Thank you for viewing the AFib Ablation Registry Monthly Case Scenario for September of 2022. This case scenario will focus on the coding of haspled labial INR found in sequence 4100. 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's no physician documentation found of the patient having a history or diagnosis of labial INR in the pre-procedure documentation. Based on the patient's documented history, how will haspled labial INR sequence 4100 be coded? Number one, no, or number two, yes. Please take a few moments to review the documentation in question to determine the best answer. How will sequence number 4100 haspled labial INR be coded? The answer is yes, because based on the INR values, 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 the 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 is no patient lab work to reflect an INR drawn in the last 30 days, but the physician has documented a history of labial INRs in the past. How is sequence number 4100 coded? Please code yes to sequence number 4100 if the HNP in which a history of having been diagnosed with having labial INR results was written within 30 days prior to the procedure. For our bonus question number two, when reviewing documentation, the provider documented their own haspled assessment of the patient and included labial INR results as a condition to award a point to the risk score. Is sequence 4100 coded as yes? And the answer is yes. When the provider documents their own haspled assessment of the patient and includes the condition of labial INRs into their haspled risk score assessment, labial INR can be coded as yes automatically. Just to recap, these are the options we have for coding this element. Our first option is a provider documented haspled assessment in which labial 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 haspled assessment, we then must rely on the documented history of the patient. We can use documentation of the patient having a history or being diagnosed with labial 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 reviewing the AFib Ablation Registry Monthly Case Scenario for September of 2022.

coding

labial INR values

non-valvular paroxysmal atrial fibrillation

therapeutic range

haspled risk score assessment