Find comprehensive information on WATCHMAN Device Implantation, including clinical documentation requirements, medical coding guidelines, and healthcare best practices. Learn about LAA closure, left atrial appendage occlusion, atrial fibrillation stroke prevention, and device implantation procedures. Explore resources for physicians, coders, and healthcare professionals seeking accurate and up-to-date information on WATCHMAN implant coding, post-operative care, and patient management.
Also known as
Insertion of LAA occlusion device
Placement of a device in the left atrial appendage.
LAA Occlusion Procedures
Closing off the left atrial appendage.
Other specified atrial fibrillation
Atrial fibrillation as indication for WATCHMAN.
Presence of cardiac assist device
WATCHMAN as an alternative to long-term anticoagulation.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the WATCHMAN device being implanted for atrial fibrillation?
When to use each related code
| Description |
|---|
| WATCHMAN Implant |
| Left Atrial Appendage Closure |
| Atrial Fibrillation Ablation |
Incorrect device code reported (e.g., using LAA occlusion codes instead of 02HA3DZ/02HK3DZ). Impacts reimbursement.
Lack of atrial fibrillation (I48.xx) or high stroke risk (Z86.73) diagnosis documented. Affects medical necessity.
Unspecified or missing documentation of percutaneous endoscopic approach (02HK3DZ/02HA3DZ). Leads to coding errors.
Q: What are the evidence-based best practices for patient selection and pre-procedural evaluation for WATCHMAN device implantation in non-valvular atrial fibrillation?
A: Patient selection for WATCHMAN implantation requires a thorough evaluation to minimize procedural risks and maximize long-term success. Current guidelines recommend the CHA2DS2-VASc score to assess stroke risk and determine eligibility for long-term oral anticoagulation. Specifically, patients with a high risk of bleeding (HAS-BLED score 3 or higher) and a contraindication to long-term oral anticoagulation are ideal candidates. Pre-procedural evaluation should include transesophageal echocardiography (TEE) to assess left atrial appendage (LAA) anatomy, exclude thrombus, and measure ostium size. Cardiac CT or MRI can provide further anatomical details and assist in device sizing. Careful evaluation of renal function, bleeding risk factors, and other comorbidities is crucial. Explore how our comprehensive resources can assist in pre-procedural planning for WATCHMAN device implantation.
Q: How do I manage peri-procedural anticoagulation and antiplatelet therapy in patients undergoing WATCHMAN LAA closure, considering the latest consensus guidelines and real-world clinical experience?
A: Peri-procedural anticoagulation management in WATCHMAN implantation is complex and requires careful consideration. Current consensus guidelines recommend continuing oral anticoagulation, typically warfarin, with a target INR of 2.0-3.0 perioperatively. Post-procedure, oral anticoagulation is continued for 45 days or until a satisfactory LAA seal is confirmed by TEE, at which point it can be transitioned to dual antiplatelet therapy (DAPT) with clopidogrel and aspirin. DAPT is typically continued for 6 months, followed by long-term aspirin monotherapy. However, in patients with a high risk of bleeding, shorter durations of DAPT may be considered. Real-world experience suggests individualizing these regimens based on patient-specific factors like bleeding risk and compliance. Consider implementing our decision support tools to optimize peri-procedural medication management for your patients.
Patient presented for left atrial appendage closure (LAAC) with the WATCHMAN device. The patient has a history of non-valvular atrial fibrillation (NVAF) and is at increased risk for stroke based on their CHA2DS2-VASc score. Oral anticoagulation is contraindicated due to a history of gastrointestinal bleeding. After discussing the risks and benefits of LAAC with the patient, informed consent was obtained. Transesophageal echocardiography (TEE) confirmed suitability for WATCHMAN implantation, demonstrating adequate LAA anatomy and no evidence of left atrial thrombus. The procedure was performed under general anesthesia with TEE guidance. The WATCHMAN device (specific size documented) was successfully deployed and released within the left atrial appendage, achieving stable positioning and satisfactory occlusion confirmed by angiography and TEE. Hemostasis was achieved at the access site. The patient tolerated the procedure well and was transferred to post-anesthesia care unit (PACU) in stable condition. Post-procedure plan includes monitoring for complications such as pericardial effusion, device embolization, and access site bleeding. The patient will be discharged on dual antiplatelet therapy (DAPT) with aspirin and clopidogrel, with plans for transition to single antiplatelet therapy after 45 days and eventual discontinuation per guidelines. Follow-up TEE is scheduled to assess device sealing and LAA occlusion. This procedure aligns with established guidelines for stroke prevention in patients with non-valvular atrial fibrillation who are not suitable for long-term anticoagulation. ICD-10 code I51.1 for atrial fibrillation, Z95.0 for presence of cardiac implantable electronic device, and 02RF3DZ for percutaneous closure of left atrial appendage with intraluminal device are documented for billing and coding purposes. CPT code 33340 is documented for this procedure.