Thank you for joining us for the September 2022 case scenario for the LAAO Registry. In continuing our series on the Haas blood data elements, this month we focus on sequence number 4100, Haas blood labile INR. In this scenario, a patient presents with a history of non-valvular paroxysmal atrial fibrillation for the last two years. In the last 30 days, the patient has had three INRs drawn, which show 1.8 seconds, 1.6 seconds, and 2.4 seconds. There is no physician documentation found on the patient having a history or a diagnosis of labile INR in the pre-procedure documentation. Given the INRs that have been reported in the last 30 days, how would sequence number 4100 be coded? Is it number one, no, or number two, yes? Please take a few moments to review the documentation and the question to determine the best answer. How will sequence number 4100 Haas blood labile INR be coded? The answer is yes, because based on the INR value, less than 60% were in the therapeutic range of two to three seconds within the target value of any occurrence between 30 days prior to the procedure and the procedure. In this case, we have only one out of three values within the two to three second range. That gives us approximately 33% of the values being in the therapeutic range, which is less than 60%. For our bonus question number one, there's no patient lab work to reflect an INR drawn in the last 30 days, but the physician has documented a history of labile INRs in the past. How is sequence number 4100 coded? And the answer is, please code yes to sequence 4100 if the H and P in which a history of having been diagnosed with having labile INR results was written within 30 days prior to the procedure. And for our bonus question number two, when reviewing documentation, the provider documented their own Haas blood assessment of the patient and included labile INR results as a condition to award a point to the risk score. Can sequence number 4100 be coded as yes? And the answer, yes, when the provider documents their own Haas blood assessment of the patient and includes the condition of labile INRs into their Haas blood risk score assessment, labile INR can be coded as yes automatically. Now just to recap, these are the options we have for coding this element. Our first option is a provider documented Haas blood assessment in which labile INR values is included as a condition to award a point to the risk score. With this option, yes can be automatically coded. If the provider has not documented their own Haas blood assessment, we then must rely on the documented history of the patient. We can use documentation of the patient having a history of being diagnosed with labile INR values between 30 days prior to the procedure. Another option is using INR values that have been performed between 30 days of the procedure. When using this option, the criteria to code yes to the element is that less than 60% of the values must be within the therapeutic range of 2 to 3. Thank you for viewing the LAAO Registries Case Scenario for September of 2022. We'll see you next month for the next installment of our Haas blood series.

sequence number 4100

Haas blood labile INR

non-valvular paroxysmal atrial fibrillation

INR readings

therapeutic range