1222 - Sequence # 13765 | 12 Lead Electrocardiogram Findings-1222 - Sequence # 13765

Video Transcription

Welcome to the STS-ACC-TVT Registry Case Scenario for December of 2022. This month, we will focus on coding sequence number 13765, 12-lead electrocardiogram findings.  An 82-year-old patient with severe aortic stenosis presented for an elective TAVR. A TAVR valve was successfully deployed and temporary wire was removed.  Hemostasis was achieved in both the groins and the patient was transferred to the ICU. The patient went into complete heart block with a heart rate in the 30s the next day.  The patient was brought back to the cath lab and a permanent pacemaker was implanted. The patient was V-paced on ECG and discharged home two days later.  The question is, how is sequence number 13765, 12-lead electrocardiogram findings coded? Number one, cardiac arrhythmia.  The patient has a new onset of an atrial or ventricular arrhythmia requiring medication or other therapy, and this includes brady or tachyarrhythmias.  Number two, no significant changes. Number three, pathological Q-wave. Or number four, new left bundle branch block.  Please take a few moments to review the documentation and the question prior to making your final selection. And the answer is number one, cardiac arrhythmia.  Cardiac arrhythmia would be coded as the patient has a new onset of an atrial or ventricular arrhythmia with their complete heart block as it required medication or other therapy,  in this case, a permanent pacemaker. Of note, this includes both brady or tachyarrhythmias. But a follow-up question, if the patient is V-paced, why code a cardiac arrhythmia?  Sequence number 13765, 12-lead ECG findings, holds a target value of any occurrence between end of the procedure and discharge.  The end of the procedure is the time coded in sequence number 7005, procedure end, date, and time.  The ECG with a complete heart block on the day after the TAVR procedure would be coded as cardiac arrhythmia as the patient has a new onset of an atrial or ventricular arrhythmia,  the complete heart block, requiring medication or other therapy, which is the pacemaker placement. Thank you for viewing the December 2022 STS ACC TVT registry case scenario.  We'll see you next month.

Video Summary

In this video, the focus is on coding sequence number 13765, which pertains to the 12-lead electrocardiogram findings of an 82-year-old patient with severe aortic stenosis undergoing a TAVR procedure. After the successful deployment of a TAVR valve and removal of the temporary wire, the patient experienced complete heart block with a heart rate in the 30s the following day. The patient was taken back to the cath lab and a permanent pacemaker was implanted. The correct code for the 12-lead ECG findings is cardiac arrhythmia as it involves a new onset of an atrial or ventricular arrhythmia requiring medication or therapy, in this case, a pacemaker.

Keywords

coding sequence number 13765

12-lead electrocardiogram findings

severe aortic stenosis

TAVR procedure

permanent pacemaker