0722 - Sequence # 4070 | HAS BLED - Stroke-0722 - Sequence # 4070

Video Transcription

Thank you for joining us for the July 2022 case scenario. In this month's case scenario, we will be reviewing sequence number 4070, Haas bled stroke.  This is the second in the Haas bled data element review. In this scenario, a 64-year-old female has been admitted for an LAA occlusion procedure.  The patient has a history of non-valvular atrial fibrillation times four years, which is classified as persistent.  While on aspirin and dual oral anticoagulants for the treatment of atrial fibrillation in the past, the patient has had two episodes of gastrointestinal bleeding.  In addition, it is confirmed that the patient has a history of a stroke with minimal residual right-sided weakness.  On further review of the documentation of the stroke, it is found that the patient had an ischemic stroke with hemorrhagic transformation.  Our question is, based on the patient history of an ischemic stroke with hemorrhagic transformation, how would Haas bled stroke, sequence number 4070, be coded? Number one, no.  Or number two, yes. Please take a few moments to review the documentation and question prior to determining the best answer.  Based on the documentation of a previous stroke, sequence 4070, Haas bled stroke, would be coded as yes. Now for a bonus question.  Using the same patient documentation and history data, and based on the information that the  patient had an ischemic stroke with a hemorrhagic transformation, what stroke type from sequence numbers 4075 through 4085 would be captured? Number one, ischemic stroke only.  Number two, hemorrhagic stroke only. Number three, undetermined stroke only. Or number four, both ischemic and hemorrhagic stroke.  For an ischemic stroke with hemorrhagic transformation, sequence 4080, ischemic stroke, would be coded as yes.  Hemorrhagic stroke, in sequence 4075, and undetermined stroke, in sequence 4085, would be coded as no.  Rationale for the data dictionary supporting definitions for sequence number 4075, when a hemorrhage is the consequence of an ischemic stroke, the stroke is an ischemic stroke with  hemorrhagic transformation, and not a hemorrhagic stroke.  Thank you for viewing the LAAO Registries case scenario for July of 2022. We'll see you next month.

Video Summary

In this video, the case scenario is about a 64-year-old female patient who was admitted for an LAA occlusion procedure due to a history of non-valvular atrial fibrillation. The patient has previously experienced two episodes of gastrointestinal bleeding while being treated with aspirin and dual oral anticoagulants. It is also confirmed that the patient had a previous stroke with minimal residual right-sided weakness, which was an ischemic stroke with hemorrhagic transformation. The video asks whether the condition, Haas bled stroke, should be coded based on this patient's history and the answer is yes. The bonus question asks about capturing the stroke type, and the answer is that an ischemic stroke with hemorrhagic transformation should be coded as yes, while a hemorrhagic stroke and an undetermined stroke should be coded as no. The video concludes with gratitude for viewing the case scenario and mentions the next month's video.

Keywords

LAA occlusion procedure

non-valvular atrial fibrillation

gastrointestinal bleeding

ischemic stroke with hemorrhagic transformation

Haas bled stroke