Ob-Gyn Coding Alert

Question: The ob-gyn performed a LAVH with BSO (uterine weight of 270 grams); the hysterectomy was completed laparoscopically; during inspection prior to closing the patient, he noted an area of bleeding just below the uterine pedicle. His attempt to secure this area of bleeding with a clip as well as two separate Endoloops was without success, and the bleeding became more brisk. At that point, he converted the procedure to an exploratory laparotomy. He located the area of bleeding on the right pedicle; he then grasped this area with an Allis clamp and placed three separate 0 Vicryl figure-of-eight sutures with excellent hemostasis. After more inspection and irrigation, he noted no additional bleeding and closed the patient. Later on the same day, during post op rounds, the patient had to go back to the OR on an emergent basis due to a large hematoma discovered on ultrasound. He performed an [...]