Cardiac Catheterization Utilization Report

Michigan Department of Health & Human Services

CERTIFICATE OF NEED
AUTHORITY:PA 368 of 1978, as amended
COMPLETION:Is voluntary, but is required to obtain a
Certificate of Need. If not completed, a
Certificate of Need will not be issued. / The Department of Health & Human Services is an equal opportunity employer, services and programs provider.

INSTRUCTIONS:

  • “Cardiac Catheterization Laboratory” means an individual radiological room equipped with a variety of x-ray machines and devices such as electronic image intensifiers, high speed film changers and digital subtraction units to assist in performing diagnostic and therapeutic cardiac catheterizations and electrophysiology studies.
  • “Cardiac Catheterization Procedure” means any cardiac procedure, including diagnostic, therapeutic, and electrophysiology studies performed on a single patient during a single session in a laboratory.
  • Report number of cardiac catheterization sessions for the most recent continuous 12-month period. A single session may include 1 or more cardiac catheterization procedures.
  • Report actual data only for the cardiac catheterization procedures and other peripheral procedures performed on a patient during a single session in a cardiac catheterization laboratory.
  • Report eachindividual session in only 1 of the 5 categories. A session should be reported in the category based on the most complex procedure performed during the session. For example, a session that includes only a diagnostic cardiac cath should be reported in Line 1 while a session that includes a diagnostic cardiac cath followed by a therapeutic cardiac cath should be reported only in Line 3, giving that session the maximum weight possible.

Table 1- Cardiac Catheterization Laboratory Utilization

Adult Session / Conversion Factor
(a) / No. of Sessions
(b) / Equivalents
(a x b)
Most Recent
12-Month Period
1. Diagnostic Cardiac Cath Session / 1.5
2. Diagnostic Peripheral Session / 1.5
3. Therapeutic Cardiac Cath Session / 2.7
4. Therapeutic Peripheral Session / 2.7
5. Complex Percutaneous Valvular Session* / 4.0
*Complex percutaneous valvular sessions includes, but is not limited to, procedures performed percutaneously or with surgical assistance to repair or replace aortic, mitral and pulmonary valves such as transcatheter aortic valvular implantation (Tavi) procedures. These sessions can only be performed at hospitals with open heart surgery services.
6. TOTAL SESSIONS**/EQUIVALENTS
** The total of rows 1-5 under column “b” should equal the number of patients seen in a cardiac cath lab where at least one (1) procedure was performed.
7. Total number of labs where cardiac cath procedures are performed
8. Number of CON approved but not operational cardiac cath labs

Table 2- Cardiac Catheterization Laboratory Utilization

Pediatric Session / Conversion Factor
(a) / No. of Sessions
(b) / Equivalents
(a x b)
Most Recent
12-Month Period
1. Diagnostic Cardiac Cath Session / 2.7
s2. Diagnostic Peripheral Session / 2.7
3. Therapeutic Cardiac Cath Session / 4.0
4. Therapeutic Peripheral Session / 4.0
5. Complex Percutaneous Valvular Session* / 7.0
*Complex percutaneous valvular sessions includes, but is not limited to, procedures performed percutaneously or with surgical assistance to repair or replace aortic, mitral and pulmonary valves such as transcatheter aortic valvular implantation (Tavi) procedures. These sessions can only be performed at hospitals with open heart surgery services.
6. TOTAL SESSIONS**/EQUIVALENTS
** The total of rows 1-5 under column “b” should equal the number of patients seen in a cardiac cath lab where at least one (1) procedure was performed.
7. Total number of labs where cardiac cath procedures are performed
8. Number of CON approved but not operational cardiac cath labs