OB-GYN-L Messages for June, 2005: Re: Admitting labs, wasTocolytics

Re: Admitting labs, wasTocolytics

From: David Rivera

cuurmudgeon@sbcglobal.net

Tue Jun 14 07:35:19 2005

Elrod Darryl G MAJ 48 MDOS/SGOBO <Darryl.elrod@LAKENHEATH.AF.MIL> wrote:So it's the 'spend more money to get more money' sort of mentality. I don't buy it.

I rounded on my 'elective' c/s this morning and didn't even look at the CBC. She was up in the chair, eating, minimal bleeding, etc etc. Why did I even order it in the first place??? Certainly not so the hospital can make more money!

Glen

-----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Joanne Bulley, MD Sent: Tuesday, June 14, 2005 2:38 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Admitting labs, wasTocolytics

I agree with you ... but some of the hospitals that have mostly medicaid want / need the highest possible DRG find they get paid more if they have the H/H showing the degree of drop in H/H ... So there are definitely places where the lab test is ordered just for the fact that it will increase reimbursements on some patients ...

Joanne

At Mon, 13 Jun 2005, Elrod Darryl G MAJ 48 MDOS/SGOBO wrote: >
>I go with the flow and order a new CBC on admission. What I refuse to
>do is order a 'routine' postpartum CBC on vaginal deliveries. What a
>waste of time and money. They are ALL anemic and if they have any
>significant bleeding that requires treatment, you'll recognize it and
>then order a CBC.
>
>Glen
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
Joanne >Bulley, MD
>Sent: Sunday, June 12, 2005 2:04 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Admitting labs, wasTocolytics
>
>They hospital may get paid more (a higher DRG) IF there is a drop in
the >HGB pre and post partum ... other than that I don't think you need to
>do them again. It would not likely alter care anyway - and I do
believe >in not ordering a lab test unless it is part of your decision making
for >the current level of care.
>
>Joanne
>
>At Sat, 11 Jun 2005, RModugno@aol.com wrote:
>>
>>In a message dated 6/11/2005 4:59:48 PM Eastern Standard Time,
>igold@cox.net
>>writes:
>>
>>OK, so this is a good question. Earlier in the week, I'm admitting my
>first
>>patient since bieng credentialed. The nurse asks me which labs I
want, >CBC,
>>type and screen? I look at the chart and see that the patients labs
>were done
>>in the lab at this hospital, so it would seem repeating the type
>uneccessary.
>>Last Hgb 11.6 at 36 weeks, hospital lab. What would I do with a new
>result
>>anyway, other than shrug. So what do you all do, recommend? (I told
>her to
>>defer labs)
>>
>>Ingrid Gold, CNM
>>Phoenix
>>
>>In our hospital - anesthesia will NOT place an epidural if they do not
>have
>>a current platelet count. We therefore do a Heme 8 and also an
>rpr(trird
>>trimester reqd by state law if not already done)
>>
>>Robert Modugno MD MBA FACOG
>>Marietta, Ga
>
>--
>Joanne Bulley, MD
>Keene, NH, USA
>

-- Joanne Bulley, MD Keene, NH, USA

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