Welcome to the STS-ACC TBT Registry Case Scenario, where we will review sequence number 10116, Cardiac Rehab Referral, and its impact on metric 21, Cardiac Rehab Referral from an inpatient setting. An 88-year-old female presented and underwent a successful transcatheter mitral repair procedure. After a two-night stay, her strength declined drastically, requiring a discharge to a skilled nursing unit for nursing care and physical therapy. There is no documentation a Cardiac Rehab Referral was provided. The question we have is, how is sequence number 10116, Cardiac Rehab Referral, coded? One, no. Reason not documented? Two, no. Healthcare system reason documented? Three, no. Medical reason documented? Four, no. Patient-oriented reason? Or five, yes. Pause here and take a few moments to review the documentation before making a final selection. The answer is number one, no. The reason is not documented. When a patient is discharged to a skilled nursing facility and there is no documented medical or health care system reason why such a referral was not made on discharge, to satisfy the target value, quote, no, reason not documented, end quote, would be coded for sequence number 10116, Cardiac Rehab Referral, as reasons cannot be assumed nor correlated. Meaning, to code no medical health care system reason documented in sequence 10116 for Cardiac Rehab Referral, there must be a documentation reflecting Cardiac Rehab Referral not provided due to, and then insert medical or health care system reason why, upon discharge. The STS ACC TVT registry metric number 41 is Cardiac Rehab Referral, and it mirrors the writing committee's 2018 ACC AHA Clinical Performance and Quality Measures for Cardiac Rehab, PM number one, referral from inpatient setting. This includes denominator exceptions when there is documentation to support either a patient reason, medical reason, or a health care system reason. According to the Cardiac Rehab Performance Measures publication, cardiac rehab services have been shown to help reduce morbidity and mortality in persons with valvular heart disease, but these services are used in less than 30% of eligible patients. A key component to outpatient CR program utilization is the appropriate and timely referral of patients. Generally, the most important time for this referral to take place is while the patient is hospitalized for a qualifying event or diagnosis, including cardiac valve repair or replacement. This performance measure has been developed to help health care systems implement effective steps in their systems of care that will optimize the appropriate referral of a patient to an outpatient CR program. Effective referral of appropriate inpatients to an outpatient CR program is a responsibility of the health care team within a health care system that is primarily responsible for providing cardiovascular care to the patient during hospitalization. The in-hospital based executive summary measure and metrics companion guide is in the STS-ACC TVT registries resources link when you select documents under the headings of executive summary measures and metrics companion guide documents. This patient meets the denominator criteria for metric 41, cardiac rehab referral. However, they do not meet any denominator exclusion nor denominator exception criteria. Therefore, this patient will not appear in the numerator as she did not receive a referral and there was no reason documented as to why one was not provided. Thank you for viewing the TVT registry case scenario for February 2024.

vendor error

1130 error code

DQR

base and follow-up data

link problem

transcatheter mitral repair procedure

decline in strength

skilled nursing unit

Cardiac Rehab Referral

outpatient Cardiac Rehab programs