This is the IMPACT Registry August 2024 case scenario where we will review Section N Intra Post-Procedure Events. A four-month-old female with a history of hypoplastic left heart syndrome, status post Norwood procedure presents to the cath lab for a right and left heart cath, angiography and balloon angioplasty of the aorta in preparation of her Stage 2 procedure. During the procedure and prior to balloon angioplasty of the aorta, patient experiences sudden bradycardia with a heart rate of 40 beats per minute and receives chest compressions for less than 10 seconds. During this time, no heart block is noted. No further interventions are required as the patient's heart rate returns to normal. While in recovery, vital signs are heart rate 120, blood pressure 108 over 52, respiratory rate 40, and non-labored. However, it is noted that oxygen saturations have decreased to 80%, and she has started on continuous oxygen by blow-by and saturations improved to 90%. There are no further episodes of bradycardia or desaturations, and she is discharged the following day. Our question, how is sequence number 8,000 cardiac arrest, sequence 8,005 arrhythmia, and sequence 8,075 airway event requiring escalation of care coded in the given scenario? Number one, code no to all data elements. Number two, code yes to all data elements. Number three, code yes to cardiac arrest and airway event requiring escalation of care and code no to arrhythmia. Or number four, code yes to airway event requiring escalation of care and no to cardiac arrest and arrhythmia. Please take a moment to review the documentation and select the best answer. And the answer is number one, code no to all data elements in the given scenario. The coding instructions and supporting definitions are not met. The supporting definition for cardiac arrest provides there is the sudden cessation of cardiac activity, no normal breathing, and no signs of circulation. In the given scenario, our patient experiences a bradycardic episode with a heart rate decreasing to 40 beats per minute requiring CPR. There is a parent-child relationship when capturing arrhythmias. Arrhythmia, the parent, is captured when the arrhythmia requires an intervention, such as an antiarrhythmic medication, cardioversion, temporary pacemake, or a permanent pacemaker, which are all child data fields. When the arrhythmia spontaneously resolves, then the parent coding instructions are not met. Please note in the data dictionary full specifications, arrhythmia spontaneously resolved is obsolete. An airway event can include episodes of apnea, hypoxia, or obstruction requiring escalation of care. For the purposes of the registry, escalation of care would include the use of CPAP, BiPAP, laryngeal mask airway, intubation, tracheostomy, et cetera. Thank you for viewing the IMPACT Registry Case Scenario for August 2024, Section N, Intra- and Post-Procedure Events.

transcatheter pulmonary valve replacement

complications

arrhythmia

covered stent

registry

IMPACT Registry

Section N

intra-procedure events

post-procedure events

cardiac history