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Ob: Coding questionFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Sat Feb 24 12:01:14 2007
27 week P1001, Prev. C/S and GDM, had her hand crushed in a machine at work, and comes into the ER via ambulance. She will require surgery, and, long story short, lost 2 digits and a third was re-connected and may or may not survive. I saw her in the ER (no Ob complaint) at the request of the ER MD, Hand Surgeon, and the anesthesiologist to "pass judgment" that it was OK to go to surgery, and since the surgery could be from 2 to 12 hours, depending on the intraop findings, that general anesthesia while pregnant was again "OK," and, by the way, did we really have a choice? I felt compelled to be in the OR for anesthesia induction, to supervise positioning on her side, setting up the intraop fetal monitor with the L and D nurse, etc. How would you code this? I coded: ER 99285 (highest end ER code) and 99354, prolonged service, face to face, over 30 minutes because I was there in the pre-op area and OR above 30 minutes. Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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