The EP device implant registry case scenario for August 2021 will review shared decision making. A 56-year-old male presents for a single-chamber ICD for primary prevention. The patient has been experienced single-bullet episodes which are thought to be due to ventricular arrhythmias. An electrophysiology study was performed and sustained monomorphic ventricular tachycardia was elicited. Other documentation in the medical records states patient was informed of the risk associated with the procedure such as infection, extraction, and death. Patient agrees to undergo ICD implant. The question is, how is sequence number 14732 shared decision making coded? Is it number one, no, or number two, yes? Please take a moment to review the documentation and select an answer. The answer is number one, no. The provider documentation in this scenario is not clear. When the documentation is not clear, shared decision making discussion cannot be assumed. Therefore, no is coded for sequence 14732 shared decision making. There is no implied coding. Informed consent is not synonymous with shared decision making. Informed consent is a brief description of the planned procedure or surgery with the explanation of risks and benefits. This is a process of obtaining the patient's permission to proceed. Shared decision making is a patient-centered conversation where the clinician and patient together map out the best course of action based on patient preferences as it relates to the clinical evidence. It is a process in which both the patient and the physician or non-physician practitioner contribute to the medical decision making process and agree on treatment decisions. This is shown to increase the knowledge and satisfaction regarding care, define clearer goals for treatment, and to align health decisions with patient values. When there is clear documentation in the medical record that a shared decision making discussion occurred, then yes is coded for sequence 14732. This data element is intended for all initial primary prevention procedures. However, it is also available to capture for all procedures. Of note, shared decision making is required by the CMS National Coverage Determination for Primary Prevention Initial ICD Implantation. Some additional information related to the child fields of shared decision making. The intent of sequence 14733, Shared Decision Making Tool Used, is to capture if a tool was used in conjunction with the shared decision making discussion, regardless if the tool used was evidence-based. The intent of sequence number 14734, Shared Decision Making Tool Name, is to capture the name of an evidence-based tool if one were used. To learn more about shared decision making, please locate and review the lesson labeled Procedure Information ICD Indication 7015, Shared Decision Making 14732-14734, located within the QII Learning Center. The QII Learning Center can be accessed from the left navigational bar by selecting Learning Center within the Resources link. To locate version 2.3 training videos, select the Click Here hyperlink, and this will bring the user to the landing page of version 2.3 educational videos. Select the hyperlink to the desired video presentation. Here are some useful resources. A short webinar that features the same shared decision making tool mentioned in the National Coverage Determination, developed by the American College of Cardiology and Heart Rhythm Society, or HRS, leaders. Access to decision aids to assist with the shared decision making discussion. Access to a shared decision making instructional video and decision making tool, available in both English and Spanish languages. Thank you for viewing the EP Device Implant Registry Case Scenario for August of 2021, which highlights shared decision making.

case scenario

56-year-old male

single-chamber ICD implant

shared decision making

patient-centered conversation