Medical assistants and limited scope radiography

I receive fewer questions than I did seven or 10 years ago about the legalities of medical assistants performing limited scope radiography. However, in some states medical assistants are called upon to expose patients to ionizing radiation, as specifically directed by the overseeing/delegating provider.

The legality of this task is governed by state law. In some states unlicensed professionals such as medical assistants are forbidden from doing any limited scope radiography. Only licensed radiologic technologists are permitted to perform radiography. In other states medical assistants are required to complete a short course and pass a test in order to be delegated limited scope radiography. In other states limited scope radiography under direct/on-site provider supervision is not regulated. Physicians are permitted to delegate limited scope radiography to knowledgeable and competent employees.

Posted in delegation, On the Job, Professional Identity, Scope of Practice | Tagged , , , , , , | 15 Comments

Preparation and Administration of Injections by Medical Assistants

In the current ambulatory care environment, medical assistants are being delegated the preparation of injectable substances, as well as the administration of injections. I often receive questions about legal restrictions on medical assistants preparing injectable substances. In some states, there are specific laws that address this question. In general, it is my legal opinion that, if there is a likelihood of significant harm to a patient if an injectable substance is prepared improperly, the delegating provider must verify the identity and the dosage of the injectable substance before it is administered by the medical assistant.

Posted in medication administration, On the Job, Professional Identity, Scope of Practice | Tagged , , | 49 Comments

“Registered” vs. “Certified”: A Question of Terminology

A common source of confusion within medical assisting is the question of whether medical assisting credentials with “registered” in the name are superior to medical assisting credentials with “certified” in the name.

The answer to this question is no. National medical assisting credentials with the word “registered” as part of the credential name are not of a higher level status than medical assisting credentials with “certified” in their name.

This confusion may be engendered by the fact that “registered” indicates licensed status for credentials in fields other than medical assisting.  For example, in professional nursing, a “registered nurse” is a nurse who has met state educational and testing requirements, and is licensed to practice professional nursing.

However, this is not the case in medical assisting.  A medical assistant with a credential that has “registered” in its title is not in a different or higher legal category than a medical assistant with a credential that has “certified” in its title.

In fact, CMA (AAMA) certification has rigorous college-level education requirements, physician-quality exam standards, and is nationally and globally accredited, unlike other certifications and registrations.

Posted in Certification and the CMA (AAMA) Credential, Professional Identity, Uncategorized | Tagged , , , , , , , | 25 Comments

Scope of Practice in Correctional Facilities

The versatility of CMAs (AAMA) is being reflected in the questions I am starting to receive about the scope of practice for medical assistants working in correctional facilities.

If the CMAs (AAMA) are working under direct provider supervision in a clinic within a correctional facility, the standard laws for medical assisting scope of practice apply.  However, if a CMA (AAMA) is functioning as a medication aide and distributing medications under registered nurse supervision (similar to what occurs in a skilled nursing facility or an assisted living facility), the medical assistant would have to meet the state requirements and register with the appropriate state agency as a medication aide.

Posted in medication aide, Scope of Practice | Tagged , , , , | 7 Comments

CMA Today Referenced in Part B News

As many readers of this blog know, I write at length about legal issues affecting the medical assisting profession in each issue of CMA Today, the official publication of the American Association of Medical Assistants. Recently, one of those articles was referenced in a question-and-answer piece in Part B News. (Note: Subscription required.)

The write-up discusses CPT code 69209 (Removal of cerumen using irrigation/lavage) and whether the procedure can be billed if a medical assistant performs it. The author notes several important considerations—for example, the differences in state law and the vagaries of some CPT language—in addition to discussing the CPT definition of “clinical staff” as it relates to medical assistants. Ultimately, the author states the following:

In aggregate, when it comes to medical assistants being eligible to perform services incident to a physician, the answer is “generally yes,” according to recent guidance from the American Association of Medical Assistants (AAMA).

The language the author cited was from my article “‘Incident-to’ billing: Medical assistants’ services under the Medicare CCM program,” which can be found on the AAMA website.

Posted in CPT, CPT codes, delegation, Eligible Professionals, On the Job, Scope of Practice | Tagged , , , , , | 2 Comments