Welcome to lesson number two of this learning activity titled Understanding the LAAO Registries Follow-up Process. The content in this lesson was developed and narrated by myself. I am Fernando Garcia Barbón. In this lesson, we will review the coding of the patient's follow-up status. Follow-up status is found in sequence 13015. The choices in this element are alive, deceased, or lost to follow-up. The first choice of the element is coding the patient as alive. The patient will be coded as alive if they were alive at the time of the follow-up assessment being captured. The second choice of the element is coding the patient as deceased. The patient will be coded as deceased if the patient expired after hospital discharge from the index LAAO procedure or at any time within the follow-up period. When do we capture a deceased patient? If the patient expires after hospital discharge or after any follow-up assessment that has already been performed, the patient will be coded as deceased on the next follow-up interval. For example, if the patient expires between the time of hospital discharge and the 45-day follow-up, the patient's death will be captured on the patient's 45-day follow-up. Here is another example. If the patient expires between the time of the 45-day follow-up assessment and the 6-month follow-up, the patient's death will be captured on the 6-month follow-up. Let's go through the most common error generated when coding a patient as deceased, which is System Alert and Selection Error 6625. This error will be assigned when the follow-up assessment date coded is not within the follow-up date range of the interval selected. We will discuss this error using a case scenario. We have documentation of a 65-year-old female patient who underwent a successful LAAO procedure in which a Watchman device was implanted on September 30, 2019. The patient had their 45-day follow-up at the clinician's office on November 19, 2019, which fell at day 50 post-procedure. The patient was readmitted to the hospital with pneumonia 30 days after their 45-day follow-up. The patient expired while in the hospital 87 days post-procedure due to complications from the pneumonia. The patient's date of death was December 26, 2019. Let's keep in mind that the patient's 45-day follow-up was already captured in the data collection tool, and the patient's death will be coded on the 6-month follow-up. When coding the patient's 6-month follow-up, what date should be coded as the assessment date? Our choices are, number one, the actual date of death, which is December 26, 2019. Number two, the planned date for 6-month follow-up, which is February 27, 2020. Or number three, any date within the 6-month follow-up date range, which for the sake of this scenario, we will use February 10, 2020. The answer is both, two and three. They are both correct choices based on the fact that they are both within the 6-month follow-up date range. February 27, 2020 falls 150 days post-procedure and February 10, 2020 falls 133 days post-procedure. If the actual date of death is used as the 6-month follow-up assessment date, the system will generate error 6625, as the date coded is still within the 45-day follow-up date range, specifically 87 days post-procedure, not within the 6-month follow-up date range. Remember, the system only allows for one follow-up entry per interval, and a 45-day follow-up assessment was already entered. The third choice of the element is coding the patient as lost to follow-up. The patient will be coded as lost to follow-up if the patient could not be reached for a follow-up or refuses to take part of the follow-up process. Quick reminder, in order to code a patient as lost to follow-up, there must be at least one documented attempt to reach the patient. If the patient is being coded as lost to follow-up based on their refusal to be part of the follow-up process, there must be also documentation of the patient's refusal. This concludes Part 2 of 3 of Understanding the LAAO Registry Follow-up Process. Thank you for your participation.

LAAO Registries Follow-up Process

coding patient follow-up status

alive

deceased

lost to follow-up