Thank you for reviewing the AFib Ablation Registry Monthly Case Scenario for November of 2022. This case scenario will be focused on coding HASP-led drugs in sequence 4110 and 4115. Here we have documentation of Mrs. Smith being admitted for an AFib ablation procedure. Mrs. Smith's documented past medical history includes longstanding persistent AFib, ischemic stroke, and uncontrolled hypertension. Mrs. Smith's daily medication regimen includes metoprolol, amiodarone, aspirin, and topical diclofenac sodium gel for osteoarthritis pain. When capturing the patient's HASP-led risk score based on the documentation provided and the patient's medication regimen, how will aspirin, 162 milligrams daily, be coded? Under one, sequence 4110 antiplatelet, or under two, sequence 4115 NSAIDs? Please take a few moments to review the documentation and the question to determine the best answer. The answer is number one, sequence 4110 antiplatelet. Based on the HASP-led definition in the data dictionary, sequence 4110 is coded if the patient is taking aspirin, 325 milligrams. However, after additional discussions within registry team and the steering committee, the registry has updated coding instructions of HASP-led medication elements when coding aspirin. After multiple discussions, the registry team agreed that any dosage of aspirin should be coded as antiplatelet in sequence 4110, HASP-led antiplatelet. The target value for this sequence is any occurrence between 30 days prior to the procedure, meaning the documentation used to code this data element must be within 30 days prior to the start of the procedure. Based on the documentation of the patient's daily medication regimen, including aspirin, 3262 milligrams, sequence 4110 will be coded yes. Our bonus question will be using the same documentation. Our question is, will the diclofenac gel, which is a nonsteroidal antiinflammatory medication, be coded as an NSAID in sequence 4115? Number one, yes, or number two, no. The answer is number two, no. Even though an NSAID medication that is part of the patient's daily regimen is documented, an NSAID that is topically applied will not be coded in sequence 4115. That is because a topical NSAID is intended for local treatment and will have minimal impact on the patients systematically. Sequence 4115 will be coded with traditional NSAIDs like ibuprofen, naproxen, Celebrex, or diclofenac that are not administered topically. These HASPLID data elements can be coded with these options. First, a provider-documented HASPLID assessment with antiplatelet or NSAID use documented as a condition. If the provider did not document their own HASPLID assessment, we would use number two. Any documented medication list that includes either an antiplatelet or NSAID being taken as part of the patient's daily regimen within the target value. One important reminder, antiplatelets or NSAIDs that are taken as PRN or a one-time order will not be included in the coding of these data elements. Thank you for reviewing the AFib Ablation Registry Monthly Case Scenario for November of 2022.

AFib Ablation Registry

coding HASP-led drugs

sequences 4110 and 4115

Mrs. Smith case scenario

aspirin and diclofenac gel coding