The ICD Registry case scenario for March is regarding sequence 7630, CSLV lead, and metric 10, failure to place the CSLV lead. The patient was admitted for a CRTD generator change. The old LV lead was capped and abandoned. A new LV lead was implanted into several branches of the CS, however, the thresholds obtained were inadequate and the LV lead was removed. The RA and RV leads were reused and connected to the CRTD. The patient was scheduled the next day for LV epicardial lead implant in the OR. The question is how is sequence 7630 coded and how will the coding impact metric 10? Number one, implant unsuccessful with yes displayed in the numerator. Number two, not attempted and no displayed in the numerator. Number three, successful implant and no displayed in the numerator. Or number four, previously implanted and no displayed in the numerator. Please take a moment to review the documentation and question. The answer is number one. An attempt to implant the LV lead via the coronary sinus will be captured even if the patient has an existing LV lead. If all attempts are not captured, it will impact the accuracy of metric 10. Let's look at metric 10 in the outcome report. When evaluating your data in the box and whiskers graph, the goal is to be above the 50th percentile. This site is just below the 50th percentile at 3.6%. To see how this site compares to like hospitals and the national aggregate, let's look at detail line number 1024. Line item 1024 displays the proportion of lab visits where the patient had an unsuccessful attempt to implant the CSLV lead. When reviewing the volume group comparison, we see that the score is 4.6 and the US aggregate is 5.2. This facility is actually doing better with a score of 3.6. Thank you for reviewing the March case scenario for the ICD registry.

ICD Registry

coding sequence 7630

metric 10

CRTD generator change

LV lead implant