Welcome to the CAF PCI Registry Case Scenario. We're going to be reviewing sequence number 10030, Interventions This Hospitalizations, and sequence number 10031, Intervention Type This Hospitalization. A 70-year-old male with a past medical history of severe aortic stenosis and non-obstructive coronary artery disease presents for a scheduled TAVR procedure which was successful without any intra-procedure events. However, several hours post-procedure, he developed acute chest pain and EKG revealed an anterior STEMI leading to an immediate PCI for STEMI. How would sequence number 10030, Interventions This Hospitalization, be coded? Number one, no, or number two, yes? Please pause here to review the information. And the answer is yes. Sequence number 10030, Interventions This Hospitalization, captures other interventions, either percutaneous or surgical, that occurred during this hospitalization, also known as episode of care, between the arrival and discharge time frame. However, this does not include interventions that occurred during the same CAF lab visit as a diagnostic coronary angiography or percutaneous coronary intervention as those are captured in sequence number 7065 and sequence number 7066. Sequence number 10031, Intervention Types This Hospitalization, captures both percutaneous and surgical interventions that occurred during the episode of care. For example, cardiac surgery non-CABG is coded for procedures such as surgical valve repair or replacement or structural. Structural heart intervention is coded for non-valvular procedures, such as alcohol septal ablations, repair of a patent foramen ovale, or repair of a patent ductus arteriosus. Surgery non-cardiac is coded for any non-cardiac surgery, such as a hip replacement or cholecystectomy. So how would sequence number 10031, Intervention Type This Hospitalization, be coded? 1. CABG 2. Cardiac surgery 3. Surgery non-cardiac 4. Valvular intervention 5. Structural heart non-valvular 6. EP study or 7. Other Again, take a few seconds to pause here and review the information. The answer is number four, valvular intervention. As the patient had a TAVR, a transcatheter aortic valvular intervention, between arrival and discharge and outside of the cath lab visit. Post-PCI, the patient was diagnosed with an injury to the PCI arterial access site requiring surgical repair. Is an additional selection made in sequence number 10031, Intervention Type This Hospitalization, to capture the surgical repair of the PCI site? 1. No 2. Yes Pause here again to take some time to review the information. And the answer is yes. Other is also coded as the patient has a complication directly related to a diagnostic coronary angiogram and or PCI that requires a percutaneous or surgical intervention. Do the interventions captured in sequence number 10031, Intervention Type This Hospitalization, have any metric implications? 1. No 2. Yes And the answer is yes. For example, metric key 5000 major adverse events select PCI patients excludes patients with any of the following, elective or urgent CABG, cardiac surgery, non-CABG, surgery, non-cardiac, valvular intervention, such as structural heart intervention, non-valvular, and EP study. Thank you for reviewing the cath PCI case scenario for sequence number 10030, Interventions For This Hospitalization, and sequence number 10031, Intervention Type This Hospitalization.

cardiac arrest

outpatient wound center

emergency room

CATH PCI procedure

coding criteria

TAVR procedure

STEMI

PCI

valvular intervention

major adverse events