Specifications Manual for Joint Commission National Quality Measures (v2023B)
Posted: 02/03/2023
Home » Suspected Large Vessel Occlusion (LVO)

Release Notes:
Data Element
Version 2023B

Name:Suspected Large Vessel Occlusion (LVO)
Collected For: STK-OP-1
Definition:Documentation in the medical record of a suspected large vessel cerebral artery occlusion.

Large vessel occlusions (LVO) include documentation of a cerebral occlusion in the Internal Carotid Artery (ICA), ICA terminus(T-lesion; T occlusion), Middle Cerebral Artery (MCA), M1 MCA, M2 MCA, Vertebral Artery, or Basilar Artery.
Question:Is there documentation of a suspected LVO in the medical record?
Allowable Values:

Y (Yes) There is documentation of a suspected LVO.

N (No) There is no documentation of a suspected LVO, OR unable to determine from the medical record documentation.
Notes for Abstraction:
  • If there is ANY documentation of LVO prior to transfer to another hospital, select “Yes”. The percentage or degree of occlusion or stenosis is not needed to select “Yes” for this data element, e.g., “the patient has a LVO and requires transfer.”
    • Documentation of LVO alone without the location of a specific cerebral artery is sufficient to select “Yes”.
    • Disregard qualifiers describing the degree of occlusion, e.g., minimal/mild/moderate/high.
  • Documentation of suspected LVO, select “Yes”.
    Acceptable examples (select “Yes”):
    • Possible LVO requiring further evaluation.
    • High probability of left side ELVO.
    • Worrisome for ICA LVO.
    • Suspicious for left MCA territory ischemic CVA.
  • If an occlusion is documented in any of the following cerebral arteries, select “Yes”: Internal Carotid Artery (ICA), ICA terminus (T-lesion; T occlusion), Middle Cerebral Artery (MCA), M1 MCA, M2 MCA, Vertebral Artery, or Basilar Artery.
    • A brain imaging report is not needed to select “Yes”, but may be used for abstraction. Findings / impression documented by a radiologist may be used for abstraction as well as other documentation available in the medical record.
    • The term LVO does not need to be linked with the cerebral artery.
  • If there is documentation in one source that indicates the patient has a LVO, AND there is documentation in another source that indicates the patient is NOT LVO (e.g., neurology report states positive for LVO, but radiology report states negative for LVO), the source that indicates the patient has LVO would be used for this data element. Contradictory or conflicting documentation, select “Yes”.
  • If after careful examination of circumstances, context, etc., documentation of LVO is still unclear, the case should be deemed "unable to determine” (select "No”).
Suggested Data Sources:
  • Consultation notes
  • Emergency department record
  • History and physical
  • Progress notes
  • Discharge summary
  • Diagnostic test reports
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
  • Evolving large vessel occlusion (ELVO)
  • Hyperdensity or hyperdense sign in a defined location.
  • Opacification
  • Sylvian occlusion


Suspected Large Vessel Occlusion (LVO)
CPT® only copyright 2023 American Medical Association. All rights reserved.
Specifications Manual for Joint Commission National Quality Measures (v2023B)
Discharges 07-01-23 (3Q23) through 12-31-23 (4Q23)


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