Thank you for viewing the LAAO Registry Monthly Case Scenario for March 2020. We will be discussing sequence number 13015, follow-up status, with emphasis on the coding of a deceased patient. This data element's number was updated to sequence number 11004 to reflect the version upgraded to 1.4. We have documentation of a 65-year-old female patient who underwent a successful LAAO procedure in which a Watchman device was implanted on September 30, 2019. The patient had their 45-day follow-up at the clinician's office on November 19, 2019, which fell at day 50 post-procedure. The patient was readmitted to the hospital with pneumonia 30 days after their 45-day follow-up. The patient expired while in the hospital due to complications from the pneumonia. The patient's date of death was December 26, 2019, 87 days post-procedure. Based on the follow-up information and date of death, when will the patient's death be coded? Will the patient's death be coded on their 45-day follow-up or on their six-month follow-up? Please take a few moments to review the documentation and question to determine the best answer. And the answer is number two, six-month follow-up. The patient's death will be coded on their six-month follow-up as their 45-day follow-up had already been performed and the patient was alive at the time of that assessment. As a reminder, the patient's 45-day follow-up will capture everything that took place from the time of hospital discharge to the time of the 45-day follow-up assessment. Anything that takes place after the 45-day follow-up assessment is captured at the patient's six-month follow-up. This rule applies to all follow-up intervals. Question number two, when coding the patient's six-month follow-up, what date will be coded as the assessment date in sequence 13,000? Number one, the date of death, 12-26-2019, which was 87 days post-procedure. Two, the planned date for the six-month follow-up. Number three, any date within the six-month follow-up date range. Or number four, answers two and three. Please review the documentation and question to determine the best answer. And the answer is number four. The assessment date on the patient's six-month follow-up can be coded as either the planned date for their six-month follow-up assessment, or it can be coded as any date within the six-month follow-up date range. If the actual date of death, which was 87 days post-procedure, is attempted to be coded as a 45-day follow-up, the system will generate an error since there is already a 45-day follow-up entry and the system only allows one follow-up entry per follow-up interval. If the date of death is used as the six-month follow-up assessment date, the system will generate an error as the date coded is within the 45-day follow-up date range, day one to day 91 post-procedure, specifically day 87 post-procedure, and not within the six-month follow-up date range, day 92 to day 256 post-procedure. The rationale for answer number two, code the date of assessment as the planned date for the patient's six-month follow-up. If the assessment date is coded as the date planned for the patient's six-month follow-up, February 27, 2020, which falls 150 days post-procedure, the system will not generate any errors as the date coded is within the six-month follow-up date range as well as the registry-recommended time window, 150 to 240 days post-procedure. The rationale for answer number three, to code the date of the assessment as any date within the six-month follow-up date range. If the assessment date is coded as any date within the six-month follow-up date range, February 20, 2020, which falls 133 days post-procedure, the system will not generate any errors. Only an outlier warning as the date coded is within the six-month follow-up date range, but outside of the registry-recommended time window. The outlier warning is only for the purpose of prompting the abstractor to recheck the date coded, but it will not prevent submission. Thank you for reviewing the LAAO Registries Case Scenario for March of 2020.

LAAO Registry

coding

deceased patient

Watchman device

follow-up