Thank you for viewing the AFib Ablation Registry Monthly Case Scenario for July of 2022. This case scenario will be focused on coding of radiation elements when no radiation was used during the procedure. Mr. Green had a successful AFib ablation procedure in which pulmonary vein isolation was used as the ablation strategy. While abstracting the procedure into the registry, the following history is documented in a his medical record, TIA, CABG in the past, hypertension, congestive heart failure, and symptomatic longstanding persistent AFib. There is also documentation of no radiation being utilized during the procedure. Based on the documentation of no radiation used during the procedure, how will sequence 7210 and 7220 be coded? Number 1, 0, number 2, 1, or number 3? Leave the elements blank. Please take a few moments to review the documentation and question to determine the best answer. The answer is number 3, leave the data elements blank, and these are the reasons why leaving the elements blank portrays more accurate data. Coding these elements as 0 will be outside of the valid range and cause an error when submitting data, so this will not be an option. Coding these elements as 1, or the lowest number of the valid range, will include these patients in the numerator of metric 16 and portray them as having received radiation, even though they did not receive any, which would not be accurate data. Leaving the elements blank will not include the patients in the numerator of metric 16 and will differentiate between these two patient populations in the metric. Before we get into discussing metric 16, let's discuss what informational data metrics are. The metrics included in the informational data section of the dashboard represent a numerator and denominator based only on data with entry without exclusions. The informational data denominators will consist of all patients or all procedures, depending on what the metric states. There are no exclusions, thus if a procedure was aborted, the patient would still be in the denominator as the patient is part of the all procedure or all patient population. Exclusions will be included in the metrics numerator based on the metrics criteria. The information provided by these metrics is only meant for facilities to review internally and will not be part of the executive summary information. So what is metric 16? Metric 16 measures the proportion of procedures with a documented radiation dose of cumulative air kerma and or dose area product. It is based on sequence number 7210, cumulative air kerma, and 7220, dose area product, and only measures if any doses are entered into one or both of these elements. If any measure is entered into one or both elements, the patient is included in the numerator of metric 16, and these elements will be shown as yes in the metric drill down. The drill down does not show the dosage entered. Leaving these elements blank, as discussed earlier, will differentiate between the two populations and give more accurate data to the facility. If any number is entered in one or both elements, the patient is included in the numerator of metric 16, and these elements will be shown as yes, since there was a dosage documented. Leaving the elements blank will not include the patients in the numerator and will differentiate between these two patient populations in the metric by showing the elements as not documented. This will inform the facility that the patients not included in the numerator is the population who did not receive radiation during the procedure. It is important to remember that these metrics are not used punitively towards the facility or providers and are only designed to provide more detailed data on the facility's population, information that can be used to review the facility's processes or used in quality improvement projects. Thank you for reviewing the AFib Ablation Registry Monthly Case Scenario for July 2022.

radiation

AFib Ablation Registry

coding elements

Mr. Green

successful AFib ablation procedure