Pre-Stroke Modified Rankin Score (mRS) (v2025A)

Specifications Manual for Joint Commission National Quality Measures (v2025A)

Posted: 09/13/2024

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Release Notes:
Data Element
Version 2025A

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.

MODIFIED RANKIN SCALE

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)?

Format:

Length:	1
Type:	Alphanumeric
Occurs:	1

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.
EXCEPTION:
- 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.
EXAMPLES:
- “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

Specifications Manual for Joint Commission National Quality Measures (v2025A)
Discharges 01-01-25 (1Q25) through 06-30-25 (2Q25)

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