Re: Admitting labs, wasTocolytics
From: Anna Meenan, MD (annam@uic.edu)
Tue Jun 14 08:36:51 2005
Our hospital still requires routine cbc next day. I remember back
pre-1983 when we used to transfuse anyone with hgb<10. Now I only
transfuse them if they pass out when the nurse gets them up out of bed.
Then, I don't need a cbc to tell me she's low.
--
Anna Meenan, MD
At Tue, 14 Jun 2005, Elrod Darryl G MAJ 48 MDOS/SGOBO 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
>
