For the LAAO case scenario for December of 2022, we will be finishing out our HASPLED series and this month we will focus on HASPLED antiplatelets sequence number 4110 and HASPLED NSAIDs, sequence number 4115. In this case scenario, Mrs. Smith has been admitted for an LAAO procedure. Mrs. Smith's documented past medical history includes a five-year history of non-valvular persistent AFib, ischemic stroke, and uncontrolled hypertension. Mrs. Smith's daily medication regimen includes metoprolol, amiodarone, aspirin 162 milligrams, and topical diclofenac sodium gel for osteoarthritis pain. When capturing the patient's HASPLED risk score based on the documentation provided and the patient's medication regimen, how will aspirin 160 milligrams daily be coded? Under one, sequence number 4110 antiplatelet or under two, sequence number 4115 NSAIDs. Please take a few moments to review the documentation in question to determine the best answer. And the answer is number one, sequence number 4110 antiplatelet. Based on the HASPLED definition in the data dictionary, sequence number 4110 is coded if the patient is taking aspirin 325 milligrams. However, after additional discussions within the registry team and the steering committee, the registry has updated coding instructions of HASPLED 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 HASPLED antiplatelet. The target value for this sequence is any occurrence between 30 days prior to the procedure, meaning the documentation used to code this 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 162 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 number 4115? Is it 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 patient systematically. Sequence 4115 will be coded with traditional NSAIDs like ibuprofen, naproxen, Celebrex, or diclofenac that are not administered topically. These HASPLED elements can be coded with the following options. A provider-documented HASPLED assessment with antiplatelet or NSAID use documented as a condition. Now, if the provider did not document their own HASPLED 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 elements. Thank you for viewing the LAAO Registries case scenario for December 2022 on HASPLED drugs. We'll see you next year for our next case scenario.

LAAO case scenario

HASPLED antiplatelets sequence number 4110

HASPLED NSAIDs sequence number 4115

Mrs. Smith

medication regimen