Welcome to the IMPACT Registry March 2020 Case Scenario, discussing Sequence 8070, New Requirement for Dialysis. Our documentation involves a 52-year-old female with a history of Tetralogy of Fallot and chronic kidney disease. She presents to your cath lab for TPVR. Her pre-procedure creatinine is 3.7 mg per deciliter, which is the patient's baseline. Per MD notation, the patient may require dialysis post-procedure due to the use of iodinated contrast. The patient's post-procedure creatinine is 5.2 mg per deciliter, representing an acute worsening of kidney function. The patient undergoes dialysis the next day prior to discharge. Our question is, how is Sequence 8070, New Requirement for Dialysis, coded in the given scenario? Is it 1, No, or 2, Yes? The answer is 2, Yes. This data element seeks to capture the patient who experiences acute or worsening renal failure necessitating renal dialysis with a target value of any occurrence between start of procedure and 72 hours post-procedure or next procedure or surgery or discharge. The registry clarifies to code Yes if the patient is receiving continuous veno-venous hemofiltration, or CVVH, as a result of renal failure and not as treatment to remove fluid for heart failure. In addition, documentation stating the patient may require dialysis post-procedure does not support the patient requires dialysis currently. Therefore, when the patient does in fact receive dialysis post-procedure, this is a New Requirement. It is important to note the impact registry does not attribute cause to events that are coded in the intra- and post-procedure events section. As such, the registry is interested in tracking all events that occur after the cath lab visit that meet the coding parameters despite the patient's history or underlying conditions. This concludes the Impact Registry March 2020 Case Scenario. We thank you for your participation.

TPVR

Tetralogy of Fallot

chronic kidney disease

creatinine

dialysis