0821 - Sequence # 7002 | Procedure Start Time-0821 - Sequence # 7002

Video Transcription

The LAAO case scenario for August 2021 is sequence number 7002, Procedure Start Time.  The 84-year-old patient in this scenario presents with a long history of paroxysmal atrial fibrillation,  TIA with no residual symptoms, and an ischemic stroke with persistent left arm weakness and loss of fine motor function.  The patient's warfarin therapy was not interrupted for this procedure. The plan is for a pulmonary vein isolation ablation followed by an LAAO procedure with  the insertion of a Watchman device. The patient arrived at the procedure room at 8 a.m. The pulmonary vein isolation procedure begins at 8.15 and ends at 10.  The LAAO portion of the procedure begins at 10 with successful insertion of a Watchman device and scrub is broken to end the procedure at 11.05.  Our question is this. When the patient has two procedures in the same lab visit and the LAAO procedure is second, how is sequence number 7002 coded?  Number one, when the patient enters the procedure room at 0800? Number two, when the PVI procedure begins at 8.15? Or number three, with the time the LAAO procedure begins at 10?  Please take a few moments to review the documentation and question.  And the answer is number three, the time the LAAO procedure started. For the purpose of the LAAO registry, please code the time that the ablation ends as the  LAAO procedure start time in sequence 7001 and 7002. The procedure stop time will be coded in sequence 7006 and 7007 as the time the operator breaks  scrub at the end of the LAAO procedure. Continue by coding yes to sequence 7310 concomitant procedures performed and AFib ablation as  the concomitant procedure type in sequence 7315. In this scenario, the anticoagulation strategy did not change in between procedures, which  was heparin given after the transeptal puncture prior to ablation. Also, the last dose of warfarin was taken within 24 hours of the start of procedure,  making it part of the intra-procedure anticoagulation strategy. In addition to the anticoagulation therapy, please code the AFib ablation taking place  prior to the start of the LAAO procedure under attempt at atrial fibrillation termination and catheter ablation as the target value for this sequence is between birth and procedure.  Thank you for viewing the August case scenario regarding the coding of sequence number 7002, procedure start time. See you next month.

Video Summary

In this video, the LAAO case scenario for August 2021 is discussed. The patient in this scenario is an 84-year-old with a history of paroxysmal atrial fibrillation, TIA, and an ischemic stroke. The procedure plan includes a pulmonary vein isolation ablation followed by an LAAO procedure with the insertion of a Watchman device. The video explains how to code sequence number 7002, which refers to the start time of the LAAO procedure. The answer is that it should be coded based on the time the LAAO procedure starts, which is 10 a.m. The video also provides information on coding other related factors such as anticoagulation therapy and concomitant procedures. No credits were granted in the video.

Keywords

LAAO case scenario

August 2021

paroxysmal atrial fibrillation

TIA

ischemic stroke