Performance Measurement Network

Question: Do we need to collect 90 day mRS on pts undergoing CEA/CAS?

Do we have to do mRS on those admitted for elective carotid interventions? Do we have to do 90 day mRS on those pts admitted for symptomatic carotids?

Answer:

Only those ischemic stroke patients who receive IV t-PA, IA t-PA, or MER (mechanical endovascular thrombectomy) are captured in the CSTK-02 measure denominator population and require mRS score at 90 days to pass the measure. Patients admitted to the hospital for purposes of performing an "Elective Carotid Intervention Procedure" are excluded from the denominator.

Table 8.1a Thrombolytic Agent Procedures and Table 8.1b Mechanical Endovascular Reperfusion Procedures list the ICD-10-PCS procedure codes used to identify ischemic stroke patients who receive IV/IA t-PA or MER procedures. Effective January 1, 2016, the following open approach procedure codes were removed from Table 8.1b because some CSCs reported that codes O3CL0ZZ Extirpation of Matter from Left lnternal Carotid Artery Open Approach and O3CK0ZZ Extirpation of Matter from Right lnternal Carotid Open Approach were being used for CEA. Patients receiving CEA/CAS are not to be included in the measure population.

Hope this clarifies for you. Thank you for your inquiry.

Impacts: Table 8.1b Mechanical Endovascular Reperfusion Procedures

Effective with discharges on and after January 1, 2016 Rationale: This change removes ICD-10-PCS codes being using for carotid endarterectomy procedures and open approach procedures of the vertebral artery.

Description of Changes: Remove 9 ICD-10-PCS Codes: O3CG0ZZ Extirpation of Matter from Intracranial Artery, Open Approach Artery, O3CL0ZZ Extirpation of Matter from Left lnternal Carotid Artery, Open Approach O3CH0ZZ Extirpation of Matter from Common Carotid Artery, Open Approach O3CJ0ZZ Extirpation of Matter from Left Common Carotid Artery, Open Approach O3CK0ZZ Extirpation of Matter from Right lnternal Carotid Open Approach O3CM0ZZ Extirpation of Matter from Right External Carotid Artery, Open Approach O3CN0ZZ Extirpation of Matter from Left External Carotid Artery, Open Approach O3CP0ZZ Extirpation of Matter from Right Vertebral Artery, Open Approach O3CQ0ZZ Extirpation of Matter from Left Vertebral Artery, Open Approach)

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: CSTK, Modified Rankin Score (mRS)
Manual: Current Manual (current data collection period; prior to data transmission)
File:

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