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Anesthesia for C-Section

  1. #1
    Location
    Chicopee, Massachusetts
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    26
    Default Anesthesia for C-Section
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    I have an office person who is telling me that the c-section anesthesia should be billed as an outpatient because the patient has the choice of whether or not they want to go home. Can anyone give me any resources that either confirm or contradict this statement?
    Mary Davis, CPC, CPC-E/M

  2. #2
    Location
    Charleston, WV
    Posts
    245
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    I can't cite documentation but I can say that I have never heard anyone even suggest that you code your place of service based on whether the patient can choose to go home or not. Place of servixe is based on the patient's admission status. If the patient has been admitted, it's inpatient. I don't think I've ever seen an outpatient C-Section.

  3. Default
    Anytime someone as a C-section, the length of stay is longer than a regular delivery. If the patient stayed longer than 24 hours, I would code it as an inpatient. It does not matter if they have an "option.: It is about how long they stayed. Even in a regular, vaginal delivery...that is inpatient. No patient undergoing c-section would be coded as outpatient. Always code c-sections inptient!

  4. #4
    Location
    Charleston, WV
    Posts
    245
    Default
    Quote Originally Posted by CathyO View Post
    Anytime someone as a C-section, the length of stay is longer than a regular delivery. If the patient stayed longer than 24 hours, I would code it as an inpatient. It does not matter if they have an "option.: It is about how long they stayed. Even in a regular, vaginal delivery...that is inpatient. No patient undergoing c-section would be coded as outpatient. Always code c-sections inptient!
    The length of stay isn't what determines admission status. Patients are often in "obeservation" for more than 24 hours. To be inpatient, there has to be an order to admit from the physician.

  5. Default
    No cesarean section will be done with out admission procedures.The sooner c-section is decided the admission slip also is simultaneously signed (along with the patient's concent for surgery) and procured. Even if it was taken as an acute emergency C-section from the ER, the processing of admission keeps going along with that. No Physician on earth will perform the c-section and send her homes without admission. The sooner Cesarean is done, she is brought in to the labor suite and from the labor suite, when she is stable and out of immediate danger, say after few hours, she is transferred to the floor.
    The question of sending her back to observation Care is ruled out once cesarean done.
    Every post cesarean patient is to be necessarily admitted and be given postoperative care for a minimum of 4days, before discharging Home.
    Taking into account the expected postoperative complication( that goes along with pregnant status surgery and peurperium), that could occur- like embolism, thromboembolism, hemorrhage etc etc (even with a normal uncomplicated pregnancy history) , nobody dare to go home too within 24hours, even "against Medical Advice" !!.
    Embolism, thromboembolism/episodes commonly, generally and mostly occur during the first 3-5days of postoperative period. Thromboembolic episodes are more common in puerperal post op patients, rather than other post op ones. The reasons we all know why.

    Then how about the hospital, facility or the Physician being held responsible for the postoperative adverse events happening at home when discharge or sent home within 24hrs !!?
    Globally not even one case could have been recorded so, after the Physician performed cesarean section!!
    Last edited by preserene; 10-04-2010 at 09:29 PM.

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