Welcome to the STS-ACC TVT Registry November Case Scenario for Version 3. This month, we will cover Sequence Number 9002, Intra-Post-Procedure Events Occurred, Bleeding Hematoma at Access Site. A 60-year-old female presented for an elective TAVR procedure. After successful valve delivery, her right femoral valve delivery site received a perclose closure device. The following day, the patient voiced no complaints. Her groin checks demonstrated a quarter-sized hematoma. Her hemoglobin dropped 1.4 grams per deciliter, and she was discharged home later that day. How would Sequence Number 9002, Intra-Post-Procedure Events Occurred, be coded for Bleeding Hematoma at Access Site? Number one, no, or number two, yes. Please take a few moments to review the documentation and the question prior to making a final selection. And the answer is number one, no. Sequence Number 9002, Intra-Post-Procedure Events Occurred, would be coded as no for Bleeding Hematoma at Access Site. While the patient experienced a confirmed hematoma at the access site observed and documented in the medical record, it was not associated with any of the following, a hemoglobin drop of greater than or equal to 3 grams per deciliter, transfusion of whole blood or packed red blood cells, or a procedural intervention or surgery at the bleeding site to reverse, stop, or correct the bleeding, such as surgical closures, exploration of the arteriotomy site, balloon angioplasty to seal an arterial tear, endoscopy with cartery of a GI bleed. A bonus question, how would Sequence Number 9002, Intra-Post-Procedure Events Occurred, be coded for Vascular Complication, Minor? Would it be number one, no, or number two, yes? Please take a few moments to review the documentation and the question prior to making a final selection. And the answer is number two, yes. Sequence Number 9002, Intra-Post-Procedure Events Occurred, would be coded as yes for Vascular Complication, Minor. Per the data definition, Vascular Complication, Minor is coded anytime there is an access site or access-related vascular injury, in this case, hematoma, not leading to death, life-threatening or major bleeding, visceral ischemia, or neurological impairment. See Criteria Number 1. A little hesitant about coding the quarter-sized hematoma as Minor Vascular Complication? I see you giving me that side eye. Well, it's validated via VARC2, which we will review next. The Minor Vascular Complication definition came directly from the updated standardized endpoint definitions for transcatheter aortic valve implantation, also known as VARC2, NJACC. Table 7 lists VARC2 definitions for major and minor vascular complications. As you can see, the exact same definition is used and reported. Thank you for viewing the November 2021 STS ACC TVT Registry Case Scenario. We'll see you next month.

STS-ACC TVT Registry

Sequence Number 9002

TAVR procedure

hematoma

coding