0321 - Sequence # 4065 | HAS-BLED Risk Score - Abnormal Liver Function-0321 - Sequence # 4065 | HAS-BLED Risk Score

Video Transcription

Thank you for reviewing the LAO Registry Monthly Case Scenario for March 2021. We will be discussing the Haslett Risk Score, focusing on Sequence 4065 Abnormal Liver Function.  Our patient, Mr. Smith, is admitted for an LAA occlusion procedure. His past history includes long-standing, persistent a-fib, hypertension, cirrhosis of the liver,  GI bleeding, which required admission and transfusions, ischemic stroke, congestive heart failure, past alcohol abuse.  His daily medication regimen includes Eliquis, Aspirin 81 mg, Latulose, Lasix, Metoprolol, and Amiodarone.  When capturing the patient's Haslett Risk Score, based on the documentation provided and the patient's documented history, how will abnormal liver function be coded, yes or no?  Please review the documentation and question to determine the best answer.  The answer is number one, yes. For the purpose of the LAO Registry, Sequence 4065 is to indicate if the patient has been diagnosed with an abnormal liver function.  A diagnosis of cirrhosis or any other chronic liver condition causing an abnormal hepatic function can be used to code yes.  Yes will be coded if the patient has been diagnosed or has an active history of abnormal  liver function that has been documented between 30 days pre-procedure and the actual procedure. Information that can be used to code this data element are new diagnosis or history  of chronic hepatic disease or condition. Chronic is defined as three months or greater.  Or if no diagnosis of chronic hepatic disease is documented, biochemical evidence of significant hepatic derangement can be used.  These include bilirubin more than two times upper limit of normal in association with aspartate transaminase, alanine transaminase, and alkaline phosphatase levels more than  three times upper limit of normal. Based on Mr. Smith's documented history, his HASBLED risk score will be coded as yes  to hypertension, yes to abnormal liver function based on the active history of cirrhosis of the liver, yes to stroke, yes to bleeding as the GI bleeding history met criteria by  requiring a blood transfusion and hospitalization, and yes to antiplatelet as the patient takes aspirin 81 mg as part of his daily regimen.  Thank you for viewing the LAAO Registries Case Scenario for March 2021.

Video Summary

The video discussed the case of Mr. Smith who is admitted for an LAA occlusion procedure. His medical history includes conditions such as long-standing, persistent a-fib, hypertension, cirrhosis of the liver, GI bleeding, ischemic stroke, congestive heart failure, and past alcohol abuse. The video focused on capturing the patient's Haslett Risk Score, specifically with regard to abnormal liver function. It was determined that for the LAO Registry, a diagnosis of cirrhosis or any chronic liver condition causing abnormal hepatic function should be coded as "yes." Additionally, if there is biochemical evidence of significant hepatic derangement, such as elevated bilirubin levels and abnormal liver enzymes, it would also be coded as "yes." Based on Mr. Smith's documented history, several risk factors were coded as "yes," including hypertension, abnormal liver function, stroke, bleeding, and use of antiplatelet medication. No credits were mentioned in the transcript.

Keywords

LAA occlusion procedure

Mr. Smith

Haslett Risk Score

cirrhosis of the liver

abnormal liver function