Section E

The Society of Thoracic Surgeons Frequently Asked Questions: Adult Cardiac Surgery Database Version 2.52.1 August, 2006 How to use the interactive FAQ Document: 1. To review all clinical questions in an individual section, click on the section title below.
Section A: seq# 40-80				Section F: seq# 750-870		Section K: seq# 1630-1880		Section P: seq# 2710-3010
Section B: seq# 100-210				Section G: seq# 890-1040		Section L: seq# 1920-2350		Section Q: seq# 3020-3080
Section C: seq# 220-340				Section H: seq# 1050-1200		Section M: seq# 2360-2560		Section R: seq# 3090-3210
Section D: seq# 350-550				Section I: seq# 1210-1500		Section N: seq# 2570-2600		Section S: seq# 3220-3240
Section E: seq# 560-670				Section J: seq# 1520-1620		Section O: seq# 2610-2700
2. To review an individual Seq# clinical question, click on the Seq# title below. 310 ICUInHrs 2470 OCarAFib 340 TotHrICU 2560 OCarOthr 440 RenFail 2710 Complics 490 InfEndo 2750 COpReOth 850 ArrhyTyp 2780 CISternDeep 1050 NumDisV 2830 CNStrokP 1260 EmergRsn 2950 COtCoag 1280 OpCAB 3090-3180 Section R. 1310 OpOCard 3220 Readm30 1380 PerfusTm 3240 ReadmPro 1410 XClampTm 1640 OpMitral 1650 OpTricus 3. CC/TM: Corrections/Clarifications to Training Manual
NEW	Date	SeqNo	FieldName		Definition
		560	Incidence		Indicate if this is the patient's: -first cardiovascular surgery -first re-op cardiovascular surgery -second re-op cardiovascular surgery -third re-op cardiovascular surgery -fourth or more re-op cardiovascular surgery.
	9/04				A patient has a history of CABG in 1982, 1984, 1991, & now in July 2004. I just wanted to make sure I code this seq# correctly. 1. 1982-First CV Surgery 2. 1984-First Re-op CV Surgery 3. 1991-Second Re-op CV Surgery 4. The current surgery in 2004 -Third Re-op Surgery.		Correct. The intent of this field is to capture the incidence of the procedure that the patient is about to go through during the current hospitalization as compared to those procedures prior to this hospitalization.
	12/04				Would Abdominal Aortic Aneurysm surgery be captured here?		Surgery on the abdominal aorta is not considered a CV surgery because it is below the mediastinum. Therefore, if a patient has a history of a surgery on the abdominal aorta and is now admitted for a CABG, when answering seq# 560 "Incidence" should be coded as first CV Surgery and seq# 620 "Previous Other Cardiac" should be coded as "no." Thoracoabdominal aortic surgery is above the diaphragm and would be regarded as a prior CV surgery (seq# 560) and as a previous other Cardiac procedure (seq# 620).
		570	Prev CV Intervent		Indicate whether the patient has undergone any previous cardiovascular intervention, either surgical or non-surgical, which may include those done during the current admission.
	10/05				Where would I count the performance of a pericardial window prior to the CABG?		Thoracic surgeries are not captured in Section E as a Previous CV Intervention. The Intent for section E. in the 2.52.1 Training Manual states, "Previous interventions reference any invasive or non-invasive thoracic or cardiothoracic procedure having been performed up to and inclusive of the current cardiac procedure hospitalization." However, there are no fields in v2.52.1 Section E to capture previous Thoracic Procedures. This will be corrected in the Training Manual.
		600	Prev CAB		Indicate whether the patient had a previous Coronary Bypass Graft prior to the current admission.
		610	Prev Valve		Indicate whether the patient had a previous surgical replacement and/or surgical repair of a cardiac valve.
		620	Prev Oth Card		Indicate whether patient had a previous intrapericardial or great vessel procedure performed. Great vessels = aorta, superior inferior vena cava, pulmonary arteries and veins.
CC/TM	3/04				The Training Manual, seq# 620, Field Name Intent Section should read as follows (changed text in bold): Capture any surgical procedure performed on any cardiac organ (heart, aorta, pulmonary arteries or veins and/or the inferior/superior vena cava) that does not include repair and/or replacement of any heart valve(s) or coronary artery revascularization and was approached through the mediastinum.
	12/04				Would Abdominal Aortic Aneurysm surgery be captured here?		Surgery on the abdominal aorta is not considered a CV surgery because it is below the mediastinum. Therefore, if a patient has a history of a surgery on the abdominal aorta and is now admitted for a CABG, when answering seq# 560 "Incidence" should be coded as first CV Surgery and seq# 620 "Previous Other Cardiac" should be coded as "no." Thoracoabdominal aortic surgery is above the diaphragm and would be regarded as a prior CV surgery (seq# 560) and as a previous other Cardiac procedure (seq# 620).
	10/05				Would endocardial ablation be considered a previous other cardiac - intrapericardial intervention?		These would be coded as Seq# 660 POCPCI = Yes. This would be done in the Cath Lab, and would be considered a Percutaneous Coronary Intervention
		630	Prev Oth Card-AICD		Indicate whether the patient had a previous implant of an Automatic Implantable Cardioverter/Defibrillator.
	4/05				I am having trouble figuring out how to code the pacers and AICDs in the previous interventions sequence. For instance, I have a patient that had a biventricular pacing ICD. How do I document that?		The Database is set up to allow coding to both PrOCAICD and PrOCPace, Please code Seq# 630 PrOCAICD=Yes; Seq# 640 PrOCPace=Yes; and Seq#650 PrOCPaceT=Biventricular
		640	Prev Oth Card-Pacemaker		Indicate whether a previous permanent pacemaker was placed anytime prior to this surgical procedure.
		650	Prev Oth Card-Pacemaker-Type		Indicate whether the previous permanent pacemaker was univentricular or biventricular. Univentricular: the right ventricle is paced, as opposed to the right and left ventricle being paced. Right atria only paced = single chamber pacing Right ventricle only paced = single chamber pacing Right ventricle and right atria paced = dual chamber pacing Biventricular: both the right and left ventricles are paced = Cardiac Resynchronization Therapy (CRT)
		660	Prev Oth Card-PCI		Indicate whether a previous Percutaneous Cardiac Intervention (PCI) was performed any time prior to this surgical procedure. PCI refers to those treatment procedures that unblock narrowed coronary arteries without performing surgery. PCI may include, but is not limited to: 1. Balloon Catheter Angioplasty, Percutaneous Transluminal Coronary Angioplasty (PTCA) 2. Rotational Atherectomy 3. Directional Atherectomy 4. Extraction Atherectomy 5. Laser Atherectomy 6. Intracoronary Stent Placement
	4/05				I am assuming that a previous percutaneous Mitral valvuloplasty is counted as a Prev CV Intervent(570). (Definition states previous cv intervention, either surgical or nonsurgical.) Is that correct? If so, do I then answer Yes to Prev Valve (610)? The Prev Valve definition states it must be "surgical replacement and/or surgical repair". In other words, is a percutaneous valvuloplasty considered "surgical"?		No. A previous Mitral Valvuloplasty is not coded as a Seq# 610 PrValve. A previous Mitral Valvuloplasty either percutaneous or surgical is captured. For this particular percutaneous approach as a previous history to the current MVR, how you code this is based on what version you are currently using: Version 2.41 Seq # 710 PrCVInt = YES, Seq #740 PrCBNum = 0, Seq# 750 PrCNNum = 0, and Seq#1280 PrNSBall = YES Then proceed to code the MVR. which is a First CV Surgery. Version 2.52.1 Seq # 560 Incident = First CV Srugery, Seq# 570 = YES "previous cardiovascular intervention, either surgical or NON-SURGICAL", Seq# 660 POCPCI = YES "PCI may include, but is not limited to". The MVR case is a First CV surgery. Will add Seq# 740 PrNSBall back in as a Core data element for next spec upgrade.
	01/06				The patient had ablation therapy prior to arrival at our hospital. Would I code this as "Previous CV Interventions: Previous Other Cardiac - Intrapericardial/Great Vessel"?		You would code an ablation as Previous CV Intervention; and Previous Other Cardiac - PCI. The intent is to capture any proceudre done in the Cath Lab. The Prev Other Cardiac field, per the definition is to capture any previous intrapericardial or great vessel procedure performed. Great vessels = aorta, superior inferior vena cava, pulmonary arteries and veins."
	01/06				I recently looked to see if there was a new FAQ and had a couple of questions pertaining to the new questions that were answered.In regards to counting a endocardial ablation. In the past I sent in a question in regards to count a percutanous closure of a PFO under this area which was done in the cath lab and I think a percutaneous valvuloplasty would also be considered here. I was instructed to not count this because the definition says PCI refers to those treatment procedures that unblock narrowed coronary arteries. These procedures would not fall into this criteria as well as the ablation. Should these procedures be counted. If so the definition needs to be changed. Thanks		Point taken regarding percutaneous procedures that are done in the cath lab. The definition for Seq# 660 POCPCI will be changed for the next upgrade. Until then, code percutaneous valvuloplasties and percutaneous closure of PFO as Seq# 660 = Yes. The definition does say "PCI may include, but is not limited to:..."
		670	Prev Oth Card-PCI-Interval		Indicate the interval of time between the previous PCI and the current surgical procedure.