Hello, everyone, and welcome back to our bi-monthly case scenario for the LAAO Registry. For this month, we are taking a break from our CHADS-VASc series to focus on coding a patient death when it occurs in the follow-up timeframe. In this scenario, an 83-year-old female patient had a successful Watchman FLX inserted in June of 2022. The patient had a long history of non-valvular atrial fibrillation with multiple electrical and chemical cardioversions, CAD, and had placement of a proximal LAD stent. The patient had both a 45-day follow-up on day 51 post-procedure and a six-month follow-up completed on day 180 without incident. When the site was unable to contact the patient in the one-year follow-up timeframe, an obituary search was done that showed a date of death for the patient of March 3, 2023. Since the patient died within the six-month follow-up interval, which is 92 to 256 days post-procedure, and the patient already had a six-month follow-up completed, what timeframe would this follow-up be entered for? Number one, additional six-month follow-up, or number two, one-year follow-up? Please take a moment to review the documentation and question before making a final answer. The answer is number two, the one-year follow-up. For the purpose of the LAAO registry, when the patient dies in the six-month follow-up allowable timeframe, 92 to 256 days post-procedure, and the six-month follow-up has already been completed, the patient death would be entered in the one-year follow-up. Bonus question number one, we will use the same documentation, but this time we will look at sequence 11,000 for a date to be entered into the follow-up assessment date. In this scenario, the patient was unable to be contacted in the one-year follow-up timeframe, but an obituary was found to identify that the patient died on March 3rd, 2023, which was on day 251 post-procedure. In our previous scenario, it was noted that only one follow-up may be entered per timeframe. Keeping that in mind, the answer is four, both two and three. March 9th is the first available date of the one-year follow-up timeframe, so that date may be selected. The assessment date may also be entered for any date in the one-year follow-up. For our second bonus question, we will keep the information that our patient is an 83-year-old female who had a 45-day and a six-month follow-up. In this scenario, the patient failed to show up for the one-year follow-up. The physician was contacted and the site discovered the patient had died on day 255 post-procedure. It was discovered that there was a TTE and blood work completed prior to the patient death that was done after the six-month follow-up was completed and done specifically for the one-year follow-up. Our question is, if the patient had a TTE and lab work in the one-year follow-up timeframe with no actual one-year follow-up visit, are we supposed to include that information, TTE and lab work, regardless? And the answer is yes. If any information or assessments performed prior to the patient's death are known or documented, it is encouraged to capture them. When coding a patient death and follow-up, if no information is known about follow-up medications or follow-up events, you may leave follow-up medications sequence 11990 blank. Or you may use the Set to Know tab on the upper right corner of the page to code all follow-up medications as no. When the cause of death is unknown and clarification with the physician is unavailable, sequence number 11007, cause of death, would be left blank. This data element carries an 80% supporting threshold to pass the DQR. Please be aware that this is a change from version 1.3, where cause of death had a 90% core threshold. We thank you for taking the time to review our latest case scenario. We will continue with the series on CHADS-VASc elements in October.

coding

sequence number 4015

CHADS-VASC series

left ventricular dysfunction

LVEF value