Welcome to the SCS ACC TVT Registry case scenario for April of 2024, where we will review how to capture a re-intervention on the aortic valve. A 78-year-old female underwent a transcatheter aortic valve replacement procedure. After an uneventful two-night stay, she was discharged home. At her follow-up, an echocardiogram was performed. The implanting physician recommended a valve-in-valve TAVR procedure to be considered. After a shared decision-making discussion took place, the patient agreed. The question we have for you is, how is that second TAVR procedure captured in the TVT Registry? Please select all that apply. Is it, number one, a new base episode of care is created? Number two, a second lab visit is added to the initial TAVR base episode of care? Number three, aortic valve re-intervention is captured on the first TAVR follow-up? Or number four, aortic valve re-intervention is captured on the second TAVR follow-up? Please take a few moments to review the documentation before making a final selection. And the answer is both, one and three. When a patient has a TAVR, then is discharged home and comes back for another TAVR procedure, the second TAVR procedure will need its own base episode of care. And this will be an aortic valve re-intervention follow-up event that is captured on the first TAVR. The rationale for creating a new base episode of care is twofold. First, you need to understand what episode of care means. And to say it another way, it means hospitalization, which encompasses the period between arrival and discharge. As the second TAVR procedure occurred after the patient was discharged, the first episode of care is over, and no more lab visits would be added to that episode of care. Therefore, a new episode of care needs created for the second TAVR procedure. To do this, you need to locate the patient and select the Add an Episode icon. The rationale for capturing the aortic valve re-intervention for the first TAVR's follow-up is also twofold. First, the target value for the follow-up events can be best understood if written as followed. Number one, discharge and current follow-up assessment performed as coded in sequence number 11000, which is follow-up assessment date, or between previous follow-up performed as coded in sequence number 11000, follow-up assessment date, and current follow-up assessment performed as coded in sequence 11000, follow-up assessment date. And as the patient returned to the operating room or cath lab for any aortic valve re-intervention, the re-intervention aortic valve would be coded as yes in sequence number 14276, follow-up events occurred, as the target value is met. Thank you for viewing the TBT registry case scenario for April of 2024.

SCS ACC TVT Registry

re-intervention

aortic valve

TAVR procedure

episode of care