Welcome to the CATH PCI Registry April 2024 case scenario. This scenario covers sequence number 4630, which is cardiac arrest out of healthcare facility, and sequence number 4635, cardiac arrest at transferring healthcare facility. A 58-year-old female was receiving care at an outpatient wound center when she suffered a witnessed cardiac arrest. She was pulseless and cardiac monitor revealed ventricular fibrillation. ACLS protocol with defibrillation was promptly initiated. Return of circulation was achieved. Past medical history was significant for hypertension, insulin-dependent diabetes mellitus, venous pressure ulcers, and a strong family history of premature CAD. She was stabilized and transferred via EMS to the emergency room at the nearest acute care facility where a CATH PCI was performed. How is sequence number 4630, cardiac arrest out of healthcare facility, coded by the receiving facility? Number one, no. Number two, yes. Please pause here to review all of the information before you make a decision. And the answer is no. Sequence number 4630, cardiac arrest out of healthcare facility, captures if a cardiac arrest occurred outside any healthcare facility. In the given scenario, the cardiac arrest occurred at a wound care center, which is considered a facility that provides healthcare services. Other examples of healthcare facilities include acute care hospitals, freestanding EDs, urgent care, doctor's offices, rehab centers, etc. Out of healthcare facility includes locations such as shopping malls, parking lots, homes, etc. The intent of the target value of on arrival in sequence number 4630 is to capture when a cardiac arrest occurs and prompts the patient's need for medical treatment in the current episode of care, not a remote history of cardiac arrest. As sequence number 4630 is coded as no, the child fields of sequence number 4631, arrest witnessed, sequence number 4632, arrest after arrival of EMS, and sequence number 4633 and 4634, first cardiac arrest rhythm, will not be coded. How is sequence number 4635, cardiac arrest at transferring healthcare facility, coded by the receiving facility? One, no. Or two, yes. Pause here and review the details. And the answer is number two, yes. Sequence number 4635, cardiac arrest at transferring healthcare facility, captures cardiac arrest that occurs at a transferring healthcare facility. In the given scenario, the cardiac arrest occurred at a wound care center, which is considered a facility that provides healthcare services. Out of healthcare facility includes locations such as shopping mall, parking lot, home, etc. As with sequence number 4630, the intent of the target value of on arrival in sequence number 4635 is to capture when a cardiac arrest occurs and prompts the patient's need for medical treatment in the current episode of care, not a remote history of cardiac arrest. When either sequence number 4630, cardiac arrest out of healthcare facility, is yes, or sequence number 4635, cardiac arrest at transferring facility, is yes, both sequence number 7806, which is hypothermia induced, and sequence number 7810, level of consciousness at start of PCI status post-cardiac arrest, will need to be coded. Sequence 4630, cardiac arrest out of healthcare facility, sequence number 4635, cardiac arrest at transferring healthcare facility, and sequence number 7810, level of consciousness at start of PCI status post-cardiac arrest, are variables included in the PCI in-hospital risk standardized mortality measures, and the PCI in-hospital risk standardized AKI measure. During the development of the mortality model, it was determined that procedural urgency, cardiovascular instability, and responsiveness following cardiac arrest were the variables most predictive of in-hospital mortality. These elements are also utilized to derive the reporting cohorts for metrics number 49, PCI in-hospital risk standardized mortality, patients without cardiogenic shock or cardiac arrest, and number 51, which is PCI in-hospital risk standardized mortality, STEMI patients without cardiogenic shock or cardiac arrest. During the development of the PCI in-hospital risk standardized acute kidney injury model, one of the strongest predictors of AKI post-PCI was being unresponsive after cardiac arrest. Thank you for viewing the CAHPS PCI Registry April 2024 case scenario, sequence number 4630 and sequence number 4635.

cardiac arrest

outpatient wound center

resuscitation

CATH PCI procedure

coding criteria