CV ASC Registry Education-Seq#5032 (Electrocardiac Assessment Results)

Video Transcription

Sequence 50-32, Electrocardiac Assessment Results, is indicating the results, whether they are abnormal, uninterpretable, or normal, of the electrocardiac assessment 30 days prior  to the procedure. The coding instructions outlined in the notes are hierarchical and should be applied as follows.  First, select abnormal if the assessment identifies a heart rate or rhythm that is abnormal and clinically relevant for the patient.  The evidence of an abnormal rate or rhythm that is clinically significant may be overtly apparent, such as VTAC, VFib, symptomatic bradycardia, ST deviation of 5 mm or more  to support coding. Or the evidence of an abnormal rate or rhythm that is clinically significant may only be  apparent due to provider documentation, such as new onset AFib, exercise-induced VT, normal sinus rhythm with left ventricular hypertrophy, so on and so forth.  When the abnormality is not overtly apparent or specifically documented by the provider, but is recognized by the abstractor, we would ask that you clarify with the physician if  the rhythm is clinically significant for the patient. This is subjective and unique to the patient, and if the physician agrees the abnormality  is clinically significant, please ensure there is documentation to support coding abnormal.  But if there are no abnormal results, you would then look to see if there were any uninterpretable results.  This would be selected when there is specific documentation that a determination of normal versus abnormal of the heart's electrical activity could not be made.  And if neither abnormal or uninterpretable results are noted, you would select normal because none of the above apply.

Video Summary

Transcript section 50-32 discusses interpreting Electrocardiac Assessment results from 30 days before a procedure as abnormal, uninterpretable, or normal. Abnormal results indicate a clinically relevant heart rate/rhythm issue like VTAC, VFib, or bradycardia. In the absence of explicit documentation, the abstractor can consult the physician for clarity. Uninterpretable results are chosen if determining heart activity is impossible. If neither abnormal nor uninterpretable, normal is selected. Recognition of abnormalities is subjective and must have physician support. The section emphasizes thorough documentation to justify coding decisions based on the assessed heart rate or rhythm.

Keywords

Electrocardiac Assessment

Abnormal Results

Uninterpretable Results

Normal Results

Physician Consultation