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IMPACT-0425 - Section J: PDA Closure
0425 - Section J: PDA Closure
0425 - Section J: PDA Closure
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Video Transcription
Welcome to the IMPACT Registry April 2025 case scenario, where we will discuss Section J, PDA closure. The patient is a 6-year-old female who has been followed closely for a patent ductus arteriosus, now presenting for a planned PDA closure due to worsening symptoms and pulmonary hypertension. Initial angiographic data is obtained at the start of the procedure, and an 8-millimeter by 10-millimeter closure device is selected for deployment. Or number 3, pulmonary hypertension. Please take a few moments to review the documentation prior to making a final selection. And the answer is number 3, pulmonary hypertension. Sequence 7600 captures the primary reason why the PDA procedure is being performed. The device is successfully deployed across the defect, and a repeat angiogram reveals a small residual shunt, which was not considered by the provider to be hemodynamically significant. Our next question is, how is sequence number 7650, outcome of device coded? Is it number 1, implanted, not released? Number 2, implanted, released? Or number 3, implanted, released, and retrieved? Please take a few moments to review the documentation prior to making a final selection. And the answer is number 2, implanted, released. Sequence number 7650, PDA device outcome, seeks to capture the outcome of the PDA closure device on the current procedure. Post-procedure, the patient was monitored in the recovery room and remained stable. Shortly after transfer to an observation bed, the patient began to experience hypotension and respiratory distress. Cath lab evaluation identified that the newly placed device had embolized into the left pulmonary artery. Multiple catheter retrieval attempts fail, and surgical removal of the device is required. How is sequence number 7630, PA obstruction, coded? Number 1, no. Number 2, yes. Or number 3, not assessed. Please take a few moments to review the documentation prior to making your final selection. And the answer is number 1, no. Sequence 7630, PDA pulmonary artery obstruction, seeks to capture if the pulmonary artery was obstructed by the PDA closure device on the current procedure. Additional information, the embolized device retrieval will be captured as an intra-post-procedure event. By coding yes to sequence 8055, device embolization requiring device retrieval, and yes to sequence 8065, retrieved via surgery. And this effectively captures the PDA closure procedure. Thank you for viewing the Impact Registry Case Scenario for April 2025, Section J, PDA closure.
Video Summary
In this IMPACT Registry case from April 2025, a 6-year-old female undergoes a patent ductus arteriosus (PDA) closure due to worsening symptoms and pulmonary hypertension. During the procedure, a closure device is successfully deployed, but a small residual shunt persisted. Post-procedure, the device embolized into the left pulmonary artery, requiring surgical retrieval after failed catheter attempts. The scenario discusses the outcomes, with a focus on capturing procedural details and complications, emphasizing the need to document specific sequences, such as pulmonary obstruction and device embolization. The scenario concludes with instructions for proper coding and documentation.
Keywords
atrial fibrillation
coronary angiography
EP ablation
cath lab
medical documentation
IMPACT Registry
patent ductus arteriosus
device embolization
pulmonary hypertension
surgical retrieval
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