Welcome to Lesson 4 of this learning activity titled Getting Acquainted with the V5 Dataset. The content in this lesson was developed by Cornelia Anderson and myself. I am Kate Malish and I will be narrating this lesson. The objectives for Lesson 4 of Getting Acquainted with the V5 Dataset include discuss V5 Dataset rationale and purpose, locate coding resources, identify parameters for coding. As previously mentioned, patients are included in this registry when diagnostic coronary angiography and or PCI is performed. When a left heart cath is performed alone, it is not reason for inclusion in the registry. However, when performed with a diagnostic cath or PCI, there is the ability to identify it specifically. Users may identify concomitant procedures performed and may specify the procedure from a dynamic list that is updated as needed. As well, when a procedure is not completed through the original arterial access site, this can be identified by selecting arterial crossover. Other fields in this section capture when venous access is obtained, identifying the systolic blood pressure, and lastly, when cardiac arrest occurred at this facility. To provide a thorough depiction of radiation exposure and contrast, the registry captures the radiation cumulative air kerma and dose area product, along with fluorotime and contrast volume. If you have questions about how radiation dose is reported, please work with your radiation safety officer. The lab section captures pre-procedure and post-procedure values for troponin, hemoglobin, and creatinine, along with total and HDL cholesterol. Attention must be paid to the target values for these data elements as they vary and will determine your success in coding correctly. You have the option to code not drawn for every lab value rather than leaving the sequence blank. Section G, Cath Lab Visit, is completed for each Cath Lab Visit and contains Sequence 7400, Indications for Cath Lab Visit, which can be the most challenging and crucial data element to code correctly. As you can see, there are many coding selections, and this data element is a Select All That Apply sequence. That said, only the specific indications which are documented to be the reason for this Cath Lab Visit should be coded. Historical conditions or those which are not being addressed in this Cath Lab Visit are not captured. The Chest Pain Symptom Assessment captures the type of angina, if any, the patient is experiencing and should correlate with the timeframe in which the indication for Cath Lab Visit was coded. For example, a patient having a Cath Lab procedure for new-onset angina less than or equal to two months should have the characteristics of that angina coded in Sequence 7405, even when he or she is asymptomatic upon current procedure. Sequence 7410 captures any ongoing cardiovascular instability which is present at the start of the Cath Lab procedure. Once you have indicated the patient has cardiovascular instability, you may select all instability types that apply in Sequence 7415. Finally, you are asked to capture when ventricular support is required at any time during the Cath Lab procedure. This includes both pharmacologic and mechanical ventricular support. As an example of the resources designed to support your coding, the Registry developed a helpful chart which aids participants in coding Sequence 7405, Chest Pain Symptom Assessment, when only descriptive documentation is in the medical record. A good example of parent-child fields. When valvular disease is coded in Sequence 7400, you are prompted to code the valvular disease type and severity. Data definitions for each severity are provided in the Data Dictionary to assist with coding. Furthermore, when preoperative evaluation is coded in Sequence 7400, you are prompted to code the type of surgery along with some risk assessment information. This helps to appropriately capture the acuity of the patient. Patients who have a Cath Lab procedure for organ donor purposes are also captured in this section. The Coronary Anatomy section is robust and must be coded for each Cath Lab visit. Only vessels having greater than or equal to 50% stenosis are captured. The Registry provides a coronary anatomy diagram to assist in identifying the specific segment number, which we encourage participants to share with physicians. Adjunctive measurements, such as IVUS and FFR, are only captured in this section. When performed on a vessel with greater than or equal to 50% stenosis and prior to intervention, you must have the actual measurement documented to code these data elements. This concludes Lesson 4 of Getting Acquainted with the Cath PCI Registry V5 Dataset. Thank you for your participation.

V5 Dataset

coding resources

parameters for coding

diagnostic coronary angiography

PCI