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when do you check the E?

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Every weekday we have both a surgicalist and an ortho trauma add on room. They are for all the cases that come in overnight. The surgeon knowing that he/she has a dedicated room the following day has cut down significantly the number of cases that are done overnight. Even though these cases cannot wait 2 weeks to be done, I typically do not mark them as emergent.

If the patient has sepsis or another uncontrolled condition that I would not regularly give anesthesia to, I will mark with an E.

Labor epidurals do not get an E modifier.

Failure to progress C-sections do not get an E from me. Placental abruption or non-reassuring fetal heart tone c-sections will often get an E from me.
 
Correct. The CODA studies in 2020-2021 were published in NEJM and JAMA. Surgeons are slow to change their practice from residency. Appendicitis is never a surgical emergency and can be treated with antibiotics with similar short-term and long-term outcomes.
But how many rvus does that approach make?