Thank you for viewing the Chest Pain MI Registry June case scenario regarding sequence 7845 first device activation date and time. A patient presents to your facility at 1204 with STEMI diagnosed by EMS ECG. The cath lab is activated and the patient arrives in the cath lab at 1236. The cardiologist performs a diagnostic coronary angiography which reveals a 99% mid-LAD lesion. Immediate PCI follows. Upon insertion of the guidewire at 1250, the physician documents that blood flow was restored. This is followed by a balloon inflation at 1254 and a drug eluting stent placed at 1257. The PCI is successful and the patient is admitted overnight. How is sequence 7845 first device activation date and time coded in this scenario? Is it 1 517 21 at 1250? Is it 2 517 21 at 1254 or is it 3 517 21 at 1257? Please take a moment to review the documentation and the question. The answer is number 2, 517 21 at 1254. The coding instructions for this data element are to indicate the date and time the first device was activated. This could be the time of first balloon inflation, time of first stent deployment, or the time of first treatment with thrombectomy device, laser, or atherectomy device. Only if the lesion cannot be crossed with a guidewire or device, and thus none of the above apply, do you code the time of guidewire introduction. In this scenario, the first device activated was the balloon inflation at 1254. The data dictionary clarifies further by saying this sequence is a process improvement measure about the timeliness of treatment. It is not a clinical outcomes measure based on TIMI flow or clinical reperfusion. What is being measured is the time of the first mechanical treatment of the culprit lesion, not the time when TIMI 3 flow was or was not restored. In this scenario, although reperfusion occurred with introduction of the guidewire, the first mechanical treatment of the culprit lesion was the balloon inflation. Thank you for viewing the Chess Pain MI Registry's June 2021 case scenario.

sequence 7845

first device activation date and time

chest pain MI registry

STEMI

cath lab activation