Specifications Manual for Joint Commission National Quality Measures (v2023B)
Posted: 02/03/2023
Home » Pre-Stroke Modified Rankin Score (mRS)

Release Notes:
Data Element
Version 2023B

Name:Pre-Stroke Modified Rankin Score (mRS)
Collected For: CSTK-10
Definition:The pre-stroke Modified Rankin Score (mRS) is a score used to assess the patient’s pre-stroke or baseline level of function. Scores reflect the patient’s ability to perform activities of daily living prior to the hospitalization for the acute ischemic stroke event.

Score Description
0 The patient had no residual symptoms.
1 The patient had no significant disability; able to carry out all activities.
2 The patient has slight disability; unable to carry out all pre-stroke activities but able to look after self without daily help.
3 The patient has moderate disability; requiring some external help but able to walk without the assistance of another individual.
4 The patient has moderately severe disability; unable to walk or attend to bodily functions without assistance of another individual.
5 The patient has severe disability; bedridden, incontinent, requires continuous care.

Question:What is the patient's pre-stroke Modified Rankin Score (mRS)?
Allowable Values:

1  A score value of 0, 1, or 2 was documented in the medical record, OR physician/APN/PA documentation that the patient was able to look after self without daily help prior to this acute stroke episode.

2  A score value of 3, 4, or 5 was documented in the medical record, OR physician/APN/PA documentation that the patient could NOT look after self without daily help prior to this acute stroke episode.

3  A score value was not documented, OR unable to determine (UTD) from the medical record documentation.

Notes for Abstraction:
  • A pre-stroke mRS value (i.e., 0, 1, 2, 3, 4, or 5) may be documented by the physician/APN/PA, nurse (RN), medical assistant, or any individual trained to perform the mRS.
  • If more than one pre-stroke mRS value is documented, select the highest value.
  • If a score range is documented, e.g. 2-3, select the higher value.
  • Pre-stroke mRS values may be documented any time during the hospital stay or within 30 days prior to hospital arrival.
    • A discharge mRS cannot be used as a baseline pre-stroke mRS score. Score documentation must clearly reflect the patient’s functional status prior to arrival at the hospital for management of the acute ischemic stroke event.
  • If an acutal pre-stroke mRS value is not documented in the medical record, physician/APN/PA documentation only may be used to document the patient’s pre-stroke functional status.
    • “Patient independent and living alone prior to stroke onset. No past history of TIA or stroke”, select allowable value “1”.
    • “Mrs X lives with her daughter and has some memory deficit requiring assistance with meals and dressing. Ambulates without help”, select allowable value “2”.
  • If there is conflicting documentation of baseline pre-stroke functional status in the medical record, select the highest score value.
  • If there is an actual pre-stroke mRS value documented in the medical record, then that score should be used for abstraction over other physician/APN/PA documentation.
  • If no pre-stroke mRS is documented or unable to determine, select allowable value “3”.

Suggested Data Sources:
  • Consultation notes
  • Emergency department record
  • History and physical
  • Progress notes
  • Discharge summary
  • Admission note
  • Outpatient record
Additional Notes: Excluded Data Sources: Any documentation dated/timed after discharge
Guidelines for Abstraction:
Inclusion Exclusion
None None

Pre-Stroke Modified Rankin Score (mRS)
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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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