1122 - Coding Multiple Procedures Under the Same Episode of Care-1122 - Coding Multiple Procedures Under the Same Episode of Care

Video Transcription

Welcome to the STS-ACC TVT Registry November 2022 case scenario. This month, we will focus on coding multiple procedures under the same episode of care.  A 79-year-old patient with severe aortic stenosis presented for an elective TAVR. During induction of anesthesia, patient went into respiratory arrest resulting in intubation  and CPR. The procedure was aborted and the patient was transferred to ICU for stabilization.  Two days later, the patient was brought back to the cath lab and a TAVR procedure was performed successfully on the second attempt. The patient was discharged home two days later.  The question, is the second attempt of the TAVR procedure added as a new episode of care? Number one, no. Or number two, yes.  Please take a few moments to review the documentation and the question prior to making your final  selection. And the answer is number one, no. When more than one procedure occurs during the same episode of care, however, on different  days, the user will apply, add a lab visit located under the lab visit tab in version three.  To further explain, the first TAVR procedure is entered into the data collection tool for the first lab visit and coded as aborted.  Lab visit number two is added and entered into the data collection tool as a non-aborted TAVR. Both lab visits are entered in the same base episode of care.  Our second bonus question, given the same scenario, what would happen if two episodes of care are entered instead of two lab visits? And how would one resolve it?  An error message is generated when a second episode of care is added while the patient is still admitted in the hospital for the first episode of care.  It is not logical for a patient to have overlapping episodes of care. To demonstrate, here we have two overlapping episodes of care.  When this happens, errors will generate and cause system alerts. In scenarios where two lab visits occur during an episode of care, the user will need to  delete one episode of care from the data collection tool and re-enter all that procedural information  into the remaining episode of care using the edit button and add that lab visit and rerun the quality check and submit the data to the DQR.  Thank you for viewing the November 2022 STS-ACC TVT registry case scenario. We'll see you next month.

Video Summary

In this video, the STS-ACC TVT Registry presents a case scenario involving a 79-year-old patient with severe aortic stenosis. The patient initially underwent an elective TAVR procedure but experienced complications, leading to the procedure being aborted and the patient being transferred to the ICU. Two days later, a second attempt at the TAVR procedure was successful, and the patient was discharged two days after that. The video addresses the question of whether the second attempt should be considered a new episode of care, to which the answer is no. If multiple procedures occur during the same episode of care on different days, a lab visit should be added under the lab visit tab in version three of the data collection tool. The video also explains that entering two episodes of care for overlapping lab visits will generate errors and alerts, and suggests deleting one episode of care and re-entering all relevant information into the remaining episode of care. No credits were mentioned in the transcript.

Keywords

STS-ACC TVT Registry

case scenario

aortic stenosis

TAVR procedure

complications