0823 - Sequence # 7010 | PPM Pacemaker to CRT-D-0823 - Sequence # 7010

Video Transcription

Welcome, and thank you for taking the time to review the August case scenario for the EP device implant registry regarding sequence number 7010 procedure type for procedures  involving a dual-chamber pacemaker upgrade to CRTD. In this scenario, a 65-year-old male with a past medical history of sick sinus syndrome  and a dual-chamber permanent pacemaker that is nearing the end of battery life was admitted with shortness of breath, lower extremity swelling, and a New York Heart Association  functional class of two. Further evaluation, including an angiogram, revealed normal coronary arteries and an ejection fraction of 30%.  He was diagnosed with non-ischemic cardiomyopathy. After the evaluation, guideline-directed medical therapy was initiated, and a CRTD is recommended.  A shared decision-making conversation occurred, and the patient and provider together decided the best option was to upgrade the permanent pacemaker to a CRTD device.  Our question is, how is sequence number 7010 procedure type coded? Number one, initial generator implant. Number two, generator change. Number three, generator explant.  Or number four, the procedure is not captured.  Please take a moment to review the documentation, questions, selections, and choose your response. And the answer is initial generator implant.  Only the leads associated with the CRTD are abstracted. Leads that were associated with permanent pacemaker only are not captured.  Based on the coding guidance located under Resources and Documents, this procedure is captured as initial generator implant.  Please access the document, Coding Guide for Procedure Type and Lead Capture, located within the Resources link, by selecting Documents.  This document is useful in determining how sequence 7010 procedure type is coded and the appropriate leads that are captured in sequence number 7710 lead counter for all  possible scenarios. Thank you for viewing the August case scenario regarding sequence number 7010 procedure type permanent pacemaker to CRTD.

Video Summary

The video discusses two case scenarios related to the EP Device Implant Registry. In the first scenario, a 67-year-old Chinese woman with a history of prior MI and persistent AFib received a dual-chamber permanent pacemaker implant. She was later admitted with a left bundle lead dislodgement, which was extracted and replaced with an RV lead. The proper coding for this procedure is identified as "lead only," as the RV lead is not associated with a novel permanent pacemaker. In the second scenario, the same woman underwent a pacemaker generator replacement and HIS bundle lead implant. The correct coding for this procedure is "generator change" since a novel pacemaker was implanted. The video concludes by thanking viewers for watching the case scenarios.

Keywords

EP Device Implant Registry

case scenarios

dual-chamber permanent pacemaker implant

lead dislodgement

RV lead