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EP Device Implant v2.3 Education
History and Risk Factors – Ventricular Fibrillatio ...
History and Risk Factors – Ventricular Fibrillation, 14719-14720; VAD 14651-14652; Prior Aortic Valve Procedure 14722, 14724, 14726
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Video Transcription
Section C, History and Risk Factors, has several new data elements and updates. All data elements highlighted in yellow indicate a change from version 2.2. Ventricular fibrillation will no longer be coded in ventricular tachycardia sequence 4245 as previously directed in version 2.2. We added ventricular fibrillation as a separate data element to accurately capture ventricular fibrillation not due to a reversible cause, whether from an arrest or those treated by a cardiac defibrillator. Ventricular fibrillation sequence 14719 seeks to capture a history of ventricular fibrillation not due to a reversible cause from birth to the first procedure in this admission. It is rapid, usually more than 300 beats per minute, grossly irregular ventricular rhythm with marked variability in QRS cycle length, morphology, and amplitude. Ventricular fibrillation date sequence 14720 seeks to capture the date of the ventricular fibrillation event. The target value is the last value between birth and the first procedure in this admission. To conform with current industry standards, these elements were renamed VAD, therefore candidate for LVAD sequence 4365 has been retired. Although a ventricular assist device can be placed in the left, right, or both ventricles, it is most often used in the left ventricle. Please indicate if the patient has been identified as a candidate for any ventricular assist including LVAD, RVAD, or BIVAD capturing any occurrence between birth and the first procedure in this admission. Currently on LVAD sequence 4370 has been retired. Currently on VAD sequence 14752 seeks to capture if the patient is currently on any ventricular assist device including LVAD, RVAD, or BIVAD capturing any occurrence between birth and the first procedure in this admission. If the patient was on a VAD in the past but is not currently, please code no to sequence 14752. We're going to continue in section C, history and risk factors, and discuss other history. Please note all yellow highlighted areas indicate a change from version 2.2. The work group believes it's important to gain an understanding of the current landscape, notably patients who recently underwent valve procedures who now require devices. For prior aortic valve procedure sequence 14722 indicate if the patient had an aortic valve procedure coding the last value between birth and the first procedure in this admission. Sequence 14725 seeks to capture the date of the most recent aortic valve procedure coding the last value between birth and the first procedure in this admission. If the month or the day of the aortic valve procedure is unknown but you know the year, please code 0101 and that year. If the specific year is unknown in the current record, the year may be estimated based on timeframes found in prior medical record documentation. Example, if the patient had an aortic valve procedure documented in a record from 2018, then the year 2018 can be utilized and coded as 01-01-2018. Sequence 14726 is indicating if the prior aortic valve procedure was performed as an elective procedure and was not performed in an urgent or emergent situation. For stable inpatients, the procedure was performed during the hospitalization for the convenience and ease of scheduling and not because the patient's clinical situation demanded the procedure prior to discharge. This is coded based on the last value between birth and the first procedure in this admission.
Video Summary
In section C, the video discusses updates in the History and Risk Factors data elements. Ventricular fibrillation is now being captured as a separate data element rather than being coded in the ventricular tachycardia sequence. There are also changes in the coding for ventricular assist devices (VAD) and left ventricular assist devices (LVAD). The video provides instructions on how to code for past and current occurrences of VAD and LVAD. The discussion then moves on to history related to aortic valve procedures, including coding for prior procedures and recording the date of the most recent procedure. The video also explains how to code for elective aortic valve procedures that were not urgent or emergent.
Keywords
facility site profile
NCDR registry site
hospital demographic information
benchmark reporting
site profile completion
updates
ventricular fibrillation
ventricular assist devices
aortic valve procedures
coding
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