This is the CAHPS PCI Registry case scenario for December 2020. We will discuss adjunctive measurements performed. A 70-year-old male with aortic regurgitation presents to your facility with complaints of typical angina for the past three months, which is relieved with sublingual nitroglycerin. Prior to having TAVR, a diagnostic coronary angiography is performed for stable angina and suspected CAD. The physician notes a 60% stenosis in the proximal RCA. FFR is performed, which is 0.79. After the cath lab visit, the physician reviews treatment options with the patient, including treating medically versus undergoing PCI. The patient states he would prefer having PCI. The next day, an elective PCI to the proximal RCA is performed for stable known CAD, along with TAVR. How, if at all, is FFR performed in the first cath lab visit captured? Number one, code yes to sequence 7065, concomitant procedures performed, and procedure type not listed in sequence 7066. Number two, code yes to sequence 7511, adjunctive measurements performed, and 0.79 in sequence 7512, native vessel FFR. Number three, both one and two. Here is your documentation and question for review. The answer is number two. Code yes to sequence 7511, adjunctive measurements performed, and 0.79 in sequence 7512, native vessel FFR. An invasive measurement was obtained of the native vessel segment having greater than or equal to 50% stenosis and was performed prior to intervention. To clarify, when coding instructions and target value are met, the adjunctive measurement may be captured even when intervention is not performed. Adjunctive measurements are not considered concomitant procedures for the purposes of the registry. They are only captured in sequence 7511 when all coding parameters are met. How, if at all, is FFR captured in the second cath lab visit? Number one, code yes to sequence 7511, adjunctive measurements performed, and 0.79 in sequence 7512, native vessel FFR, or two cannot be captured. Here is your documentation and question for review. The answer is number one. Code yes to sequence 7511, adjunctive measurements performed, and 0.79 in sequence 7512, native vessel FFR. The registry has added notes to the coding instructions for sequence 7511, which allow for capturing an adjunctive measurement when it was obtained in the current episode of care during a diagnostic-only procedure and is the rationale for PCI. This information is found in the V5 Data Dictionary Supplement with pending Data Element Updates, page 22. Looking at how this scenario will be reflected in metric 2, PCI procedures with positive stress or imaging study, this PCI procedure will be included in the denominator as it was an elective PCI procedure and there are no denominator exclusions. Then the patient will also be included in the numerator since FFR was performed within six months and was less than or equal to 0.8. Thank you for viewing the CAHPS PCI Registry Monthly Case Scenario for December 2020.

aortic regurgitation

angina

coronary angiography

FFR

PCI