Thank you for viewing this CAF PCI Registry Case Scenario for December of 2022. In this scenario, we will cover Section H, Coronary Anatomy, and Section J, Lesions and Devices. A 68-year-old male was admitted with STEMI. During the first CAF Lab visit, the patient received a stent to the proximal LAD with a noted 0% residual stenosis. Additionally, there was an 80-90% stenosis noted in the mid-left circumflex. However, it was decided to bring the patient back for a subsequent PCI procedure. During the second PCI procedure, while the patient did receive PCI of the mid-left circumflex, he also received PCI again on the proximal LAD for a distal edge dissection, noted during angiography that was causing about a 30% obstruction. Our question is, how is sequence number 7507, native vessel with stenosis greater than or equal to 50%, coded for the second procedure? Number one, no. Or number two, yes. Please take a few moments to review the documentation prior to making a final selection. The answer is number two, yes. Sequence 7505, native vessel with stenosis greater than or equal to 50%, captures any native vessel with a lesion greater than or equal to 50% between six months prior to the current procedure and the current procedure. In this scenario, the patient had an 80% to 90% stenosis of the mid-left circumflex on the current procedure, meeting the coding instructions. How many segments are added to the counter for sequence number 7507 for the second procedure? Is it two, both the proximal LAD and mid-left circumflex, since both received PCI? Or is it one, the mid-left circumflex, since it had disease of 80% to 90%? Or is it none, since neither had new disease worse than 50%? Please take a few moments to review the documentation prior to making a final selection. And the answer is number two. Only the one segment, the mid-left circumflex, as it had disease of 80% to 90% is selected. Sequence 7507 captures the native lesion segment with 50% or greater stenosis between six months prior to the current procedure and the current procedure. In this scenario, while the patient received PCI, only the one segment, the mid-left circumflex, as it had disease of 80% to 90% is selected. While the patient received PCI to the proximal LAD, the obstruction caused by the edge dissection was documented at 30%. And so this is how section H, coronary anatomy, would be coded in the data collection tool for the second procedure. Our follow-up question. Would we capture the proximal LAD in sequence 8000, lesion counter, for the second procedure? Number one, yes. Or number two, no. Please take a few moments to review the documentation prior to making your final selection. The answer is number one, yes. This section of the data set is designed to capture all segments within the coronary vessels which had mechanical intervention. In this way, the registry and your facility will have the data needed to review unintended consequences, such as perforation, significant dissection, plaque shift, etc. or major adverse events, such as intra- or post-procedure MI, bleeding, or death. The section is not dependent on what was coded in section H, coronary anatomy. And shown here is a look at how section J, lesions and devices, would be coded in the data collection tool for the second procedure. Thank you for viewing this CAF PCI registry case scenario.

CAF PCI Registry

coronary anatomy

lesions

devices

STEMI