Good morning OBGYN Group,
Wanted to ask if we have a code for the Methylene Blue Tampon Dye Test in which the patient was not taken back to the OR, I have researched and I saw a while back that we should use the unlisted code and compare it to 57150 and then I read something on the AUGS site that said it would probably bundle into the E&M code. This patient had a LAVH on 03/21/23 and was admitted on 03/24/23 with post op complications and doctor performed test due to suspicion of a bladder injury since patient was experiencing vaginal discharge.
Methylene Blue Tampon Dye Test Procedure Note
Patient inserted a clean, dry tampon into the vagina. Approximately 10 cc of methylene blue was injected into a 1000 cc bag of normal saline and mixed. Foley catheter was inserted into the bladder in a sterile fashion. The catheter drained approximately 20 cc clear yellow urine s/p Pyridium administration. The foley catheter was kinked. One hundred cc of the saline-methylene blue mixture was slowly injected, back-filling the bladder. Patient unable to tolerate any further volume administration past 100cc. The foley catheter was then removed. The patient was instructed to walk for 20 minutes.
The caudal end of the tampon was visible at the introitus and was removed. Scant blue was noted on the caudal end which was attributed to foley catheter removal. A new tampon was then inserted by the patient further into the vagina after verifying there was no methylene blue on the vulva. She walked for an additional 20 minutes.
Result: Tampon clean. No orange or blue coloration.
Impression: No apparent bladder injury, vesicovaginal or ureterovaginal fistula
And then the other question I have is that the patient was seen by two of our OBGYN doctors on the same day, one saw the patient for the hospital visit and then another one of our OBGYN doctors within the same tax ID of our group did the Dye test procedure, not sure how that would work. ?????
Thank you for your assistance!
Wanted to ask if we have a code for the Methylene Blue Tampon Dye Test in which the patient was not taken back to the OR, I have researched and I saw a while back that we should use the unlisted code and compare it to 57150 and then I read something on the AUGS site that said it would probably bundle into the E&M code. This patient had a LAVH on 03/21/23 and was admitted on 03/24/23 with post op complications and doctor performed test due to suspicion of a bladder injury since patient was experiencing vaginal discharge.
Methylene Blue Tampon Dye Test Procedure Note
Patient inserted a clean, dry tampon into the vagina. Approximately 10 cc of methylene blue was injected into a 1000 cc bag of normal saline and mixed. Foley catheter was inserted into the bladder in a sterile fashion. The catheter drained approximately 20 cc clear yellow urine s/p Pyridium administration. The foley catheter was kinked. One hundred cc of the saline-methylene blue mixture was slowly injected, back-filling the bladder. Patient unable to tolerate any further volume administration past 100cc. The foley catheter was then removed. The patient was instructed to walk for 20 minutes.
The caudal end of the tampon was visible at the introitus and was removed. Scant blue was noted on the caudal end which was attributed to foley catheter removal. A new tampon was then inserted by the patient further into the vagina after verifying there was no methylene blue on the vulva. She walked for an additional 20 minutes.
Result: Tampon clean. No orange or blue coloration.
Impression: No apparent bladder injury, vesicovaginal or ureterovaginal fistula
And then the other question I have is that the patient was seen by two of our OBGYN doctors on the same day, one saw the patient for the hospital visit and then another one of our OBGYN doctors within the same tax ID of our group did the Dye test procedure, not sure how that would work. ?????
Thank you for your assistance!
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