EPDIR-0822 - Sequence # 10205 Discharge Medications Prescribed | Metric 4 - Proportion of ICD/CRT-D Implant Patients with LVSD, who were Prescribed ACE-I, ARB, or ARN-0822 - Sequence # 10205 Discharge Medications Prescribed | Metric 4 - Proportion of ICD/CRT-D Implant Patients with LVSD, who were Prescribed ACE-I, ARB, or ARN

Video Transcription

The EP Device Implant Registry Case Scenario for August of 2022 will review Sequence 10205,  Discharge Medications Prescribed, and Metric 4, the proportion of ICD-CRTD implant patients, LVSD, who were prescribed an ACE inhibitor, ARB, or ARNI.  A 45-year-old female with a history of severe non-ischemic cardiomyopathy is admitted for a heart transplant. Her CRTD device is explanted prior to the surgery.  The most recent LVEF prior to the CRTD explant is 15%. The heart transplant was successful with an LVEF value of 55%.  Based on the Data Abstractor's coding of the documentation provided by the physician, the 45-year-old female with a history of severe non-ischemic cardiomyopathy who was admitted  for a heart transplant is displayed in Metric 4 on Monday morning after the weekend aggregation.  Why is this patient displayed as a no in the numerator of Metric 4? Is it number one, the LVEF was not coded per the coding instructions and target value?  Number two, Metric 4 is not functioning as expected? Number three, the coding advice in the FAQ database was not utilized for data abstraction?  Or number four, heart transplant episodes of care are excluded from the registry? Please review the documentation, the question, and the possible answers prior to making your  final selection. The answer is number three, coding advice in the FAQ database was not utilized for data abstraction.  FAQ 25252 was developed to support coding of episodes of care where a heart transplant surgery is performed. Question, the patient had a heart transplant with the ICD-X planted.  Upon discharge, the patient is no longer prescribed an ACE inhibitor, ARB, ARNI, or beta blocker as the LVEF is greater than 40%. How are these medications coded?  And the answer, in the scenario of a heart transplant in the same episode of care, please code no medical reason, sequence 10205, as it relates to ACE inhibitor, ARB, ARNI, or  beta blocker. The registry is unable to capture the exclusion based on the improved LVEF of the patient at the time of discharge.  The coding of this episode of care was updated based on the coding advice provided in FAQ 25252, where all three medications receive no medical reason.  The episode of care now meets the numerator criteria for metric four. Thank you for viewing the EP device implant registry case scenario for August of 2022.

Video Summary

In this video, the EP Device Implant Registry Case Scenario for August 2022 is reviewed. They focus on Sequence 10205, which is about the discharge medications prescribed, and Metric 4, which measures the proportion of ICD-CRTD implant patients with LVSD who were prescribed an ACE inhibitor, ARB, or ARNI. The case involves a 45-year-old female with severe non-ischemic cardiomyopathy who is admitted for a heart transplant. Her CRTD device is removed before the surgery, and the heart transplant is successful. However, there is an issue with Metric 4 as the coding advice in the FAQ database was not utilized for the data abstraction. By following the coding advice in FAQ 25252, the episode of care now meets the criteria for the numerator of Metric 4.

Keywords

EP Device Implant Registry

Metric 4

ICD-CRTD implant patients

heart transplant

coding advice