I think the problem they’re having is with the reason a hysterectomy was performed if the admitting diagnosis was a bacterial infection inside the gut. That’s something for the doctor to explain to insurance in the appeal. They’re seeing it as someone getting rear ended and claiming to need a new headlight.
All they knew when she was rolled into the operating room was that she had a major infection somewhere..probably in her belly since that was where the pain was. I asked her if she knew whether the docs could have gotten the infection out (her belly was FULL of pus..docs said they had NEVER seen anything like it on a live person)without doing the hysterectomy but she wasn’t sure. The infection was in her fallopian tubes as well as everywhere else in her abdomen. This was a BIG emergency situation.