Sequence 4250, VT date, sequence 4275, VT type, and sequence 4255, post-cardiac surgery within 40 hours, sequence 4260, bradycardia dependent, sequence 4265, reversible cause, and sequence 4270, hemodynamic instability, will all populate when a history of ventricular tachycardia is captured. These child fields are coded according to the recent and most significant ventricular tachycardia event. The hierarchy from least to most severe is as follows, non-sustained ventricular tachycardia to monomorphic ventricular tachycardia to polymorphic ventricular tachycardia to monomorphic and polymorphic ventricular tachycardia. If the patient has a history of ventricular tachycardia, the first thing the registry wants to know is the most recent date of the most significant episode. If only the year is known, then the abstractor may code 01-01 and insert that known year. If the specific year is not known, the year may be estimated based on timeframes found in prior documentation. For example, if the patient had most recent ventricular tachycardia documented in a record from 2011, 2011 can be utilized and coded as 01-01-2011. When the patient has a history of ventricular tachycardia and a timeframe is unavailable and clarification with the clinician unobtainable, then please code the ventricular tachycardia as having occurred five years ago. Sequence 4275, Ventricular Tachycardia Type, is coded according to the most recent and most significant ventricular tachycardia event. The hierarchy from least to most severe is as follows, non-sustained ventricular tachycardia to monomorphic ventricular tachycardia to polymorphic ventricular tachycardia to the most severe of monomorphic and polymorphic ventricular tachycardia. When there is documentation that doesn't neatly fit into one of the selections, the notes provide additional coding guidance. When sites find documentation the patient experienced ventricular tachycardia, that is enough to code non-sustained in sequence 4275. And when there is documentation of a sustained ventricular tachycardia or evidence ventricular tachycardia was treated appropriately with ATP or shock therapy or ventricular tachycardia arrest, but the type is unknown, that is enough to code monomorphic ventricular tachycardia. Sequence 4255, Ventricular Tachycardia Occurred Post-Cardiac Surgery, seeks to capture if the patient's most significant episode of ventricular tachycardia occurred within 48 hours of cardiac surgery. Sequence 4260, Bradycardia Dependent Ventricular Tachycardia, seeks to capture if the patient's most significant episode of ventricular tachycardia was bradycardia dependent. Sequence 4265, Ventricular Tachycardia Reversible Cause, seeks to capture if the patient's most significant episode of ventricular tachycardia was deemed to be a result of a reversible cause. The most common reversible causes of ventricular tachycardia can include acute ischemia and electrolyte imbalance. Others can be drug-induced. Sequence 4270, Ventricular Tachycardia with Hemodynamic Instability, seeks to capture if the patient's most significant episode of ventricular tachycardia caused the patient to experience hemodynamic instability, whether it was sustained or non-sustained. Hemodynamic instability can be described as periods of reduced, unstable, or abnormal blood pressure with near syncope or episodes of syncope. It creates a state of hypoperfusion that does not support normal organ perfusion or function.

ventricular tachycardia

coding sequences

severity hierarchy

documentation guidance

registry prioritization