Partially inverted uterus with delivery

lcathey@smsc.org

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This is a new one for me. I'm not sure if I can code anything extra for the Dr. that delivered, but seems I should be able to bill something for the Dr. that came in and assisted with replacening the uterus. I would appreciate any suggestions for coding this. It was not a package, so I will be coding delivery only. Thanks for your help.


Anesthesia: None
EBL: 1000
Repair: none

Comments: Delivery complicated by uterine inversion and post partum hemorrhage. Vigorous neonate delivered in direct OA position, nares and oropharynx suctioned with bulb suction. Fluid: Clear Infant handed off to nurses for drying and stimulation. Placenta delivery was difficult and complicated by a partially inverted uterus. Dr. Sargent was in the nursing station and came to assist accompanied by Dr. Smith. Dr. Sargent was able to replace the uterus after a significant post partum hemorrhage of approximately 1 liter. A second IV was quickly placed, the patient got a dose of 2 grams of IV Ancef and a shot of methergine IM. Excellent hemostasis was achieved at that point. The patient was tachycardic and mildly hypotensive. She had a dose of 5 mg IV valium and some inhaled nitrous for sedation during the procedure and she tolerated those interventions well. Her hemoglobin dropped 2 points to 9.9 post partum.
 
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