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Dr. Christopher  Sonnenday  Md image

Dr. Christopher Sonnenday Md

1500 East Medical Center Dr 2Nd Floor Taubman Ctr Recp F
Ann Arbor MI 48109
734 365-5738
Medical School: Vanderbilt University School Of Medicine - 1997
Accepts Medicare: Yes
Participates In eRX: Yes
Participates In PQRS: Yes
Participates In EHR: Yes
License #: 4301088731
NPI: 1639103740
Taxonomy Codes:
208600000X

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Awards & Recognitions

About Us

Practice Philosophy

Conditions

Dr. Christopher Sonnenday is associated with these group practices

Procedure Pricing

HCPCS Code Description Average Price Average Price
Allowed By Medicare
HCPCS Code:50360 Description:Transplantation of kidney Average Price:$10,271.80 Average Price Allowed
By Medicare:
$2,766.90
HCPCS Code:50205 Description:Renal biopsy open Average Price:$2,524.00 Average Price Allowed
By Medicare:
$431.61
HCPCS Code:50605 Description:Insert ureteral support Average Price:$2,347.00 Average Price Allowed
By Medicare:
$535.59
HCPCS Code:50323 Description:Prep cadaver renal allograft Average Price:$916.31 Average Price Allowed
By Medicare:
$134.49
HCPCS Code:99233 Description:Subsequent hospital care Average Price:$211.00 Average Price Allowed
By Medicare:
$105.53
HCPCS Code:99221 Description:Initial hospital care Average Price:$210.42 Average Price Allowed
By Medicare:
$105.41
HCPCS Code:99232 Description:Subsequent hospital care Average Price:$151.00 Average Price Allowed
By Medicare:
$73.49
HCPCS Code:99205 Description:Office/outpatient visit new Average Price:$230.98 Average Price Allowed
By Medicare:
$173.60
HCPCS Code:99215 Description:Office/outpatient visit est Average Price:$119.33 Average Price Allowed
By Medicare:
$113.38
HCPCS Code:99214 Description:Office/outpatient visit est Average Price:$85.00 Average Price Allowed
By Medicare:
$80.64
HCPCS Code:99213 Description:Office/outpatient visit est Average Price:$55.00 Average Price Allowed
By Medicare:
$52.69

HCPCS Code Definitions

50605
Ureterotomy for insertion of indwelling stent, all types
99205
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
50360
Renal allotransplantation, implantation of graft; without recipient nephrectomy
99213
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
50205
Renal biopsy; by surgical exposure of kidney
99214
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99215
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99233
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
99232
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.
99221
Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of low severity. Typically, 30 minutes are spent at the bedside and on the patient's hospital floor or unit.

Medical Malpractice Cases

None Found

Medical Board Sanctions

None Found

Referrals

NPI
Doctor Name
Specialty
Count
1467488783
Nephrology
1,539
1700968237
Gastroenterology
1,084
1679628317
Gastroenterology
1,000
1053496000
Infectious Disease
998
1780784678
General Surgery
587
1790746154
Nephrology
581
1366495566
Diagnostic Radiology
512
1114023702
Diagnostic Radiology
505
1659457612
Cardiac Electrophysiology
461
1225194582
Diagnostic Radiology
443
*These referrals represent the top 10 that Dr. Sonnenday has made to other doctors

Publications

Decision support for organ offers in liver transplantation. - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Organ offers in liver transplantation are high-risk medical decisions with a low certainty of whether a better liver offer will come along before death. We hypothesized that decision support could improve the decision to accept or decline. With data from the Scientific Registry of Transplant Recipients, survival models were constructed for 42,857 waiting-list patients and 28,653 posttransplant patients from 2002 to 2008. Daily covariate-adjusted survival probabilities from these 2 models were combined into a 5-year area under the curve to create an individualized prediction of whether an organ offer should be accepted for a given patient. Among 650,832 organ offers from 2008 to 2013, patient survival was compared by whether the clinical decision was concordant or discordant with model predictions. The acceptance benefit (AB)-the predicted gain or loss of life by accepting a given organ versus waiting for the next organ-ranged from 3 to -2 years (harm) and varied geographically; for example, the average benefit of accepting a donation after cardiac death organ ranged from 0.47 to -0.71 years by donation service area. Among organ offers, even when AB was >1 year, the offer was only accepted 10% of the time. Patient survival from the time of the organ offer was better if the model recommendations and the clinical decision were concordant: for offers with AB > 0, the 3-year survival was 80% if the offer was accepted and 66% if it was declined (P < 0.001). In conclusion, augmenting clinical judgment with decision support may improve patient survival in liver transplantation. Liver Transpl 21:784-791, 2015. © 2015 AASLD.© 2015 American Association for the Study of Liver Diseases.
Quality of life in liver transplant candidates: frailty is a better indicator than severity of liver disease. - Transplantation
In an effort to understand the diminished quality of life (QoL) exhibited by patients with end-stage liver disease (ESLD), we studied the association of frailty and severity of liver disease with quality of life in this patient population.In a prospective, single-center cohort study (N=487), we assessed frailty and QoL in patients with ESLD referred for liver transplant. Frailty was measured on a scale from 0 to 5 by grip strength, gait speed, exhaustion, shrinkage, and physical activity, with scores of 3 or higher characterized as frail. Physical, mental, and combined overall quality of life scores ranging from 0 to 100 were assessed using Short Form 36. Pearson correlation and multiple linear regression were used to identify variables associated with QoL.Quality of life was notably low in the study cohort (mean: physical, 42.9±24.1; mental, 58.3±23.2). In multivariate analysis adjusted for demographic and clinical characteristics, frailty was significantly negative associated with physical (slope, -22.55, 95% confidence interval, -26.39 to -18.71; P<0.001) and mental QoL (slope, -17.59, 95% confidence interval, -21.47 to -13.71; P<0.001). Model for ESLD (MELD) was not associated with QoL.In ESLD patient referred for liver transplant, diminished QoL appears to be significantly negatively associated with frailty and not with severity of liver disease as measured MELD. With further study, if frailty is shown to be a remediable condition, targeted programs may help decrease frailty and improve quality of life in ESLD patients.
Internal biliary stenting during orthotopic liver transplantation: anastomotic complications, post-transplant biliary interventions, and survival. - Clinical transplantation
Biliary complications are a leading source of surgical morbidity following orthotopic liver transplantation (OLT).We examined how prophylactic internal biliary stent placement during OLT affected post-transplant morbidity and mortality in a single-center retrospective cohort study of 513 recipients (2006-2012). Recipient and donor covariates were collected. Biliary complications included major and minor anastomotic leaks, strictures, or stenoses. Multivariate regression models were created to estimate how operative biliary stents affected outcomes.About 87.3% (n = 448) of recipients had a duct-to-duct biliary anastomosis, and 43.1% (n = 221) had biliary stents placed. The biliary complication rate was <15% at five yr, and 44.8% (n = 230) overall. Stenting was not protective from anastomotic biliary complications (p = 0.06). Stenting was associated with a 74% higher adjusted risk of needing multiple endoscopic retrograde cholangiographies (ERCs; odds ratio [OR] 1.74, p = 0.011), and trended toward a lower adjusted risk for repetitive percutaneous transhepatic cholangiography (PTCs; OR 0.56, p = 0.063). Stenting had no effect on the cumulative freedom from biliary complications (p = 0.94). Biliary complications were associated with mortality (HR 1.86, p = 0.014) and was unaffected by stenting (aHR = 0.72, p = 0.246).Biliary stenting during OLT does not deter biliary complications and is associated with higher risk of multiple invasive biliary interventions, particularly ERCs. Surgeons should evaluate the utility of biliary stents at OLT within this context.© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Dorsal muscle group area and surgical outcomes in liver transplantation. - Clinical transplantation
Better measures of liver transplant risk stratification are needed. Our previous work noted a strong relationship between psoas muscle area and survival following liver transplantation. The dorsal muscle group is easier to measure, but it is unclear if they are also correlated with surgical outcomes.Our study population included liver transplant recipients with a preoperative CT scan. Cross-sectional areas of the dorsal muscle group at the T12 vertebral level were measured. The primary outcomes for this study were one- and five-yr mortality and one-yr complications. The relationship between dorsal muscle group area and post-transplantation outcome was assessed using univariate and multivariate techniques.Dorsal muscle group area measurements were strongly associated with psoas area (r = 0.72; p < 0.001). Postoperative outcome was observed from 325 patients. Multivariate logistic regression revealed dorsal muscle group area to be a significant predictor of one-yr mortality (odds ratio [OR] = 0.53, p = 0.001), five-yr mortality (OR = 0.53, p < 0.001), and one-yr complications (OR = 0.67, p = 0.007).Larger dorsal muscle group muscle size is associated with improved post-transplantation outcomes. The muscle is easier to measure and may represent a clinically relevant postoperative risk factor.© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Morphometric age and mortality after liver transplant. - JAMA surgery
Morphometric assessment has emerged as a strong predictor of postoperative morbidity and mortality. However, a gap exists in translating this knowledge to bedside decision making. We introduced a novel measure of patient-centered surgical risk assessment: morphometric age.To investigate the relationship between morphometric age and posttransplant survival.Medical records of recipients of deceased-donor liver transplants (study population) and kidney donors/trauma patients (morphometric age control population).A retrospective cohort study of 348 liver transplant patients and 3313 control patients. We assessed medical records for validated morphometric characteristics of aging (psoas area, psoas density, and abdominal aortic calcification). We created a model (stratified by sex) for a morphometric age equation, which we then calculated for the control population using multivariate linear regression modeling (covariates). These models were then applied to the study population to determine each patient's morphometric age.All analytic steps related to measuring morphometric characteristics were obtained via custom algorithms programmed into commercially available software. An independent observer confirmed all algorithm outputs. Trained assistants performed medical record review to obtain patient characteristics.Cox proportional hazards regression model showed that morphometric age was a significant independent predictor of overall mortality (hazard ratio, 1.03 per morphometric year [95% CI, 1.02-1.04; P < .001]) after liver transplant. Chronologic age was not a significant covariate for survival (hazard ratio, 1.02 per year [95% CI, 0.99-1.04; P = .21]). Morphometric age stratified patients at high and low risk for mortality. For example, patients in the middle chronologic age tertile who jumped to the oldest morphometric tertile have worse outcomes than those who jumped to the youngest morphometric tertile (74.4% vs 93.2% survival at 1 year [P = .03]; 45.2% vs 75.0% at 5 years [P = .03]).Morphometric age correlated with mortality after liver transplant with better discrimination than chronologic age. Assigning a morphometric age to potential liver transplant recipients could improve prediction of postoperative mortality risk.
Association between sarcopenia and the risk of serious infection among adults undergoing liver transplantation. - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Although sarcopenia (muscle loss) is associated with increased mortality after liver transplantation, its influence on other complications is less well understood. We examined the association between sarcopenia and the risk of severe posttransplant infections among adult liver transplant recipients. By calculating the total psoas area (TPA) on preoperative computed tomography scans, we assessed sarcopenia among 207 liver transplant recipients. The presence or absence of a severe posttransplant infection was determined by a review of the medical chart. The influence of posttransplant infections on overall survival was also assessed. We identified 196 episodes of severe infections among 111 patients. Fifty-six patients had more than 1 infection. The median time to the development of an infection was 27 days (interquartile range = 13-62 days). When the patients were grouped by TPA tertiles, patients in the lowest tertile had a greater than 4-fold higher chance of developing a severe infection in comparison with patients in the highest tertile (odds ratio = 4.6, 95% confidence interval =  2.25-9.53). In a multivariate analysis, recipient age (hazard ratio = 1.04, P = 0.02), pretransplant TPA (hazard ratio = 0.38, P < 0.01), and pretransplant total bilirubin level (hazard ratio = 1.05, P = 0.02) were independently associated with the risk of developing severe infections. Patients with severe posttransplant infections had worse 1-year survival than patients without infections (76% versus 92%, P = 0.003). In conclusion, among patients undergoing liver transplantation, a lower TPA was associated with a heightened risk for posttransplant infectious complications and mortality. Future efforts should focus on approaches for assessing and mitigating vulnerability in patients undergoing transplantation.© 2013 American Association for the Study of Liver Diseases.
Neoadjuvant stereotactic body radiation therapy, capecitabine, and liver transplantation for unresectable hilar cholangiocarcinoma. - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Hilar cholangiocarcinoma (CCA) is a difficult malignancy to treat surgically because of its anatomical location and its frequent association with primary sclerosing cholangitis. Neoadjuvant chemoradiotherapy followed by liver transplantation in lymph node-negative patients has been advanced by select liver transplant centers for the treatment of patients with unresectable disease. This approach has most commonly used external-beam radiotherapy in combination with biliary brachytherapy and 5-fluorouracil-based chemotherapy. Our center recently embarked on a protocol using stereotactic body radiation therapy (SBRT) followed by capecitabine in lymph node-negative patients until liver transplantation. We, therefore, retrospectively determined the tolerability and pathological response in this pilot study. During a 3-year period, 17 patients with unresectable hilar CCA were evaluated for treatment under this protocol. In all, 12 patients qualified for neoadjuvant therapy and were treated with SBRT (50-60 Gy in 3-5 fractions over the course of 2 weeks). After 1 week of rest, capecitabine was initiated at 1330 mg/m(2) /day, and it was continued until liver transplantation. During neoadjuvant therapy, there were 35 adverse events in all, with cholangitis and palmar-plantar erythrodysesthesia being the most common. Capecitabine dose reductions were required on 5 occasions. Ultimately, 9 patients were listed for transplantation, and 6 patients received a liver transplant. The explant pathology of hilar tumors showed at least a partial treatment response in 5 patients, with extensive tumor necrosis and fibrosis noted. Additionally, high apoptotic indices and low proliferative indices were measured during histological examinations. Eleven transplant-related complications occurred, and the 1-year survival rate after transplantation was 83%. In this pilot study, neoadjuvant therapy with SBRT, capecitabine, and liver transplantation for unresectable CCA demonstrated acceptable tolerability. Further studies will determine the overall future efficacy of this therapy.© 2013 American Association for the Study of Liver Diseases.
Morphometric age and surgical risk. - Journal of the American College of Surgeons
A cornerstone of a surgeon's clinical assessment of suitability for major surgery is best described as the "eyeball test." Preoperative imaging may provide objective measures of this subjective assessment by calculating a patient's morphometric age. Our hypothesis is that morphometric age is a surgical risk factor distinct from chronologic age and comorbidity and correlates with surgical mortality and length of stay.This is a retrospective cohort study within a large academic medical center. Using novel analytic morphomic techniques on preoperative CT scans, a morphometric age was assigned to a random sample of patients having inpatient general and vascular abdominal surgery from 2006 to 2011. The primary outcomes for this study were postoperative mortality (1-year) and length of stay (LOS).The study cohort (n = 1,370) was stratified into tertiles based on morphometric age. The postoperative risk of mortality was significantly higher in the morphometric old age group when compared with the morphometric middle age group (odds ratio 2.42, 95% CI 1.52 to 3.84, p < 0.001). Morphometric old age patients were predicted to have a LOS 4.6 days longer than the morphometric middle age tertile. Similar trends were appreciated when comparing morphometric middle and young age tertiles. Chronologic age correlated poorly with these outcomes. Furthermore, patients in the chronologic middle age tertile found to be of morphometric old age had significantly inferior outcomes (mortality 21.4% and mean LOS 13.8 days) compared with patients in the chronologic middle age tertile found to be of morphometric young age (mortality 4.5% and mean LOS 6.3 days, p < 0.001 for both).Preoperative imaging can be used to assign a morphometric age to patients, which accurately predicts mortality and length of stay.Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Racial disparities in surgical resection and survival among elderly patients with poor prognosis cancer. - Journal of the American College of Surgeons
Reports indicate that black patients have lower survival after the diagnosis of a poor prognosis cancer, compared with white patients. We explored the extent to which this disparity is attributable to the underuse of surgery.Using the Surveillance, Epidemiology, and End Results program and Medicare database, we identified 57,364 patients, ages 65 years and older, with a new diagnosis of nonmetastatic liver, lung, pancreatic, and esophageal cancer, from 2000 to 2005. We evaluated racial differences in resection rates after adjustment for patient, tumor, and hospital characteristics using hierarchical logistic regression. Cox proportional hazards regression was used to assess racial differences in survival after adjusting for patient, tumor, and hospital characteristics, and receipt of surgery.Compared with white patients, black patients were less likely to undergo surgery for liver (adjusted odds ratio [aOR] = 0.49; 95% CI, 0.29-0.83), lung (aOR = 0.62; 95% CI, 0.56-0.69), pancreas (aOR = 0.53; 95% CI, 0.41-0.70), and esophagus cancers (aOR = 0.64; 95% CI, 0.42-0.99). Hospitals varied in their surgery rates among patients with potentially resectable disease. However, resection rates were consistently lower for black patients, regardless of the resection rate of the treating hospital. Although there were no racial differences in overall survival with liver and esophageal cancer, black patients experienced poorer survival for lung (adjusted hazard ratio = 1.05; 95% CI, 1.00-1.10) and pancreas cancer (adjusted hazard ratio = 1.15; 95% CI, 1.03-1.30). In both instances, there were no residual racial disparities in overall survival after adjusting for use of surgery.Black patients are less likely to undergo surgery after diagnosis of a poor prognosis cancer. Our findings suggest that surgery is an important predictor of overall mortality, and that efforts to reduce racial disparities will require stakeholders to gain a better understanding of why elderly black patients are less likely to get to the operating room.Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Implementation of a small bowel obstruction guideline improves hospital efficiency. - Surgery
We performed an internal review of triage decisions and outcomes for all patients admitted for small bowel obstruction (SBO). Concern for potential delays in operation led to formalization of an institution-wide SBO management guideline. We hypothesized that use of the guideline would improve initial triage and patient outcomes.Members of the departments of surgery, medicine, and emergency medicine created a SBO service triage and initial management guideline that was instituted in 2011 after education and a multidisciplinary Grand Rounds on the subject. Administrative data from fiscal year 2010 (FY2010) was compared with the first 6 months of 2011. Time to computed tomography scan, the OR, general surgery (GS) consultation, and hospital duration of stay were collected and compared for those admitted to a medicine service before (Med2010) and after (Med2011) the guideline and those admitted to a general surgery service before (GS2010) and after (GS2011) the guideline. Groups were compared with Student t test and χ2 analysis.There were 490 SBO admissions in FY2010 and 240 in the first 6 months of 2011. After implementation of the guidelines, the percent of SBO patients admitted to GS2011 increased from 55 to 66% (P < .01). The percent of patients admitted to a medicine service requiring operation for SBO did not change from 14 to 7% for Med2011, but there was a shorter time to GS consultation (P < .001). Time from admission to operation decreased from 0.9 to 0.4 days (P < .05) with a mean decrease in hospital duration of stay of 2 days (8 ± 6 compared with 6 ± 4 days, P < .001) for those admitted during GS2011.Implementation of a hospital-wide SBO guideline that addressed initial management and triage shortened time to operative intervention and hospital duration of stay for patients requiring operative therapy for SBO.Copyright © 2012 Mosby, Inc. All rights reserved.

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1500 East Medical Center Dr 2Nd Floor Taubman Ctr Recp F Ann Arbor, MI 48109
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