 respirators for protection against COVID-19 by the general public,” said Jason McDonald, spokesperson for the CDC.

Resources: COVID-19 workforce protection guidance: www.osha.gov/coronavirus/safework.

Bloodborne pathogen standard: www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030

Enforcement guidance: www.osha.gov/coronavirus/standards#temp_enforcement_guidance.