Thank you for joining us for the February 2022 case scenario for the LAAO Registry. Today we will be talking about inclusion of a new procedure, how the new procedure will be coded in sequence number 13160 and 13170, follow-up events and events occurred, and if the new procedure will require follow-up. In this scenario, a 78-year-old male is seen for his six-month follow-up after successful Watchman implantation. At the time of the 45-day follow-up, a PERI device leak of 7 millimeters was identified on TEE, and anticoagulation was continued until the device could be re-evaluated at a later date. The leak reassessment TEE at six months identified the leak as 6 millimeters. A decision was made at the time of the six-month follow-up to fix the leak, and an Amplatzer duct occluder device was implanted two weeks later, with the post-procedure TEE showing no leak. Our question is, would the procedure to implant the duct occluder device be abstracted as a new procedure? Number one, no, or number two, yes. Please review the documentation and question to determine the best answer. We will give you a few seconds to review. And the answer is number two, yes. After consulting with the LAAO team, we confirmed that if an Amplatzer duct occluder or any other device is implanted in the left atrial appendage to repair a device leak, the implant of the new device will be included in the registry as a new procedure. The procedure will be included in the registry since it is an LAA occlusion procedure with a device that has been FDA approved. Question, when a second device is implanted during follow-up, what is coded in sequence number 1316013170, follow-up events occurred? Please code LAA occlusion re-intervention, device-related readmission, and unplanned intervention only if the second procedure was unplanned at the time of the original procedure on the next applicable follow-up for the first Watchman procedure. And a bonus question, when a second LAAO procedure is performed to repair a PERI device leak, will the second procedure require a new set of follow-ups? And the answer, the second LAAO procedure which used a new device will require a new set of follow-ups, including 45-day, 6-month, 1-year, and 2-year follow-up. Because the first device was not implanted in the scenario, the follow-up schedule for the first procedure will not change. Thank you for reviewing the LAAO Registries Case Scenario for February of 2022. We'll see you next month.

LAAO Registry

Watchman implantation

PERI device leak

Amplatzer duct occluder device

follow-up events