0222 - Sequence #5263 | Prior Diagnostic Coronary Angiogram Without Intervention-0222 - Sequence #5263 | Prior Diagnostic Coronary Angiogram Without Intervention

Video Transcription

Welcome to the CAF PCI Registry Case Scenario for February 2022, in which we will discuss sequence number 5263, Prior Diagnostic Coronary Angiogram Without Intervention.  The documentation is as follows. A 79-year-old male patient complains of recent chest pain that occurs when he is walking upstairs.  The patient's medical history is significant for hypertension, hyperlipidemia, bradyarrhythmia, heart block, and CAD.  The patient's procedure history includes a permanent pacemaker placed in 2011, a coronary  angiogram in 2012, which identified non-obstructive CAD, as well as a coronary angiogram and PCI  in 2017, wherein the patient received a drug-eluting stent to his mid-circumflex and second OM  Most recently, the patient had a positive nuclear stress test on December 15, 2021, that resulted in an intermediate risk for a cardiac event.  The patient now presents again for an elective coronary angiogram on January 4, 2022. Our question is, how is sequence number 5263, Prior Diagnostic Coronary Angiogram Without  Intervention coded? Is it number 1, no? Or number 2, yes? Please take a moment to review the documentation before considering your response.  And the answer is, number 1, no. While a diagnostic coronary angiogram was performed in both 2012 and 2017, PCI was performed in the most recent cath lab visit in 2017.  The target value, any occurrence between birth or previous procedure and current procedure, should be understood within the context of the note, which states, Code No if the most  recent cath lab visit involved PCI. The intent is to assess whether the patient's most recent coronary angiogram informed the need or led to a subsequent PCI procedure or not.  Our follow-up question is, why does the registry collect this data? The 2013 Multimodality Diagnostic AUC for the Detection and Risk Assessment of Stable  Ischemic Heart Disease is currently being developed. Prior Diagnostic Coronary Angiography Procedure, the most recent procedure date, and results  of the angiogram procedure collected in sequence numbers 5263, 5264, and 5265, respectively, will all be utilized in the algorithm that informs the Multimodality Diagnostic AUC.  The objective of the forthcoming Multimodality Diagnostic AUC is to determine the appropriate use of cardiovascular imaging for selected patient indications.  Thank you for viewing the Cath PCI Registry Monthly Case Scenario for February 2022, where we discussed sequence number 5263, Diagnostic Coronary Angiogram Without Intervention.

Video Summary

In this video, the case scenario focuses on sequence number 5263, which involves a prior diagnostic coronary angiogram without intervention. The patient in question is a 79-year-old male with a medical history of hypertension, hyperlipidemia, bradyarrhythmia, heart block, and CAD. The patient has undergone several procedures in the past, including a permanent pacemaker placement in 2011, a coronary angiogram in 2012 that identified non-obstructive CAD, and a coronary angiogram with PCI in 2017, where a drug-eluting stent was placed. The patient recently had a positive nuclear stress test indicating an intermediate risk for a cardiac event and is now presenting for an elective coronary angiogram. The question posed in the video is whether sequence number 5263 is coded as "no" (not involving PCI) or "yes" (involving PCI). The answer is "no" because while angiograms were done in 2012 and 2017, only the 2017 visit involved PCI. The video also mentions the purpose of the registry collecting this data, which is to inform the development of the Multimodality Diagnostic AUC for the appropriate use of cardiovascular imaging in selected patient indications.

Keywords

sequence number 5263

diagnostic coronary angiogram

CAD

PCI

Multimodality Diagnostic AUC