Notice2021-28377
Agency Information Collection Activities: Submission to OMB for Review and Approval; Public Comment Request; National Practitioner Data Bank: Modification of the National Practitioner Data Bank Code Lists
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
January 3, 2022
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
HRSA, a sub-agency of the Department of Health and Human Services, is announcing a change in the NPDB Basis for Action Code Lists for Federal Licensure, and State Licensure or Certification Actions to individuals and entities authorized to report and request information from the NPDB. These changes will contain updated codes and code use guidance applicable to organizations submitting Federal Licensure, or State Licensure or Certification Actions. The code modifications and guidance are intended to provide improved report accuracy and promote a better understanding of the use and application of the basis of action codes available for report submission. The modifications are based in part upon recommendations made through a collaborative effort with NPDB industry partners: the Federation of State Boards of Physical Therapy, the National Council of State Boards of Nursing, the Federation of State Medical Boards, the Association of State and Provincial Psychology Boards, the National Board for Certification in Occupational Therapy, the Association of Social Work Boards, and the National Association of Boards of Pharmacy. Basis for Action codes help to accurately describe the basis for licensure actions reported. Basis for Action codes have no impact on the licensure action reported or the applicability of NPDB reporting criteria. New, modified, and retired codes have no impact on historical reporting. The coding of previously submitted reports will remain unchanged.
Full Text
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<title>Federal Register, Volume 87 Issue 1 (Monday, January 3, 2022)</title>
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[Federal Register Volume 87, Number 1 (Monday, January 3, 2022)]
[Notices]
[Pages 95-103]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-28377]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Submission to OMB for
Review and Approval; Public Comment Request; National Practitioner Data
Bank: Modification of the National Practitioner Data Bank Code Lists
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services.
ACTION: Request for public comment on the National Practitioner Data
Bank's (NPDB) Basis for action code lists for licensure and
certification actions.
-----------------------------------------------------------------------
SUMMARY: HRSA, a sub-agency of the Department of Health and Human
Services, is announcing a change in the NPDB Basis for Action Code
Lists for Federal Licensure, and State Licensure or Certification
Actions to individuals and entities authorized to report and request
information from the NPDB. These changes will contain updated codes and
code use guidance applicable to organizations submitting Federal
Licensure, or State Licensure or Certification Actions. The code
modifications and guidance are intended to provide improved report
accuracy and promote a better understanding of the use and application
of the basis of action codes available for report submission. The
modifications are based in part upon recommendations made through a
collaborative effort with NPDB industry partners: the Federation of
State Boards of Physical Therapy, the National Council of State Boards
of Nursing, the Federation of State Medical Boards, the Association of
State and Provincial Psychology Boards, the National Board for
Certification in Occupational Therapy, the Association of Social Work
Boards, and the National Association of Boards of Pharmacy. Basis for
Action codes help to accurately describe the basis for licensure
actions reported. Basis for Action codes have no impact on the
licensure action reported or the applicability of NPDB reporting
criteria. New, modified, and retired codes have no impact on historical
reporting. The coding of previously submitted reports will remain
unchanged.
DATES: Submit comments no later than February 2, 2022.
ADDRESSES: Written and/or electronic comments should be submitted to
<a href="/cdn-cgi/l/email-protection#d09e80949280bfbcb9b3a990b8a2a3b1feb7bfa6"><span class="__cf_email__" data-cfemail="eca2bca8aebc8380858f95ac849e9f8dc28b839a">[email protected]</span></a> by February 2, 2022.
[[Page 96]]
FOR FURTHER INFORMATION CONTACT: David Loewenstein, Director, Division
of Practitioner Data Bank, Bureau of Health Workforce, HRSA, (301) 443-
2300, <a href="/cdn-cgi/l/email-protection#4907190d0b192625202a3009213b3a28672e263f"><span class="__cf_email__" data-cfemail="175947535547787b7e746e577f65647639707861">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: The current published NPDB Code Lists are
available on the NPDB website: <a href="https://www.npdb.hrsa.gov/hcorg/codes.jsp">https://www.npdb.hrsa.gov/hcorg/codes.jsp</a>.
The NPDB is authorized by the Health Care Quality Improvement Act
of 1986 (the Act), Title IV of Public Law 99-660, as amended (42 U.S.C.
11101 et seq.). Further, two additional statutes expanded the scope of
the NPDB--Section 1921 of the Social Security Act, as amended (42
U.S.C. 1396r-2) and Section 1128E of the Social Security Act, as
amended (42 U.S.C. 1320a-7e). Information collected under the Section
1128E authority was consolidated within the NPDB pursuant to Section
6403 of the Affordable Care Act, Public Law 111-148; this consolidation
became effective on May 6, 2013.
Proposed NPDB Code Lists Modifications
----------------------------------------------------------------------------------------------------------------
Guideline or
Table Code Status Current code New/modified code explanation of Code use examples
description description status change and explanations
----------------------------------------------------------------------------------------------------------------
Non-Compliance With Requirements
----------------------------------------------------------------------------------------------------------------
48........ 44.......... U......... Default on Health ................. Fails to meet Explanation: Use
Education Loan health education only if your
or Scholarship loan or state has this
Obligations. scholarship requirement.
obligations.
48........ 35.......... U......... Drug Screening ................. Fails a drug Examples:
Violation. screening test. <bullet> Failure
of a required
drug screen or
failure to
comply with the
requested drug
screen;
<bullet> Sample
is adulterated,
invalid or
substituted;
<bullet> Failure
of a drug screen
for employment.
48........ A2.......... U......... Failure to Comply ................. Fails to meet the Examples:
With Continuing continuing <bullet> Failure
Education or education or to complete
Competency competency state
Requirements. requirements for requirements;
renewal or <bullet> If the
reinstatement. licensee
falsified
meeting the
requirements,
then also use
Code E3.
48........ 31.......... M......... Failure to Comply Failure to comply Fails to comply Examples:
With Health and with health and with federal, <bullet> Failure
Safety safety state, local, or to meet required
Requirements. requirements or institutional health tests or
state health safety inoculations.
code. requirements or DO NOT use for:
state health <bullet>
codes. Violation of
infection
control, sterile
technique, and
isolation
requirements;
instead use Code
17.
48........ 23.......... U......... Failure to ................. Interferes with Examples:
Cooperate With an investigation <bullet> Failure
Board or disciplinary to respond or to
Investigation. proceeding by respond
withholding adequately to
information, board
deliberate investigation
misrepresentatio requests;
n of facts or <bullet> Failure
attempts to to cooperate
suppress with the board
evidence. as a witness to
an
investigation.
48........ 50.......... M......... Failure to Failure to Fails to meet Example:
Maintain Maintain or documentation <bullet> Failure
Adequate or Provide Adequate requirements for to provide
Accurate Records. or Accurate maintaining adequate
Medical Records, patient care, documentation of
Financial financial or treatment/care
Records or Other other records. in the medical
Required record.
Information.
48........ 45.......... R......... Failure to ................. Redundant code,
Maintain Records use code 50.
or Provide
Medical,
Financial or
Other Required
Information.
48........ A3.......... R......... Failure to Meet ................. Use code A1......
Licensing Board
Reporting
Requirements.
[[Page 97]]
48........ A1.......... M......... Failure to Meet Failure to Meet Fails to meet Examples:
the Initial Licensure board specified <bullet> Failure
Requirements of Requirements/ licensing to meet board
a License. Licensing Board requirements or requirements
Reporting provide other than
Requirements. requested/ threshold
required licensure
information. requirements;
NOTE: Do not <bullet> Failure
report or to provide
include information
threshold required by the
criteria: the board (e.g.,
accepted minimum criminal
licensure conviction, loss
requirements of job due to
that are unprofessional
universally conduct,
applied without disciplinary
decision or action in
exception. another
Examples include jurisdiction,
academic change of
degrees, address etc.);
criminality, <bullet> Failure
certifications, to report any
or training renewal and
hours or reinstatement
requirements. requirements;
<bullet> Failure
to report
another health
care
professional as
required by
mandatory
reporting
obligations.
DO NOT use for:
<bullet> Failure
to meet
threshold
criteria: the
accepted minimum
licensure
requirements
that are
universally
applied without
decision or
exception.
Examples include
academic
degrees,
criminality,
certifications,
or training
hours or
requirements;
<bullet>
Continuing
Competency
requirements;
instead use Code
A2;
<bullet>
Obtaining a
license but
failing to
disclose
required
information on
the application;
instead use Code
E4.
48........ 37.......... M......... Failure to Pay Failure to Pay or Fails to meet Explanation: Use
Child Support/ Delinquent with child support only if your
Delinquent Child Child Support. responsibilities. state has this
Support. requirement.
48........ 39.......... M......... License Disciplinary Grounds for Examples:
Revocation, Action Taken by action are based <bullet> A
Suspension or another Federal, on action(s) licensee is
Other State or Local taken by another licensed in
Disciplinary Licensing state licensing, another
Action Taken by Authority. federal, or jurisdiction and
a Federal, State other authority. has final
or Local disciplinary
Licensing action by that
Authority. authority.
DO NOT use for:
<bullet> Your own
jurisdiction's
disciplinary
action.
48........ 29.......... U......... Practicing Beyond ................. Provides care not Examples:
the Scope of permitted under <bullet>
Practice. the terms of a Performing
license or practice
within the interventions,
licensee's level whether advanced
of education, or not, without
training, required
knowledge, license,
skills, certification or
experience, or training;
demonstrated <bullet> Failure
competency. to work with
adequate/
required
supervision.
DO NOT use for:
<bullet>
Substandard or
Inadequate Care
for incompetence
issues; instead
use Code F6;
<bullet>
Negligence for
not exercising
reasonable
judgement;
instead use Code
13.
48........ 24.......... U......... Practicing With ................. Fails to renew Example:
an Expired license and <bullet> Failure
License. continues to to renew license
practice. intentionally or
unintentionally
and continues to
practice.
DO NOT use for:
<bullet> A new
graduate who
fails the exam
and continues to
practice under a
temporary
license which
expired on
getting exam
results; instead
use Code A4;
<bullet> Someone
who has had
their license
revoked and
continues to
practice;
instead use Code
A4.
48........ 25.......... R......... Practicing ................. Redundant code,
Without a use code A4.
License.
48........ A4.......... U......... Practicing ................. Practices without Examples:
Without a Valid obtaining the <bullet> Failure
License. proper to cease
authorization. practice after a
temporary
license or
permit has
expired;
<bullet>
Applicant or
licensee
practices after
passing the exam
but before
licensing
authority has
issued license.
DO NOT use for:
<bullet> Someone
whose license
has expired;
instead use Code
24.
[[Page 98]]
48........ A6.......... U......... Violation of ................. Violation of Examples:
Federal or State federal or state <bullet> Failure
Statutes, statutes, to meet alimony
Regulations or regulations or responsibilities
Rules. rules not ;
associated with <bullet> Failure
the practice act. to report abuse
or other federal
or state
requirement.
DO NOT use for:
<bullet>
Violations of
the state
practice act;
<bullet> Failure
to meet child
support; instead
use Code 37.
48........ 36.......... U......... Violation of ................. Fails to meet Example:
Federal or State federal or state <bullet> Failure
Tax Code. tax code to meet federal
responsibilities. or state tax
code
responsibilities
.
Explanation:
<bullet> Use with
appropriate
criminal
conviction or
adjudication
code if
applicable.
48........ 84.......... R......... Violation of ................. Redundant code,
State Health use code 31.
Code.
48........ A5.......... U......... Violation of or ................. Fails to comply Example:
Failure to with a specific <bullet> Failure
Comply With board order. to meet terms of
Licensing Board a board order.
Order.
----------------------------------------------------------------------------------------------------------------
Criminal Conviction or Adjudication
----------------------------------------------------------------------------------------------------------------
49........ 19.......... U......... Criminal ................. Convicted of a Example:
Conviction. felony or <bullet>
misdemeanor Convicted of a
crime. felony or
misdemeanor
crime.
Explanation:
<bullet> Use this
code along with
the appropriate
code to describe
the underlying
violation of
law;
<bullet> If there
is no
appropriate
code, describe
the criminal
conviction in
the narrative.
49........ 18.......... U......... Deferred ................. Plea that avoids Explanation:
Adjudication. criminal <bullet> Deferred
conviction by adjudication
meeting certain involves
probationary probation,
requirements. treatment
programs, and/or
some type of
community
supervision;
<bullet> Use this
code along with
the appropriate
code to describe
the underlying
violation of
law;
<bullet> If there
is no
appropriate
code, describe
the violation in
the narrative.
49........ B1.......... U......... Nolo Contendere ................. Plea of no
Plea. contest, same
consequence as a
guilty plea.
49........ I1.......... U......... Diverted ................. Pre-trial Explanation:
Conviction. sentencing that <bullet> Pretrial
avoids criminal sentencing
conviction by includes
completing a participating in
court ordered a treatment or
intervention rehabilitation
program. program;
<bullet> Use this
code along with
the appropriate
code to describe
the underlying
violation of
law;
<bullet> If there
is no
appropriate
code, describe
the violation in
the narrative.
----------------------------------------------------------------------------------------------------------------
Confidentiality, Consent or Disclosure Violations
----------------------------------------------------------------------------------------------------------------
50........ C3.......... U......... Breach of ................. Releases or Example:
Confidentiality. obtains patient <bullet>
information Releasing or
without obtaining
appropriate patient
authorization. information
without
appropriate
authorization.
50........ C2.......... U......... Failure to Comply ................. Fails to meet Examples:
With Patient requirements for <bullet> Failure
Consultation consultation to consult with
Requirements. with other or refer to an
health care appropriate
providers or licensee when
refer when care is beyond
appropriate. the licensee's
level of
training, skill,
expertise or
license;
<bullet> Failure
to keep a
referring source
informed of the
patient's
progress.
50........ C1.......... U......... Failure to Obtain ................. Fails to meet Examples:
Informed Consent. informed consent <bullet> Failure
requirements. to explain
procedures and
possible
complications;
<bullet> Failure
to obtain
permission of
the patient to
evaluate and
treat; as well
as failure to
obtain parental
permission for a
minor.
----------------------------------------------------------------------------------------------------------------
[[Page 99]]
Misconduct or Abuse
----------------------------------------------------------------------------------------------------------------
51........ D4.......... U......... Abusive Conduct ................. Engages in the Example:
Toward Staff. maltreatment of <bullet> Engaging
a colleague or in the
employee which maltreatment of
can include a colleague or
mental, physical employee (i.e.
and/or verbal mental, physical
abuse. and/or verbal
abuse).
DO NOT use for:
<bullet> Sexual
abuse; instead
use Code D1.
51........ D7.......... M......... Conduct Conduct Engages in Examples:
Evidencing Evidencing conduct that is <bullet> Failure
Ethical Ethical or Moral unethical or to respect the
Unfitness. Unfitness. violates the beliefs and
ethical code of values of
conduct. patient without
prejudice;
<bullet> Failure
to protect or
disregards the
rights, health,
safety of the
patient.
51........ D6.......... R......... Conduct ................. Use Code D7......
Evidencing Moral
Unfitness.
51........ 71.......... U......... Conflict of ................. Fails to disclose Examples:
Interest. information that <bullet> Failure
presents a to-disclose
conflict of ownership;
interest. <bullet> Failure
to provide
freedom of
choice.
51........ D5.......... U......... Disruptive ................. Engages in Example:
Conduct. conduct which <bullet>
interferes with Interferes with
or disrupts or disrupts
normal normal
operations in operations in
the patient care the patient care
setting or setting or
workplace. workplace.
DO NOT use for:
<bullet> Patient
abuse; instead
use Code 14.
51........ D3.......... U......... Exploiting a ................. Exploits a Examples:
Patient for professional <bullet> Takes
Financial Gain. relationship advantage of the
with a patient patient
to benefit relationship by
financially selling products
beyond that that are not
which is needed for
reasonable for treatment or
the provision of could be
treatment. obtained for a
lower price;
<bullet> Takes
advantage of the
patient
relationship by
inviting them
into business
opportunities.
DO NOT use for:
<bullet>
Excessive or
fraudulent
billing; instead
use Code 55.
51........ 16.......... U......... Misappropriation ................. Uses a patient's Example:
of Patient or coworker's <bullet> Using or
Property or property or the taking a
Other Property. property of a patient's or
facility without coworker's
approval or property or the
permission. property of a
facility without
approval or
permission.
Explanation:
<bullet> Also use
Code 19 Criminal
Conviction if
there has been a
criminal
conviction.
DO NOT use for:
<bullet>
Diverting
medications from
a patient;
instead use Code
H6.
51........ D2.......... M......... Non-Sexual Dual Non-Sexual Engages in a non- Examples:
Relationship or Boundary sexual <bullet>
Boundary Violation. relationship, Excessive
Violation. behavior or personal
boundary disclosure,
violation that secrecy,
involves reversal of
exploitation or roles or actions
coercion of a that meet the
patient or needs of the
former patient licensee
and contains (borrowing
harmful or money);
potentially <bullet>
harmful elements. Non[hyphen]sexua
l relationship
with a patient's
significant
other.
51........ 14.......... U......... Patient Abuse.... ................. Engages in the Example:
maltreatment of <bullet> Mental,
a patient which physical and/or
can include verbal abuse of
mental, physical a patient.
and/or verbal DO NOT use for:
abuse. <bullet> Sexual
abuse or sexual
assault; instead
use Code D1.
51........ D1.......... U......... Sexual Misconduct ................. Engages in Examples:
behavior that <bullet> Sexual
exploits the exploitation of
practitioner- a patient;
patient <bullet>
relationship in Workplace sexual
a sexual way, or harassment;
engages in <bullet> Sexual
workplace sexual Assault;
harassment such <bullet> Sexual
as unwelcome Abuse.
sexual advances
or conduct of a
sexual nature
which interferes
with the
performance of
another person's
job or creates
an intimidating,
hostile, or
offensive work
environment.
51........ D8.......... R......... Other ................. Redundant code,
Unprofessional covered by other
Conduct, Specify. categories, or
use code 99.
----------------------------------------------------------------------------------------------------------------
[[Page 100]]
Fraud, Deception, or Misrepresentation
----------------------------------------------------------------------------------------------------------------
52........ E6.......... U......... Failure to ................. Fails to disclose Examples:
Disclose. information that <bullet> Failure
is required by to disclose
the board. criminal or
disciplinary
history on a
license
application;
<bullet> Failure
to disclose
revenues
generated from
selling
equipment or
other financial
relationships,
etc.
52........ E3.......... U......... Filing False ................. Fabricates Examples:
Reports or patient, <bullet> Failure
Falsifying medical, health, to provide
Records. employee, or accurate
other records. patient,
medical, health,
employee, or
other records;
<bullet>
Documenting
treatment that
did not occur.
Explanation: Use
this code in
conjunction with
A2 Failure to
Comply with
Continuing
Education or
Competency
Requirements for
falsifying
licensee
continuing
education or
competence
records.
DO NOT use for:
<bullet> False
billing for care/
treatment;
instead use Code
56.
52........ 5........... R......... Fraud--Unspecifie ................. Redundant code,
d. covered by other
fraud codes.
52........ E4.......... U......... Fraud, Deceit or ................. Provides false, Examples:
Material altered or <bullet> Provides
Omission in omitting false
Obtaining documents and documentation in
License or information when licensure
Credentials. applying for application
licensure. materials
(transcript,
letters, etc.);
<bullet> Failure
to disclose
prior
disciplinary
action or
criminal
conviction on
application;
<bullet>
Falsifies
testing
materials
(cheating,
trafficking,
etc.).
52........ 55.......... M......... Improper or Improper Billing Knowingly or Examples:
Abusive Billing Practices. intentionally <bullet>
Practices. bills improperly. Knowingly uses
incorrect
treatment or
billing codes;
<bullet> Charges
unreasonable
fees;
<bullet>
Intentionally
overbills.
DO NOT use for:
<bullet>
Conviction of
insurance fraud;
instead use Code
E1.
52........ E1.......... U......... Insurance Fraud ................. Convicted of Examples:
(Medicare, Medicare, <bullet>
Medicaid or Medicaid or Convicted of
Other Insurance). other insurance Medicare,
fraud. Medicaid or
other insurance
fraud.
Explanation:
<bullet> Use in
conjunction with
Code 19 Criminal
Conviction.
52........ E5.......... U......... Misleading, False ................. Uses misleading, Example:
or Deceptive false or <bullet> False or
Advertising or deceptive misleading
Marketing. advertising or advertising
marketing related to
related to license.
services, DO NOT use for:
treatment, <bullet> Failure
procedures or to correctly
care. identify
credentials;
instead use Code
81.
52........ 81.......... U......... Misrepresentation ................. Fails to properly Example:
of Credentials. identify oneself <bullet> Failure
with regards to to properly
education, identify
training, education,
knowledge, training,
experience, or knowledge,
skills. experience, or
skills.
52........ E2.......... U......... Providing or ................. Orders or Examples:
Ordering provides <bullet>
Unnecessary unnecessary Overutilization
Tests or tests, of tests/
Services. procedures, services;
treatment or <bullet>
services. Providing
unnecessary
treatment.
52........ 56.......... U......... Submitting False ................. Requests Example:
Claims. reimbursement <bullet>
for services Intentionally
that did not billing for
occur or does interventions/
not reflect the care that did
actual treatment not occur.
provided. DO NOT use for:
<bullet>
Conviction for
insurance fraud;
instead use Code
E1;
<bullet>
Documenting
treatments/care
that did not
occur or
falsifying
patient records;
instead use Code
E3.
----------------------------------------------------------------------------------------------------------------
Unsafe Practice or Substandard Care
----------------------------------------------------------------------------------------------------------------
53........ F8.......... U......... Failure to ................. Fails to provide Example:
Consult or Delay or delaying <bullet> Failure
in Seeking proper to consult with
Consultation consultation or report to a
With Supervisor/ with supervisor supervisor/
Proctor. or proctor. ordering health
care provider/
proctor.
[[Page 101]]
53........ 53.......... R......... Failure to ................. Redundant code,
Provide use code 13.
Medically
Reasonable and/
or Necessary
Items or
Services.
53........ F1.......... M......... Immediate Threat Immediate Threat Presents an Examples:
to Health or to Public. immediate risk <bullet>
Safety. to health or Emergency or
safety; Board summary
uses emergency suspension of a
measures to license.
remove a Explanation:
practitioner <bullet> Use in
from practice. combination with
a code that best
describes the
violation.
53........ 17.......... U......... Inadequate or ................. Fails to conform Example:
Improper to recognized <bullet> Failure
Infection standards or to follow
Control orders for policies or
Practices. infection procedures for
control. infection
control, sterile
technique or
isolation
requirements.
DO NOT use for:
<bullet> Failure
to comply with
federal, state,
local or
institutional
safety
requirements or
state health
codes; instead
use Code 31.
53........ FA.......... U......... Inappropriate ................. Refuses to treat Example:
Refusal to Treat. a patient due to <bullet> Refusal
religious, moral to treat a
or other reasons. patient due to
religious, moral
or other
reasons.
53........ 11.......... R......... Incompetence..... ................. Redundant code,
use F1 or F6.
53........ 12.......... R......... Malpractice...... ................. Redundant code,
use specific
reason
associated with
malpractice.
53........ 13.......... U......... Negligence....... ................. Fails to exercise Example:
the skill, care <bullet> Failure
and learning to exercise
expected of a reasonable
reasonably judgment.
prudent health DO NOT use for:
care provider. <bullet>
Competence
issue; instead
use Code F6.
53........ F9.......... U......... Patient ................. Terminates care Example:
Abandonment. without adequate <bullet> Deserts
notice of the or neglects a
professional patient with
relationship whom there is an
between a health established
care provider provider-patient
and a patient/ relationship
client at a time without making
when the patient reasonable
needs further arrangements for
care. the continuation
of care and
without
reasonable
notice.
53........ 15.......... R......... Patient Neglect.. ................. Redundant code,
use 13.
53........ F6.......... M......... Substandard or Substandard Care Fails to meet Example:
Inadequate Care. or Inadequate clinical <bullet> Failure
Skill Level. standards of to provide
practice, unable competent care.
to practice DO NOT use for:
competently or <bullet>
practicing with Practicing
insufficient beyond level of
skill. training;
instead use Code
29.
53........ F7.......... R......... Substandard or ................. Redundant code,
Inadequate Skill use code F6.
Level.
53........ F5.......... R......... Unable to ................. Redundant code,
Practice Safely. use code F2, F3,
or F4.
53........ F2.......... M......... Unable to Unable to Unable to Example:
Practice Safely Practice Safely practice safely <bullet> Failure/
by Reason of by Reason of by reason of inability to
Alcohol or Other Substance Use. substance use. practice safely
Substance Abuse. by reason of
substance use.
53........ F4.......... M......... Unable to Unable to Unable to Example:
Practice Safely Practice Safely practice safely <bullet> Failure/
by Reason of by Reason of by reason of inability to
Physical Illness Physical physical practice safely
or Impairment. Impairment. impairment. by reason of
physical
impairment.
53........ F3.......... M......... Unable to Unable to Unable to Example:
Practice Safely Practice Safely practice safely <bullet> Failure/
by Reason of by Reason of by reason of inability to
Psychological Psychological psychological practice safely
Impairment or Impairment. impairment. by reason of
Mental Disorder. psychological
impairment.
53........ To be N......... N/A.............. Incorrect Site Procedure Example:
determined. Procedure. performed on the <bullet>
wrong side or Performing an
site of the invasive
body, wrong procedure on
surgical wrong side of
procedure the body;
performed. <bullet>
Performing a non-
invasive
procedure on the
wrong side of
the body, i.e.
taking blood
pressure on the
side of an
arteriovenous
fistula.
[[Page 102]]
53........ To be N......... N/A.............. Foreign Body Leaves an item(s) Example:
determined. Retained inside a patient <bullet> Retained
Inappropriately after a foreign body
in a Patient. procedure that refers to any
should not be item or foreign
there. object related
to any operative
or invasive
procedure that
is left inside a
patient. Common
items include
sponges and
towels;
retractors,
unretrieved
device
components or
fragments, parts
of trocars,
guidewires,
catheters, and
pieces of
drains; needles
and other
sharps.
53........ To be N......... N/A.............. Wrong Patient.... Procedure or Example:
determined. treatment <bullet>
performed on the Performing an
wrong patient. invasive
procedure on the
wrong patient;
<bullet>
Performing a non-
invasive
procedure on the
wrong patient
i.e. ambulating
the wrong
patient.
----------------------------------------------------------------------------------------------------------------
Improper Supervision or Allowing Unlicensed Practice
----------------------------------------------------------------------------------------------------------------
54........ G2.......... U......... Allowing or ................. Allows or assists Example:
Aiding someone practice <bullet>
Unlicensed without a Knowingly allows
Practice. license. unlicensed
practice.
54........ G1.......... U......... Improper or ................. Fails to Example:
Inadequate supervise <bullet> Failing
Supervision or adequately or to supervise
Delegation. properly those adequately or
assigned to you. properly those
assigned to you.
----------------------------------------------------------------------------------------------------------------
Improper Prescribing, Dispensing, Administering Medication/Drug Violation
----------------------------------------------------------------------------------------------------------------
55........ H6.......... U......... Inappropriate ................. Diverts Example:
Acquisition or prescription <bullet> Removing
Diversion of medication from a prescribed
Controlled a patient or a medication from
Substance. healthcare a patient's
facility with inventory,
intent to sell, unused portion,
distribute or waste, trash or
consume for healthcare
personal misuse. facility
inventory for
self or someone
other than the
patient.
55........ H5.......... U......... Error in ................. Makes an error Examples:
Prescribing, when <bullet> Giving
Dispensing or prescribing, the wrong
Administering dispensing, or medication;
Medication or administering <bullet> Giving
Sedation. medications. medication to
the wrong
patient;
<bullet> Giving
the wrong dosage
of medication;
<bullet> Improper
storage of
medication.
55........ H1.......... M......... Narcotics Drug Drug Violation or Controlled Examples:
Violation or Other Violation substance <bullet>
Other Violation of Drug Statutes. violation Controlled
of Drug Statutes. regardless of substance
conviction. violation
regardless of
conviction.
Explanation:
<bullet> If there
is a conviction,
also use Code 19
Criminal
Conviction.
55........ H4.......... U......... Inappropriate or ................. Administers Example:
Unauthorized medications <bullet> Failure
Administration improperly or to administer
of Medication or without the medications
Sedation. appropriate properly or
prescription or without the
medication order. appropriate
prescription/
order.
55........ H3.......... U......... Inappropriate or ................. Dispenses Example:
Unauthorized medication <bullet> Failure
Dispensing of improperly or to obtain
Medication. without the authorization or
appropriate prescription to
authorization. dispense
medication.
55........ H2.......... U......... Inappropriate or ................. Improper Examples:
Unauthorized prescribing or <bullet> Forging
Prescribing of attempting to signature on
Medication. prescribe order/
without prescription;
authority or <bullet> Altering
altering an order/
medication order. prescription;
<bullet> Failure
to obtain
prescriber
authorization or
signature.
----------------------------------------------------------------------------------------------------------------
Other
----------------------------------------------------------------------------------------------------------------
56........ 99.......... U......... Other--Not ................. Use only if no
Classified, other code is
Specify. applicable.
----------------------------------------------------------------------------------------------------------------
Table Key:
[ssquf] Table # and name as it appears in published NPDB Code Lists.
[ssquf] Code # as it appears in published NPDB Code Lists. NOTE: Code number is subject to change with the next
published version.
[ssquf] Status: Unchanged (U), Modified (M), Retired (R), New (N).
[ssquf] Current Code Description.
[ssquf] New or Modified Code Description.
[ssquf] Guideline: a new category of information to help explain the code.
[ssquf] Code use examples and explanations: a new category of information to show how to apply the code.
[[Page 103]]
Diana Espinosa,
Acting Administrator.
[FR Doc. 2021-28377 Filed 12-30-21; 8:45 am]
BILLING CODE 4165-15-P
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</html>Indexed from Federal Register on January 3, 2022.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.