Outpatient procedures with bronchiectasis and MAC

Posted by becleartoday @becleartoday, Sep 15, 2022

I recently scheduled a routine colonoscopy. Two weeks before the procedure, I received a call from the GI’s office saying that the anesthesiologist had reviewed my chart. He said because of my MAC infection, I needed to have the procedure done in the hospital rather than an outpatient setting.

I found this so odd and emailed my pulmonologist. She said that although I was very stable, it is at the discretion of the doctor to decide if a procedure can be done outpatient.

It really isn’t a big deal, just a surprise. I checked around and no one else I know with BE/MAC has experienced this so I thought I would post it.

Anyone?

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I am a retired RN/discharge planner, fairly recently retired, but rules could have changed since I was working so my information may not be up to date. It is possible to have a procedure in the hospital setting and still be considered an outpatient. They have a status called "observation" or "holding" where you can receive care for 24 hrs and still be in the outpatient setting. Different insurances have different criteria. The doctor may put you in this setting to observe you and make sure you are stable prior to discharge. You would also need to make sure with the physician that is making this decision that it gets it preauthorized with your insurance company if that is required. Sometimes it is, and sometimes not. However, if admited, that decision would be made after the procedure depending on your condition since it is normally done as an outpatient. Many times admissions require the authorization after a procedure like this, but observation does not. All this also depends on your own policy. This is probably confusing but many insurances are confusing anymore. Good luck with this and hope it works out.

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Yes. I’m supposed to have outpatient surgery on my back next week. Will probably have to reschedule in hospital because the procedure requires general anesthesia and I will have to be on my stomach for about an hour. Anesthesiologist is worried about respiratory problems during the surgery & recovery. Awaiting advice from surgeon. I’m not on 02 or having any significant SOB but better safe than sorry . I would accept your dr’s advice.

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The procedure is supposed to be done at a surgery center. Their concern is respiratory failure which would have to be dealt with in a hospital. I don’t think that’s likely based on my history with successful colonoscopies. But this is a surgical and much longer procedure.

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@becleartoday Hmm --- News to me. Even while I was on the Big 3 I was scoped in the doctor's office, and again this Spring, 4 years later, the same.

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@lupine

Yes. I’m supposed to have outpatient surgery on my back next week. Will probably have to reschedule in hospital because the procedure requires general anesthesia and I will have to be on my stomach for about an hour. Anesthesiologist is worried about respiratory problems during the surgery & recovery. Awaiting advice from surgeon. I’m not on 02 or having any significant SOB but better safe than sorry . I would accept your dr’s advice.

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Yes I am going with the doctor who does them at the hospital. They just want to have the hospital facilities if they shouldn’t need them. I get that. But it was surprising as I am not on oxygen or have any SOB issues either.

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I recently had a colonoscopy. My GI doctor is the wife of my pulmonologist so I trust her with my care. Not even a mention of doing it anywhere but there offices.

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I think it’s a liability issue for them. A patient with lung problems Lying face down for an hour long procedure under general anesthesia causes concern for respiratory complications. I have to have a stress test before the procedure. Hoping I pass🤞🤞

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My mom has BE and MAC and we're in the process of scheduling her colonoscopy now. We were told the same thing: it's not a heavy sedation, but just in case anything were to happen, her pulmonologist requires it be done at the hospital. It is still considered outpatient, just not at the freestanding surgical center.

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