0420 - Sequence # 7065 | Concomitant Procedures-0420 - Sequence # 7065

Video Transcription

Welcome to the CAHPS PCI Registry Case Scenario for April 2020. This case scenario will discuss Sequence 7065, Concomitant Procedures Performed.  Our scenario involves a 56-year-old male who presented to your ED with crushing chest pain and diaphoresis. An ECG was performed at 2130, which was diagnostic for STEMI.  Upon review of the ECG, the cardiologist on duty activated the cath lab and the patient was taken for an immediate PCI for acute STEMI.  The diagnostic coronary angiography procedure revealed a 90% stenosis with thrombus in the mid-LAD.  The physician used a thrombectomy device on the lesion at 2210 and placed a drug-eluting stent at 2217.  The remaining coronary vessels had non-obstructive CAD, therefore no further treatment was warranted. The patient left the cath lab procedure room at 2235.  Question, is thrombectomy captured as a concomitant procedure? 1. No. 2. Yes. And here is your documentation and question for review. The answer is 1, No.  A concomitant procedure is that which is performed in conjunction with a diagnostic coronary angiography and or PCI procedure.  Thrombectomy is a form of mechanical revascularization and therefore qualifies as PCI.  This treatment strategy will be captured when identifying the devices used during the procedure in Sequence 8028, Intracoronary Devices Used.  Additionally, the thrombectomy time will be used to code Sequence 7845, First Device Activation Date and Time.  This data element is coded with the earliest time a mechanical revascularization device was used, in this case a thrombectomy device.  The time at which PCI is first initiated is when the calculation of the door-to-balloon time will end. In this scenario, your door-to-balloon time is a speedy 40 minutes.  Thank you for viewing the Cath PCI Registry Monthly Case Scenario for April 2020. We appreciate your participation.  www.cdc.gov.au

Video Summary

In the CAHPS PCI Registry Case Scenario for April 2020, a 56-year-old male presents to the emergency department with severe chest pain and sweating. An ECG reveals a STEMI and the cardiologist immediately performs a PCI procedure in the cath lab. The diagnostic coronary angiography shows a 90% stenosis with a blood clot in the middle of the left anterior descending artery. The physician performs a thrombectomy to remove the clot and places a drug-eluting stent. No further treatment is needed for the other coronary vessels. Thrombectomy is considered a concomitant procedure, which qualifies as PCI and should be documented. The door-to-balloon time for this case is 40 minutes.<br /><br />(Note: No credits are provided in the video transcript.)

Keywords

CAHPS PCI Registry

Case Scenario

56-year-old male

STEMI

PCI procedure