0122 - Sequence # 7325 | Arterial Cross Over-0122 - Sequence # 7325

Video Transcription

Welcome to the Cath PCI Registry January 2022 case scenario sequence number 7325, arterial crossover. Your 55-year-old female presents to hospital A and is diagnosed with STEMI.  She receives full-dose thrombolytics and is transferred to hospital B for further treatment. The patient is taken to the Cath lab at hospital B for persistent ischemic symptoms.  Because of her recent full-dose thrombolytic therapy, a transradial approach is initiated. However, after arterial access is gained, the interventionalist is unable to pass the  guidewire. The right radial site is abandoned, but access is quickly established in the right femoral  artery and the procedure continued with a drug-eluting stent to the culprit lesion is deployed. Several hours later, the patient complains of pain to the radial access site.  The patient is diagnosed with a pseudoaneurysm and hematoma to the radial site that receives a thrombin injection.  The patient did not experience a drop in hemoglobin and there was no blood transfusions administered.  How is sequence number 7325 arterial crossover coded? Number one, no, or number two, yes. Please take a few moments to review the documentation before considering your response.  And the answer is number two, yes. The coding instructions of the data element are met.  The notes of the data dictionary clarify to code yes when the final procedure access site is subsequent to where the arterial access site for the procedure was first attempted.  Any needle puncture of the skin in pursuit of the artery is considered an attempt.  Our follow-up question, how is other vascular complications requiring treatment as an intra and post-procedure event coded? Number one, no, or number two, yes.  Please take a few moments again to review the documentation before considering your response. And the answer is number one, no.  Other vascular complications requiring treatment or intervention is specific to the arterial access site as coded in sequence number 7320 arterial access site that require treatment  or intervention. The target value for sequence number 7320 arterial access site is the last value on current procedure.  And in the given scenario, the femoral access is the last value. Thank you for viewing the CAF PCI registry monthly case scenario for January of 2022.  Sequence number 7325 arterial crossover.  Thank you. Thank you.

Video Summary

In this video, the case scenario of sequence number 7325, which focuses on arterial crossover, is presented. A 55-year-old female presents with STEMI and receives thrombolytics before being transferred to another hospital. In the Cath lab, a transradial approach is attempted but fails. The procedure is then performed through the femoral artery, deploying a drug-eluting stent. Later, the patient develops pain at the radial access site and is diagnosed with a pseudoaneurysm and hematoma, which is treated with a thrombin injection. The coding for arterial crossover is noted as "yes," while other vascular complications requiring treatment are noted as "no."

Keywords

arterial crossover

STEMI

transradial approach

pseudoaneurysm

hematoma