Patient is 34-year-old female who has four children and she and her husband have decided they are through with childbearing. She has for permanent sterilization and will be having a tubal ligation on an outpatient basis. She has normal menstrual periods and no preexisting medical conditions. The risks and benefits of the procedure were discussed with the patient, including the fact that once the
procedure is done, she will no longer be able to conceive children. Sterilization is a permanent procedure. Stating she fully understands the consequences and reiterating that she is refusing other forms of birth control, plans were made for the procedure.
Dx. Permanent sterilization
Procedure: Percutaneous endoscopic tubal ligation
First-listed/principal Dx: ________
Procedure: ________
What will be an ideal response?
First-listed/principal Dx: ________
Answer: Encounter for sterilization – Z30.2
Procedure: ________
Answer: Bilateral tubal ligation – 0UL78ZZ
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