Dr. Atul Gawande stands out as a transformative leader in

125. OPERATIVE REPORT, AMNIOCENTESIS LOCATION: Outpatient, Clinic PATIENT: Jasmine Freeman SURGEON: Andy Martinez, M.D. PREOPERATIVE DIAGNOSES: 1 Intrauterine pregnancy at 32 weeks 2 Type 1 diabetes. 3 Diabetic nephropathy. POSTOPERATIVE DIAGNOSIS: Same. PROCEDURE PERFORMED: Amniocentesis. INDICATIONS: The patient is a 25-year-old with a complicated pregnancy who has been on bed rest because of Type 1 diabetic nephropathy predating the pregnancy. Due to the fact that the fetus might be in a hostile environment, we felt that accelerated pulmonary maturity might be a possibility; therefore, at this time we elected to go with amniocentesis to help us manage her pregnancy. She had been fully informed of the risks and benefits of the procedure prior to proceeding. DESCRIPTION OF PROCEDURE: Ultrasound scanning was done by the technologist and placenta was posterior. We prepped the abdomen and draped it. We used a sterile covered ultrasound transducer with a guide and located a pocket of fluid. The 20-gauge needle was inserted. As we got into the uterus the baby moved into the area, therefore the needle was immediately withdrawn, the fetus was palpated a little bit and we stimulated the baby and it moved out of the area. We then repositioned the transducer and we were able to drop into the pocket of amniotic fluid and withdrew 20 cc of clear yellow amniotic fluid. The fluid was sent for maturity studies. The patient tolerated the procedure without difficulty. Pathology Report is pending. Code the physician services for the outpatient clinic. A. 010.213, 026.833, E10.21, Z3A.32, 59000, 76946 B. 024.013, 026.833, E10.21, Z3A.32, 59000, 76946 O C. 010.213, 026.833, E10.21, 279.4, Z3A.32, 59000 O D. 024.013, 026.833, F10.21, Z3A.32, 59001, 76946 80 D 4:19 PM

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