Consider Physical Status Exception
Question: A healthy patient with an uncomplicated seven-month pregnancy requires surgery for ankle surgery unrelated to the pregnancy. What physical status should I report for her? Delaware Subscriber Answer: The American Society of Anesthesiologists (ASA) Physical Status Classification System has been in use for more than 60 years and provides a standardized system for assessing and conveying a patient’s status — especially concerning comorbidities — before any anesthesia is used. ASA says that physical status alone cannot predict perioperative risks, but looking at a patient’s physical status along with other factors, including the type of surgery, can be helpful in understanding risks involved. ASA says that physical status may be ascertained at numerous times during preoperative encounters, but the final physical status classification is made by the anesthesiologist on the day they patient is to receive anesthesia care. In this situation, a healthy patient would usually be assessed as an ASA physical status of 1 (“a normal healthy patient”). However, ASA says that pregnancy is not a disease but the physiology of a pregnant woman (even whose pregnancy is uncomplicated) is significantly different from her physiology when not pregnant, and therefore the physical status would be 2 (“a patient with mild systemic disease”). Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC
