Specifications Manual for Joint Commission National Quality Measures (v2023B)
Posted: 02/03/2023
Home » MER Eligibility

Release Notes:
Data Element
Version 2023B

Name:MER Eligibility
Collected For: STK-OP-1
Definition:Documentation in the medical record that the ischemic stroke patient is eligible for mechanical endovascular reperfusion (MER) therapy.

MER therapy or mechanical thrombectomy is an advanced neurological procedure for removal of a cerebral occlusion using a mechanical device, also known as a clot retrieval device or stent retriever, and/or aspiration technique.
Question:Is there documentation in the medical record that the patient is eligible for MER therapy or a mechanical thrombectomy procedure?
Allowable Values:

Y (Yes) There is documentation that the patient is eligible for MER therapy or a mechanical thrombectomy procedure.

N (No) There is no documentation that the patient is eligible for MER therapy or a mechanical thrombectomy procedure, OR unable to determine from the medical record documentation.
Notes for Abstraction:
  • If there is physician/APN/PA documentation in the medical record that the patient is a candidate or eligible for MER therapy, select “Yes".
  • Documentation by a physician/APN/PA that the patient is being transferred to a higher level stroke center for the purpose of having a mechanical thrombectomy procedure or further evaluation for possible MER therapy.
    Acceptable examples (select “Yes”):
    • Suspicious for left MCA – CT head negative for ICH – will transfer for potential LVO thrombectomy.
    • CTA abnormal, right MCA proximal M2 superior occlusion – transfer with possible neuro-intervention.
    • CT positive for LVO- transfer recommended because of the need for vascular surgical intervention.
    • Patient being transferred for potential intravascular clot removal.
    • Transfer to interventional suite.
    • Patient will be transferred for further management of stroke-like symptoms with possible acute large vessel occlusion.
      Unacceptable example (select “No”):
    • Although the patient is being transferred to a higher level of care due to complete occlusion, it is most likely that thrombectomy will not be performed.
  • If there is documentation in one source that indicates the patient is MER eligible, AND there is documentation in another source that indicates the patient is NOT eligible (e.g., ED MD states consider transfer for mechanical thrombectomy, but neurology states that the patient is not a MER candidate), or after careful examination of circumstances, context, etc., documentation of MER eligibility 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
  • Catheter-assisted intervention
  • Catheter-based intervention
  • Clot aspiration
  • Clot removal
  • Endovascular Therapy (EVT)
  • Interventional candidate
  • Intra-arterial catheter-based intervention
  • Intravascular clot removal
  • Mechanical Endovascular Reperfusion (MER) Therapy
  • Mechanical thrombectomy (MT)
  • Neuro-endovascular
  • Neuro-interventional radiology (NIR) procedure
  • Neuro IR intervention
  • Pneumbra procedure
  • Thrombectomy (head/neck only)
  • Vascular surgery intervention

  • Carotid endarterectomy
  • Carotid stent procedure
  • CT perfusion without mention of MT
  • Intra-arterial (IA) thrombolytic (t-PA) therapy without mention of MT
  • Neuro evaluation without mention of MT
  • Neurosurgery evaluation
  • Not an interventional candidate

MER Eligibility
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Specifications Manual for Joint Commission National Quality Measures (v2023B)
Discharges 07-01-23 (3Q23) through 12-31-23 (4Q23)


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