AI Scribe for Interventional Cardiology Clinics

Why Post-PCI Follow-Up Notes Drift

The six-week post-PCI visit looks routine on the schedule, but it carries more decisions than most clinic encounters. The interventionalist is confirming access-site healing, reassessing angina against the Canadian Cardiovascular Society scale, checking adherence to a P2Y12 inhibitor, reviewing a repeat echocardiogram, and deciding whether a staged procedure for residual disease is still warranted. Each thread belongs in the chart, and each is easy to lose when the note is assembled from memory at the end of clinic.

When documentation is reconstructed after hours, the details that matter most tend to blur. Stent dates become 'last spring.' Ejection fraction becomes 'improved.' The DAPT plan becomes 'continue current meds.' None of that is clinically wrong, but it leaves the covering physician, the primary care team, and any reviewing auditor without the specifics that explain why this patient remains under active interventional follow-up.

Merry listens to the encounter as it unfolds, separates the voices of physician, patient, and family member, and drafts a structured note that keeps those specifics intact. The clinician reviews every line before anything reaches the chart.

Three Data Points Every Post-PCI Note Should Carry

Our first clinical directive is simple: every post-PCI follow-up records LVEF percent, stent dates, and the DAPT plan. These three elements carry the narrative of coronary disease management across months and years, and they are the elements most often missing when a chart is pulled for review.

LVEF Percent, Modality, and Date

Ejection fraction is only useful when it is anchored. Merry captures the numeric value, the modality, whether transthoracic echo, cardiac MRI, or nuclear perfusion, the study date, and the interpretive category. It pairs that value with the current NYHA functional class as stated by the clinician, so a trajectory from 32 percent with class III symptoms to 41 percent with class II symptoms reads as the result of deliberate guideline-directed titration.

Stent Dates and Lesion History

Procedural history should read like a timeline rather than a summary. Merry records the index PCI date, each staged or repeat intervention, stent type, and lesion location, such as proximal LAD, left main, or a bifurcation. It also notes residual disease, chronic total occlusions left for medical therapy, and any interval concern for restenosis or stent thrombosis.

DAPT Plan and Bleeding Risk Rationale

Antiplatelet decisions deserve their reasoning on the page. Merry documents the agents, start date, planned duration, and the ischemic versus bleeding risk balance behind that plan. When therapy is shortened after a gastrointestinal bleed, extended after a complex left main intervention, or interrupted for noncardiac surgery, the note states why, and when the next reassessment falls.

Clinical Logic Matrix for Longitudinal Complexity

Each diagnostic indicator below maps to the data points Merry prompts for and the billing evidence a reviewer will look for. Prompt packs built on this structure are available at https://templates.scribing.io.

The matrix matters because G2211 is an add-on code. It is reported only with office or outpatient E/M base codes 99202 through 99205 and 99211 through 99215, and the visit must reflect continuing care for a serious or complex condition. CPT definitions for those base codes are maintained by the AMA at https://www.ama-assn.org/practice-management/cpt.

Mapping the Assessment Field Before the Visit

Our second directive addresses placement. Before the encounter begins, the Merry Chrome Extension identifies the cardiology Assessment and Plan field in the active EHR window. It reads visible section labels and accessibility attributes rather than session-specific element IDs, which many web EHRs regenerate at every login. Problem lists, medication orders, and the cath lab procedure log are left untouched.

Placement in the Assessment field keeps longitudinal language where clinical reasoning lives. A complexity statement in the HPI reads like boilerplate; the same statement in the Assessment, tied to a dated LVEF and a stated DAPT end date, reads as a physician explaining why this patient still needs this clinic.

Same-day procedures need a guardrail. CMS edits deny G2211 when the associated E/M is billed with modifier 25 on the same date, with narrow exceptions since January 2025 for certain preventive services. When a catheterization or PCI shares the date of service, Merry flags the conflict and offers to suppress the longitudinal paragraph.

Every inserted paragraph remains editable. The clinician accepts, revises, or deletes the text before signing, and Merry does not clone prior visit language forward. Practices in California and Texas can enable disclosure language for patient-facing derivative content to support AB 3030 and state AI governance reviews.

Audio and transcripts are not retained after the session closes. Processing runs under a signed Business Associate Agreement, and session buffers are cleared from memory once the note is delivered.