Specifications Manual for Joint Commission National Quality Measures (v2020A2)
Posted: 10/30/2019
Home » Initial Hunt and Hess Scale Performed

Release Notes:
Data Element
Version 2020A2

Name:Initial Hunt and Hess Scale Performed
Collected For: CSTK-03
Definition:Documentation of the first Hunt and Hess scale that was done at this hospital. The Hunt and Hess scale is a grading system used to classify the severity of a subarachnoid hemorrhage based on the patient’s clinical condition. The scale ranges from a score of 1 to 5. It is used as a predictor of prognosis/outcome with a higher grade correlating to a lower survival rate.

Grade - Description

1 (I) - Asymptomatic, mild headache, slight nuchal rigidity

2 (II) - Moderate to severe headache, nuchal rigidity, no neurologic deficit other than cranial nerve palsy

3 (III) - Drowsiness / confusion, mild focal neurologic deficit

4 (IV) - Stupor, moderate-severe hemiparesis

5 (V) - Coma, decerebrate posturing

Question:Was an initial Hunt and Hess scale done at this hospital?
Allowable Values:

Y (YES) Initial Hunt and Hess scale was done at this hospital.

N (No) Initial Hunt and Hess scale was not done at this hospital, OR Unable to determine (UTD) from the medical record documentation.

Notes for Abstraction:
  • The Hunt and Hess scale may be documented by the physician/APN/PA or nurse (RN).
  • Hunt and Hess obtained by teleneurology and documented in the medical record, select 'YES'.
  • Hunt and Hess obtained in response to a code stroke/stroke alert on an inpatient psychiatric or rehabilitation unit prior to admission to inpatient acute care, select 'YES'.
Suggested Data Sources:
  • Consultation notes
  • Emergency department record
  • History and physical
  • Progress notes
  • Admitting note

Excluded Data Sources:
  • Any documentation dated/timed after discharge
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
  • Hunt and Hess “1-5”
  • Hunt and Hess Grade
  • Hunt and Hess Scale
  • Hunt & Hess “1-5”
  • H/H “1-5”
  • Hunt & Hess “1-5”/Fischer “X”
  • SAH Grade “1-5”
  • Grade “1-5” SAH


Initial Hunt and Hess Scale Performed
CPT® only copyright 2019 American Medical Association. All rights reserved.
Specifications Manual for Joint Commission National Quality Measures (v2020A2)
Discharges 01-01-20 (1Q20) through 6-30-20 (2Q20)


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