Performance Measurement Network

Question: Late Coded Stroke STK-4 and STK-5

patient presents to ED 3/21 1030 for code stroke with LKN documented by ED RN and on Stroke Narrator as 3/21 0900. Symptoms include facial droop, tremors and garbled speech. CT Negative. Patient rapidly deteriorates requiring fluid resus. atropine for HR and pressors. No CPR administered and pt not intubated in ED. neurology diagnosis is status epilepticus and no mention of alteplase consideration or contraindications. patient intubated on ICU admission and within following days requires CPR multiple times. MRI on 3/25 shows infarcts which are noted by neurology to be consistent with hypoperfusion events and possibly the cause of seizure activity.

Is this still a miss for Alteplase admin, no notes for contraindication. No antithrombotics were given either, no notes for contraindication.


Erin, TLKW 0900. No documented Reason for Not Initiating IV Thrombolytic. The case will fall out for STK-4 and STK-5 if no antithrombotic was administered or reason documented.

Why is the principal diagnosis code ischemic stroke? CT scan negative and documentation states seizures / status epilepticus? If the the PX DX remains ischemic stroke, then the case will fall out.

Thank you for your inquiry.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: STK, STK-4, Late diagnosis stroke,
Manual: Current Manual (current data collection period; prior to data transmission)

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