mrolf
Guest
scenario: CAH hospital where Dr A delivered c-section with Dr B as assisting. After delivery the posterior inferior wall of the uterus was bleeding very briskly.The uterus was exteriorized wand the uterine edges were grasped with ring forcips. There were several areas of arterial bleeds with were stopped with figure-of-8 sutures. Again bleeding remained brisk. Tried several more sutures which did not help. Pitocin running wide open in patient's IV. Uterine massage was continued and the uterus was starting to firm up. However uterus continued to belled. Surgicel & packing was tried unsuccessfully. Patient's vital signs started to decline. 60/30 BP. Blood products were ordered. Uterine massage was continued. Dr. Specialist was consulted and recommeded trying Methergine & Hemabate and started to drive to our facility at least 45 min away.So at that time .2mg of Methergine was given IM and packing and pressure was again utilizied. After 15 min not working. At the time Hemabate 2.5 mg given IM. Again we packed for 15 minutes unsuccessfully. By this time she started to receive blood. She had gotten 2 units by this time. We continued to pack until Dr. Specialist could arrive. In the meatime she got two more units of blood. After this she received two units of fresh frozen plasma. We continued to pack the uterus and tried to achieve hemostasis for another 50 minutes after which Dr. SPecialist arrived.
How do you bill this service when both Dr. A & Dr B were treating this patient. Is this critical care and which doctor would receive this? Any help would be appreciated.
Thanks.
How do you bill this service when both Dr. A & Dr B were treating this patient. Is this critical care and which doctor would receive this? Any help would be appreciated.
Thanks.