0920 - Sequence # 5200 | Stress Test Performed-0920 - Sequence # 5200

Video Transcription

Welcome to the CAHPS PCI Registry Case Scenario for September 2020. This case scenario will review Sequence 5200, Stress Test Performed.  This scenario involves a 56-year-old male with a history of angina and CAD who presents to his primary care provider with complaints of worsening chest pain and shortness of breath  for the past month. His provider performs a stress echo, which is positive, with high risk of ischemia.  Given these results, along with the patient's worsening angina, the patient is scheduled for an urgent diagnostic coronary angiography procedure that day, which reveals two-vessel  disease. The cardiologist performs an urgent PCI to the mid-RCA in the same cath lab visit. The patient is then discharged and scheduled to return the following week for a staged  PCI to the left circumflex. He has no signs or symptoms of ischemia leading up to the second cath lab visit and undergoes a successful elective PCI.  How is Sequence 5200, Stress Test Performed, coded for the second cath lab visit? No or yes? Here is the information and question for your review.  The answer is number 2, yes. In this specific scenario, the coding instructions and target value are both met for the second cath lab visit.  To clarify, in the target value of Sequence 5200, the term next procedure is very specific. It refers to a PCI procedure which was performed in the same episode of care.  Since this patient was discharged after his first PCI, he now presents from home, therefore the target value becomes the last value between birth and current procedure.  Now let's look at how coding of this scenario is reflected in metric 2, PCI procedures with positive stress or imaging study.  In the first episode of care, the patient had an urgent diagnostic coronary angiography and PCI procedure.  Therefore, the patient is excluded from the denominator. In the second episode of care, the patient had a staged PCI, coded as such in Sequence  7820 and 7821, PCI for multivessal disease, and PCI procedure type. Therefore, the procedure is excluded from the denominator.  Thank you for viewing the Cath PCI Registry Monthly Case Scenario for September 2020.

Video Summary

This video discusses a case scenario involving a 56-year-old male with angina and CAD. The patient presents to his provider with worsening symptoms and undergoes a stress echo, which indicates a high risk of ischemia. He then has an urgent diagnostic coronary angiography and PCI procedure, followed by a staged PCI to another vessel in a later visit. The question is whether Sequence 5200, Stress Test Performed, should be coded for the second cath lab visit, and the answer is yes. The video explains that the coding instructions and target value are both met for the second visit. The patient is excluded from the denominator for metric 2, which relates to PCI procedures with positive stress or imaging studies.

Keywords

56-year-old male

angina

CAD

chest pain

shortness of breath

stress echo

PCI procedure

diagnostic coronary angiography