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Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other!

You’re seeing a child with CT-confirmed uncomplicated appendicitis. The child has had symptoms for 12 hours, and pain is well controlled with medications. You’ve given IV antibiotics. You’re informed by utilization review that the child is not approved to stay at your hospital and must be transferred according to the insurance plan; the transfer will take 4-8 hours to coordinate.

Would you be OK transferring non-perforated acute appendicitis for insurance reasons?

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