For the February 2020 case scenario, we will be discussing the coding of device margin residual leak, sequence number 7305 in version 1.3, and sequence 14848 in the new version 1.4. The patient is an 86-year-old male who was admitted for an LAA occlusion procedure. The clinician successfully implants a 27-millimeter Watchman and documents the residual leak as less than 6 millimeters. How will device margin residual leak, sequence number 7305 or 14848 be coded? Number one, leave the sequence blank. Number two, select not assessed. Number three, code the sequence as 5 millimeters. Or number four, code the sequence as 6 millimeters. Please take a few moments to review the documentation and the question. And the answer is number three. After consulting with the steering committee and the LAAO registry team, it was decided that a residual leak documented as less than 6 millimeters can be coded as 5 millimeters in sequence 7305 or 14848, device margin residual leak. The following FAQ has been added to the version 1.4 FAQ database under FAQ ID 25493. The FAQ lists how to code device margin residual leak if it is documented in a statement written as less than. Our bonus question. The patient is an 86-year-old male who was admitted for an LAA occlusion procedure. The clinician successfully implants a 24-millimeter Watchman and documents the residual leak as less than 6 millimeters. The abstractor codes 5 millimeters in sequence 7305 or sequence 14848, device margin residual leak. The abstractor codes procedure canceled as no. Two devices attempted. One not successfully released and one successfully deployed and released. Followed by procedure abolished. The abstractor codes procedure canceled as no. Two devices attempted. Followed by procedure aborted as no. Conversion to open heart surgery as no. And device margin residual leak as 5 millimeters. Our question is, will the patient be included in the numerator of metric number four, proportion of left atrial appendage occlusion procedure successful? Number one, no. Or number two, yes. Please take a few moments to review the documentation and the question. Based on the numerator for metric four, procedure canceled must be coded no. Procedure aborted must be coded no. Conversion to open heart surgery must be coded no. The outcome of the device must be coded deployed released or device successfully deployed in version 1.4. And the residual leak at device margin must be equal or less than 5 millimeters. The denominator includes all LAAO procedures where the patient is greater than or equal to 18 years of age and there are no exclusions. Both canceled and aborted procedures are included in this metric. Thank you for viewing the LAAO registry for February of 2020.

coding

device margin residual leak

specific case scenario

LAA occlusion procedure

Watchman implanted