Thank you for viewing the Chest Pain MI Registry May case scenario regarding Sequence No. 12295, thrombolytic, which indicates if the patient received thrombolytic therapy as an urgent treatment for STEMI or its equivalent, and Metric 17, reperfusion therapy, which is evaluating the percentage of patients with acute STEMI or its equivalent who receive fibrillinic therapy or primary PCI. The ED physician signed STEMI ECG at 6.45 p.m. and consulted the on-call cardiologist providing the transmission of the ECG at 6.47 p.m. via secure text. The cath lab team was activated at 6.50 p.m. The patient left the emergency department with both the ED and cath lab nurses in attendance at 7.15 p.m. for primary reperfusion. The angiogram revealed triple vessel disease with high-grade stenosis of the proximal LAD. Emergent CABG was performed that same night. Let us take a few moments to review how the case was abstracted. The abstractor coded the patient type as STEMI, the STEMI setting as pre-admit, thrombolytics as no, no reason, the reason the primary PCI was not performed as no medical reason, CABG as yes, comfort measures only as no, hospice care as no, and discharge status of alive. So based on this abstraction, is the patient included in the numerator of Metric 17 reperfusion therapy? Number one, no, or number two, yes? Please take a few moments to review the abstraction and the question before making your final response. The answer is number one, no. The patient is not included in Metric 17 reperfusion therapy due to an error in data abstraction of sequence 12295 thrombolytic. FAQ 25084 supports the coding of no medical reason for sequence 12295 thrombolytics. Question are there any instances where no medical reason can be selected for 12295 without explicit provider documentation of a reason? And the answer is yes, it is acceptable to select no medical reason when a thrombolytic is not administered and PCI or CABG is the primary reperfusion strategy for STEMI. The error in coding for sequence 12295 thrombolytics as no, no reason is identified during the weekly e-reports dashboard review. The participant corrected the coding for sequence 12295 to no medical reason and resubmitted the data. The coding advice provided in FAQ 25084, no medical reason is coded when the reperfusion strategy is either PCI or CABG. In this scenario, the patient proceeded to the cath lab for the initial reperfusion strategy of PCI. This is sufficient to code no medical reason to thrombolytics. Additionally, CABG is the final reperfusion strategy. Thank you for viewing the Chest Pain MI Registry's May 2022 case scenario.

chest pain

STEMI

treatment evaluation

coding

thrombolytic therapy