0420 - Sequence # 7010 | Procedure Type-0420 - Sequence # 7010

Video Transcription

Welcome to the ICD Registry April 2020 Case Scenario. This scenario will discuss Section E Procedure Information, Sequence 7010, Procedure Type.  The patient is admitted on October 7, 2019 for a generator change to a facility that submits an all-patient population.  The morning after the procedure, a device interrogation demonstrates high impedance in the RV lead. The patient returns to the lab the next day.  The clinician finds blood in the set screws and the device head is cleaned. The leads are reattached without repositioning and there are no changes to the generator or leads.  How is Procedure Type, Sequence 7010 coded? 1. Generator Change or 2. Generator Change and Lead Only? Please take a few seconds to review the documentation and the question.  The correct answer is 2. Both Generator Change and Lead Only lab visits are coded.  When a facility submits an all-patient population and the patient returns within the same admission for a lead revision or lead implant, the Lead Only lab visit is captured.  To add a lab visit, click to the next slide. Pull up the current Generator Leads patient episode. Navigate to Lab Visit at the left navigation bar.  At the top of the page and in the upper right corner, select Add Lab Visit. This provides a refreshed lab visit page. The Procedure Type, Sequence 7010, will be Lead Only.  Please capture the revised lead in the second lab visit. The existing leads captured in the first lab visit are not re-entered in the second lab visit.  The set screw issue is an adverse event and is captured in the first lab visit as the target value is met.  The coding instructions state, indicate if patient had pacing and or sensing problem associated with high impedance due to a poor connection between a lead and ICD caused by  a loose set screw. Target value, any occurrence between completion of procedure and next procedure or discharge.  Please make sure to capture the set screw issue as an adverse event under the first lab visit. Thank you for viewing the case scenario for April 2020.

Video Summary

The video transcript discusses a case scenario related to the ICD registry, specifically focusing on Section E Procedure Information, Sequence 7010, Procedure Type. The patient is admitted for a generator change at a facility that submits data for all-patient population. The day after the procedure, there is high impedance in the RV lead, so the patient returns to the lab the following day. Blood is found in the set screws and the device head is cleaned. The leads are reattached without repositioning, and there are no changes to the generator or leads. The correct coding for Procedure Type, Sequence 7010 is identified as 2. Generator Change and Lead Only. If a lead revision or implant occurs within the same admission, the Lead Only lab visit should be captured. The instructions for coding state that any pacing or sensing problem associated with high impedance due to a loose set screw should be captured as an adverse event under the first lab visit.

Keywords

ICD registry

generator change

high impedance

lab visit

coding