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0222 - Sequence # 9095 | Genitourinary Bleeding - ...
0222 - Sequence # 9095 | Genitourinary Bleeding - ...
0222 - Sequence # 9095 | Genitourinary Bleeding - Intra or Post-Procedure Event
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Video Transcription
Thank you for reviewing the AFib ablation registry monthly case scenario for February 2022. The case scenario will be focused on the capture of genitourinary bleeding as an intra or post procedure event in sequence 9095. Our patient Mr. Murphy was admitted to the hospital for an AFib ablation procedure and goes on to have a successful ablation in which PVI was used as the strategy. Mr. Murphy developed bleeding from his Foley catheter during the procedure. Overnight continuous bladder irrigation was ordered by urology and started post procedure. The bladder irrigation was discontinued in the morning. Mr. Murphy's hemoglobin level had only dropped from 12.0 pre-procedure to 10.0 grams per deciliter in the morning after the procedure, giving us only a drop of 2 grams per deciliter. Mr. Murphy was discharged home after being cleared by urology and cardiology the day after the procedure. Based on the documentation of Mr. Murphy's intra and post procedure bleeding, would we code GU bleeding as an intra or post procedure event in sequence 9095? Number one, no. Or number two, yes. Please take a few moments to review the documentation and question to determine the best response. And the answer is number one, no. For the bleeding to be coded as a GUI bleeding event, the episode would have to meet at least of the three criteria listed in the data dictionary, which are a hemoglobin drop of equal or more than 3 grams per deciliter, transfusion of whole blood or packed red blood cells, or a procedural intervention surgery at the bleeding site to reverse stop or correct the bleeding. In this case, the patient's hemoglobin did not decrease by 3 grams per deciliter or more. The patient did not have a transfusion and the registry does not consider bladder irrigation as a procedural intervention or surgery at the bleeding site to reverse stop or correct the bleeding. None of the criteria necessary to code a bleeding event have been met. And our bonus question, if Mr. Murphy would have acquired and received a transfusion of packed red blood cells, meeting the criteria for GU bleeding to be coded as an event, would he be included in metric number four as having a major adverse event? Number one, yes, or number two, no. And the answer is number two, no. Genitourinary bleeding is not an event that is categorized as a major adverse event by the metrics numerator. Therefore, Mr. Murphy will not be included in the numerator of metric four as a major adverse event. Please refer to the executive summary measures and metrics companion guide, which has been recently updated. The document is located in the resources tab under documents. Thank you for reviewing the AFib Ablation Registry Monthly Case Scenario for February 2022.
Video Summary
The video discusses a case scenario of a patient named Mr. Murphy who underwent an AFib ablation procedure. During the procedure, he experienced bleeding from his Foley catheter, which was managed with continuous bladder irrigation. However, the patient's hemoglobin level only dropped by 2 grams per deciliter, which does not meet the criteria for coding the bleeding as a genitourinary event. The video also addresses a bonus question about whether Mr. Murphy would be considered to have a major adverse event if he had received a transfusion, and the answer is no. Genitourinary bleeding is not categorized as a major adverse event. The video suggests referring to the executive summary measures and metrics companion guide for further information. No credits are mentioned.
Keywords
AFib ablation procedure
bleeding
Foley catheter
continuous bladder irrigation
hemoglobin level
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