Specifications Manual for Joint Commission National Quality Measures (v2020A1)
Posted: 9/13/2019
Home » IA Route of Alteplase Administration

Release Notes:
Data Element
Version 2020A1

Name:IA Route of Alteplase Administration
Collected For: CSTK-05, CSTK-07, CSTK-08, CSTK-09
Definition:The route of alteplase administration was intra-arterial (IA). Alteplase may be administered intra-venously (IV) by infusion directly into a vein through a peripheral or central venous catheter, or it may be given through an endovascular mircrocatheter delivery system positioned in an artery to directly infuse alteplase into the clot.
Question:Is there documentation that the route of alteplase administration was intra-arterial (IA)?
Allowable Values:

Y (Yes) The route of alteplase administration was intra-arterial (IA).

N (No) The route of alteplase administration was not intra-arterial (IA), OR unable to determine from medical record documentation.
Notes for Abstraction:
  • If the route of alteplase administration is documented as intra-arterial (IA), select “Yes”.
  • If both intravenous (IV) and intra-arterial (IA) alteplase are given either in different procedures or the same procedure, select “Yes”.
    • “IV alteplase given at hospital ‘A’ prior to transfer to hospital ‘B’ (i.e. drip and ship). Mechanical thrombectomy with IA alteplase was performed at hospital ‘B’”.
    • “NIHSS score 3 on arrival to this hospital. IV alteplase initiated in ED with initial improvement noted and NIHSS score zero post-infusion. NIHSS score 5 one hour later. Patient taken to interventional suite and IA alteplase administered.”
  • If the only route of alteplase administration was intra-venous (IV) at this hospital or a transferring hospital, select “No”.
  • If IA alteplase was administered at another hospital and the patient subsequently transferred to this hospital, select “No”.
Suggested Data Sources:
  • Consultation notes
  • Diagnostic test reports
  • Operative notes
  • Procedure notes
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion

Only Acceptable Thrombolytic Therapy for Stroke:
  • Activase
  • Alteplase
  • IA t-PA
  • Recombinant Tissue Plasminogen Activator(rt-PA)
  • Tissue Plasminogen Activator(t-PA)

  • Intravenous (IV) alteplase (t-PA)
  • IA administration of thrombolytic agents not listed as inclusions

IA Route of Alteplase Administration
CPT® only copyright 2019 American Medical Association. All rights reserved.
Specifications Manual for Joint Commission National Quality Measures (v2020A1)
Discharges 01-01-20 (1Q20) through 6-30-20 (2Q20)


CPT® only copyright 2019 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.

You, your employees and agents are authorized to use CPT® only as contained in The Joint Commission performance measures solely for your own personal use in directly participating in healthcare programs administered by The Joint Commission. You acknowledge that the American Medical Association (“AMA”) holds all copyright, trademark and other rights in CPT®.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT® for resale and/or license, transferring copies of CPT® to any party not bound by this Agreement, creating any modified or derivative work of CPT®, or making any commercial use of CPT®. License to use CPT® for any use not authorized herein must be obtained through the American Medical Association, Intellectual Property Services, AMA Plaza, 330 North Wabash Avenue, Suite 39300, Chicago, Illinois 60611-5885. Applications are available at the American Medical Association Web site, www.ama- assn.org/go/cpt.

U.S. Government Rights This product includes CPT® which is commercial technical data, which was developed exclusively at private expense by the American Medical Association, 330 North Wabash Avenue, Chicago, Illinois 60611. The American Medical Association does not agree to license CPT® to the Federal Government based on the license in FAR 52.227-14 (Data Rights - General) and DFARS 252.227-7015 (Technical Data - Commercial Items) or any other license provision. The American Medical Association reserves all rights to approve any license with any Federal agency.

Disclaimer of Warranties and Liabilities. CPT® is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT®, and the (AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this product is with The Joint Commission, and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product.

This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled “accept”.