2015 Tennessee Code
Title 63 - Professions Of The Healing Arts
Chapter 31 - Polysomnography
§ 63-31-101 - Chapter definitions.

As used in this chapter, unless the context otherwise requires:

(1) "Board" means the board of medical examiners;

(2) "Committee" means the polysomnography professional standards committee established by § 63-31-103;

(3) "Direct supervision" means that the polysomnographic technologist providing supervision must be present in the area where the polysomnographic procedure is being performed and immediately available to furnish assistance and direction throughout the performance of the procedure;

(4) "General supervision" means that the polysomnographic procedure is provided under a physician's overall direction and control, but the physician's presence is not required during the performance of the procedure;

(5) "Polysomnographic student" means a person who is enrolled in an educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), as provided in § 63-31-106(b)(1), and who may provide sleep-related services under the direct supervision of a polysomnographic technologist as a part of the person's educational program;

(6) "Polysomnographic technician" means a person who has graduated from an accredited educational program described in § 63-31-106(b)(1) but has not yet passed the national certifying examination given by the board of registered polysomnographic technologists, who has obtained a temporary permit from the board, and who may provide sleep-related services under the general supervision of a licensed physician;

(7) "Polysomnographic technologist" means a person who is credentialed by the board of registered polysomnographic technologists and is licensed by the board to engage in the practice of polysomnography under the general supervision of a licensed physician;

(8) "Polysomnographic trainee" means a person who is enrolled in an accredited sleep technologist education program (A-STEP) that is accredited by the American Academy of Sleep Medicine and who may provide sleep-related services under the direct supervision of a polysomnographic technologist as a part of the person's educational program;

(9) (A) "Practice of polysomnography" means the staging and scoring of sleep by continuous and simultaneous monitoring of the stages of sleep and wake through use of an electroencephalogram (EEG), an electroculogram (EOG) and a submental electromyogram (EMG), in conjunction with the recording and monitoring of other physiological variables, and the assignment of values for duration, frequency and type of event to each stage of sleep in which the event occurred. The following tasks are considered a part of the practice of polysomnography only when performed as part of the staging and scoring of sleep under the general supervision of a licensed physician:

(i) Monitoring and recording physiologic data during the evaluation of sleep-related disorders, including sleep-related respiratory disturbances, by applying the following techniques, equipment, and procedures:

(a) Continuous or bilevel positive airway pressure titration on spontaneously breathing patients using a mask or oral appliance; provided, that the mask or oral appliance does not extend into the trachea or attach to an artificial airway;

(b) Supplemental low flow oxygen therapy of less than six (6) liters per minute, utilizing nasal cannula or continuous or bilevel positive airway pressure during a polysomnogram;

(c) Capnography during a polysomnogram;

(d) Cardiopulmonary resuscitation;

(e) Pulse oximetry;

(f) Gastroesophageal pH monitoring;

(g) Esophageal pressure monitoring;

(h) Sleep staging, including surface electroencephalography, surface electrooculography, and surface submental electromyography;

(i) Surface electromyography;

(j) Electrocardiography;

(k) Respiratory effort monitoring, including thoracic and abdominal movement;

(l) Plethysmography blood flow monitoring;

(m) Snore monitoring;

(n) Audio or video monitoring;

(o) Body movement monitoring;

(p) Nocturnal penile tumescence monitoring;

(q) Nasal and oral airflow monitoring;

(r) Body temperature monitoring; and

(s) Monitoring the effects that a mask or oral appliance used to treat sleep disorders has on sleep patterns; provided, however, that the mask or oral appliance shall not extend into the trachea or attach to an artificial airway;

(ii) Observing and monitoring physical signs and symptoms, general behavior, and general physical response to polysomnographic evaluation and determining whether initiation, modification, or discontinuation of a treatment regimen is warranted;

(iii) Analyzing and scoring data collected during the monitoring described in subdivisions (9)(A)(i) and (ii) for the purpose of assisting a licensed physician in the diagnosis and treatment of sleep and wake disorders that result from developmental defects, the aging process, physical injury, disease, or actual or anticipated somatic dysfunction;

(iv) Implementation of a written or verbal order from a licensed physician that requires the practice of polysomnography; and

(v) Education of a patient regarding the treatment regimen that assists the patient in improving the patient's sleep;

(B) A licensed dentist shall make or direct the making and use of any oral appliance used to treat sleep disordered breathing and shall evaluate the structures of the patient's oral and maxillofacial region for purposes of fitting the appliance;

(C) The practice of polysomnography shall take place only in a hospital, a stand-alone sleep laboratory or sleep center, or in the patient's home in accordance with a physician's order; provided, however, that the scoring of data and the education of patients may take place in settings other than in a sleep laboratory, sleep center or the patient's home; and

(10) "Sleep-related services" means acts performed by polysomnographic technicians, polysomnographic trainees, polysomnographic students, and other persons permitted to perform those services under this chapter, in a setting described in subdivision (9)(C) that would be considered the practice of polysomnography if performed by a polysomnographic technologist.