Welcome to the STS-ACC TVT Registry June Case Scenario for Version 3. This month we will review Sequence 70-65 Concomitant Procedures Performed. An 85-year-old female was admitted for a TAVR procedure for severe aortic regurgitation. The patient had a history of intermittent left bundle branch block. Following valve deployment, the patient developed complete heart block with hemodynamic instability. A temporary pacing wire was inserted immediately with good capture. The decision was made to insert a permanent pacemaker, after which the patient had no further complications. Besides capturing the insertion of the permanent pacemaker in Sequence 12153, intra- and post-procedure events occurred, would the insertion of the permanent pacemaker be captured in Sequence 70-65 Concomitant Procedures Performed? No or Yes? Please take a moment to review the documentation and the question prior to making a final decision. Sequence 70-65 Concomitant Procedures Performed would be coded as Yes. Sequence 70-65 would be captured for any additional procedure performed that is not inherent to the transcatheter valve procedure. This data element captures procedures that add time in the procedure room, additional contrast dye, or additional radiation. If this data element seems familiar, it is because it replaced Sequence 66-20, Other Procedure Performed Concurrently, from Version 2.1. The type of concomitant procedure performed would be captured in Sequence 70-66. This list of procedures is dynamic and if not shown on the list, please contact the registry to have the procedure added. Sequence 70-65 will not capture procedures that are inherent to a transcatheter valve procedure, such as a TEE, pre- or post-dilation of the valve, a valvuloplasty, or the insertion of a temporary pacing wire, to name a few examples. Thank you for viewing the June 2021 STS-ACC TBT Registry Case Scenario. See you next month!

STS-ACC TVT Registry

coding of concomitant procedures

TAVR procedure

aortic regurgitation

left bundle branch block