Statistical models of stroke/TIA risk in the preindex period showed no difference in annual event rates between cohorts (meanstandard error 0.30% 0.08% ablation vs 0.28% 0.07% general AF, p=0.8292 0.37% 0.09% ablation vs 0.42% 0.08% cardioversion, p=0.5198). Matched populations had very similar demographic and comorbidity profiles, including nearly identical CHA2DS-VASc risk distribution (p-values 0.6948 and 0.8152 vs general AF and cardioversion cohorts). Index date was defined as the first ablation, the first cardioversion, or the second AF event in the general AF cohort. Yearly rates of ischemic stroke or transient ischemic attack (stroke/TIA) before and after an index date were compared between cohorts. A total of 4,991 ablation patients were matched 1:1 to general AF controls with no ablation, and 5,407 ablation patients were similarly matched to controls who underwent cardioversion. Methods and results: Using routinely collected hospital data, ablation patients were matched to two control cohorts via direct and propensity score matching. ICD-10-CM codes would be I97.89 (other post-procedural complications and disorders of the circulatory system, not elsewhere classified) and I48.0 (paroxysmal atrial fibrillation) based on the instructional note to use an additional code to specify the disorder.Abstract : Background: We sought to determine whether catheter ablation of atrial fibrillation (AF) is associated with reduced occurrence of ischemic cerebrovascular events. Now, let’s assume that the provider documented that the “post-operative course is complicated by paroxysmal atrial fibrillation requiring amiodarone drip.” This would code: Fibrillation > atrial > postoperative complication > paroxysmal. The ICD-10-CM code would be I48.0 (paroxysmal atrial fibrillation). This would code: Fibrillation> atrial > paroxysmal. Let’s assume documentation of post-operative paroxysmal atrial fibrillation. The physician has to specifically document that the post-operative atrial fibrillation is a complication of the procedure. ICD-9-CM coding allowed for post-operative atrial fibrillation to be coded as a complication, with supporting language in the Coding Clinic published for the fourth quarter of 2013. In these instances, the provider should be queried for clarification that the post-operative atrial fibrillation was, in fact, a complication. Some will agree that it is a complication, while others will say it is an expected outcome of the cardiac procedure. One area that varies among physicians is post-operative atrial fibrillation following cardiac surgery. On the other hand, if the post-operative atrial fibrillation required treatment, either with medications or defibrillation, this condition should be considered a complication. ![]() Next, if a patient develops atrial fibrillation post-operatively, what was the outcome? If the patient had several beats of atrial fibrillation noted on cardiac monitoring that resolved on its own without treatment, this should not be considered a complication. ![]() First, does the patient have a history of atrial fibrillation that is currently being treated? If so, then post-operative atrial fibrillation is not a complication of surgery and was present on admission. Determining whether or not to view post-operative atrial fibrillation as a complication has several defining factors.
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