Hello and welcome to our case scenario for the month of December 2023. This month we'll be discussing the coding of transeptal catheterization in sequence number 7175. In this scenario our patient Mrs. Roberts is admitted for an ablation procedure. Mrs. Roberts has a documented history that includes persistent a-fib, hypertension, a TIA, diabetes, and high cholesterol. During the current procedure a successful transeptal puncture using a BRK needle and an SL2 sheath is documented. During the procedure the same transeptal puncture was used to cross a second wire and sheath into the left atrium. Our question is this, based on the documentation that the only transeptal puncture made during the procedure was used to cross two wires and two sheaths into the left atrium, how will sequence number 7175 transeptal catheterization be coded? One, single, or two, double? Please take a moment to review the documentation in question before making a final answer. The answer is number two, double. Based on the sequence definition, double will be coded when the single puncture is double-wired or if a second transeptal puncture is performed. In this case, based on the documentation provided, the single puncture made was double-wired. Therefore, sequence number 7175 will be coded as double. Single transeptal catheterization will be coded when the same puncture is single-wired and all exchanges go through the same wire, meaning there is only one wire across the septum at a time. We thank you for taking the time to review our latest case scenario.

AFib Ablation Registry

Chad's Vasc Stroke

ablation procedure

coding instructions

monthly case scenario

transeptal catheterization

sequence number 7175

BRK needle

SL2 sheath