Thank you for reviewing the AFib ablation registry case scenario for August of 2023. This case scenario will focus on inclusion of aborted procedures. In this scenario, Ms. Sloan's ablation procedure is being abstracted into the registry. Ms. Sloan's documented past medical history includes symptomatic paroxysmal atrial fibrillation for which she is on a daily antiarrhythmic, high cholesterol, obesity, and hypertension. Documentation of Ms. Sloan's procedure indicates that during transeptal puncture, Ms. Sloan became hypotensive. While assessing the cause of the hypotension, a pericardial effusion was noted, which required a pericardiocentesis. The ablation procedure was then aborted, and Ms. Sloan is transferred to an ICU for close monitoring. Based on the documentation, and since the procedure was aborted after the procedure start time, which for the purpose of the AFib ablation registry, procedure start time is the time of skin incision, vascular access, or its equivalent, will this procedure be included in the registry? Number one, no, or number two, yes. Please review the documentation and the question to determine the best answer. We will provide a few seconds to review. The answer is number one, no. Based on the instruction from the steering committee, if an AFib ablation procedure is aborted or canceled prior to any attempt at utilizing an ablation strategy, the procedure will not be included in the AFib ablation registry. Even if the procedure had technically started based on the procedure start time coding instruction, inclusion of the procedure will be determined based on an attempt of ablation taking place. In this case, an attempt of ablation had not yet taken place, therefore, the procedure will not be included. In our second scenario, documentation of Ms. Sloan's procedure indicates that during pulmonary vein isolation of the left upper pulmonary vein, Ms. Sloan became hypotensive. While assessing the cause of the hypotension, a pericardial effusion was noted, which required a pericardiocentesis. The ablation procedure was then aborted, and Ms. Sloan was transferred to an ICU for close monitoring. Based on the documentation, and since the procedure was aborted after an ablation attempt had taken place, will this procedure be included in the registry? Number one, no. Or number two, yes. And the answer is number two, yes. Based on the instruction from the steering committee, if an AFib ablation procedure is aborted or canceled prior to any attempt at utilizing an ablation strategy takes place, the procedure will not be included in the AFib ablation registry. If the procedure was aborted after an ablation was attempted, the procedure will be captured. In this case, an attempt of ablation had already taken place, therefore, the procedure meets inclusion criteria. Because the registry does not have a procedure-aborted element to capture if the procedure is aborted, the abstractor will enter the procedure information to the time of the procedure being aborted. Using the documentation from the last scenario, we would code PVI as the ablation strategy. The rest of the procedure will be coded based on the documentation. If any events took place causing the procedure to be aborted, they will be coded under intra and post-procedure events. In this case, we had documentation of a pericardial effusion requiring a pericardiocentesis, which will be captured by coding yes to sequence 9065, pericardial effusion requiring intervention. Thank you for reviewing the AFib ablation registry monthly case scenario for August of 2023.

AFib Ablation Registry

June 2023

Chad's Vasc Stroke

coding instructions

Mr. Pitt