Thank you for viewing the AFib Ablation Registry Monthly Case Scenario for August 2021. This month's case scenario is focused on sequence number 7135, Current Ablation Strategy with Emphasis on the Coding of Convergent as a Strategy. Our patient, Mrs. Garcia, is admitted for an AFib ablation procedure. When abstracting the procedure, we find that Mrs. Garcia had a minimally invasive epicardial access ablation one month ago and is back for a catheter-based endocardial ablation. The documentation states both ablation procedures are part of a hybrid convergent procedure. Her past medical history includes endocardial ablation 5 years ago in which the cryoablation strategy was used, long-standing persistent atrial fibrillation, TIA times 2, hypertension, and high cholesterol. It is documented that current endocardial ablation was successful and pulmonary vein isolation was used as the strategy. Based on the documentation found, how will current ablation strategy, sequence 7135, be coded? Will it be coded as number 1, cryoablation, number 2, pulmonary vein isolation or PVI, number 3, convergent, or number 4, convergent and PVI? Please review the documentation and question to determine the best answer. We will give you a few seconds to review. The answer is number 4, convergent and pulmonary vein isolation. Based on the documentation from the provider, both the epicardial access ablation and the current PVI procedure were part of a convergent procedure. Convergent procedure is a combination of minimally invasive surgical treatment with catheter ablation to provide best results. The HEART team includes a cardiac electrophysiologist and a cardiothoracic surgeon who together perform ablation from inside and outside the heart. The procedure can be performed during the same procedure, but it can also be performed during different admissions or procedures. Because the AFib ablation registry only includes catheter-based endocardial ablations, if the endocardial ablation is not performed during the same procedure, the registry will capture convergent as one of the strategies being used when the endocardial ablation takes place. For example, if the patient is admitted and only has the surgical or epicardial part of the convergent procedure, the episode of care or procedure will not be included in the registry, as the registry does not include surgical or epicardial access procedures. When the patient is brought back for the endocardial ablation, the procedure will be included in the registry and convergent will be coded as one of the current strategies in sequence 7135 in order to capture the endocardial ablation being part of the convergent procedure. In the case of both epicardial access and endocardial ablations happening during the same procedure, the procedure will be included in the registry as a catheter-based endocardial ablation took place. The endocardial ablation will also be coded in sequence 7135. Thank you for viewing the AFib Ablation Registry Monthly Case Scenario for August of 2021.

AFib Ablation Registry

Monthly Case Scenario

Mrs. Garcia

minimally invasive epicardial access ablation

convergent procedure