Thank you for reviewing the AFib Ablation Registry Monthly Case Scenario for December 2020. This month's case scenario is focused on Sequence 9185, Hematoma at Access Site, from the Intra or Post-Procedure Events section. Mr. Simpson was admitted to the hospital for an AFib ablation procedure and goes on to have a successful procedure. The morning after the procedure, Mr. Simpson calls the nurse with complaints of lower abdominal pain. Upon assessment, a large hematoma is seen on the right groin access site used for the ablation procedure and his blood pressure is on the lower side at 98 over 60. Manual pressure is immediately applied and a normal saline bolus is started. The electrophysiologist is made aware and an order for a FemStop device is received. The device is to be applied following manual pressure. A Stat H&H is also ordered. After receiving the results, it is noted that Mr. Simpson's hemoglobin has dropped by 3 grams per deciliter and one unit of packed red blood cells is ordered. Based on the documentation of Mr. Simpson's post-procedure hematoma event, would we code hematoma at access site as an intra or post-procedure event in Sequence 9185, 1, Yes, or 2, No? Please review the documentation and question to determine the best answer. We will give you a few seconds to review. The answer is number one, yes. For the purpose of the AFib ablation registry, this event will be coded as a hematoma at access site as it meets two of the criteria necessary to be coded by having a hemoglobin drop of at least 3 grams per deciliter and requiring a transfusion. The AFib ablation registry has aligned with the LAAO registry and its definition and criteria in the coding of a hematoma at access site. The patient experienced a hematoma at the access or percutaneous entry site. To qualify, the bleeding should be associated with any of the following documented in the medical record. 1. Hemoglobin drop of greater or equal to 3 grams per deciliter. 2. Transfusion of whole blood or packed red blood cells. 3. Procedural intervention or surgery at the site to correct the hematoma. Medical or mechanical pressure will not be classified as procedural intervention at the site to correct the hematoma. The Data Dictionary document will be updated to show this change during the next document update. Thank you for reviewing the AFib ablation registry monthly case scenario for December 2020.

AFib Ablation Registry

case scenario

AFib ablation procedure

hematoma

access site