4. Services generally nonskilled may require skilled performance

Official source

Any generally nonskilled service could, because of special medical complications, require skilled performance, supervision, or observation. In such cases, the complications and special services involved must be documented by physician orders and/or nursing notes. For example, the existence of a plaster cast on an extremity would not generally indicate a need for skilled care. However, a preexisting acute skin problem and a need for special traction of the injured extremity might require the presence of professional health personnel in order to properly observe for complications and adjust traction accordingly. Such procedures should be undertaken only on specific physician orders and should be documented in the patient's clinical record. The possibility of adverse effects from the improper performance of an otherwise unskilled service does not make it a skilled service unless there is documentation.

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4. Services generally nonskilled may require skilled performance

Official source

Any generally nonskilled service could, because of special medical complications, require skilled performance, supervision, or observation. In such cases, the complications and special services involved must be documented by physician orders and/or nursing notes. For example, the existence of a plaster cast on an extremity would not generally indicate a need for skilled care. However, a preexisting acute skin problem and a need for special traction of the injured extremity might require the presence of professional health personnel in order to properly observe for complications and adjust traction accordingly. Such procedures should be undertaken only on specific physician orders and should be documented in the patient's clinical record. The possibility of adverse effects from the improper performance of an otherwise unskilled service does not make it a skilled service unless there is documentation.