CHAPTER 146
STROKE CARE REPORTING
641—146.1(135) Purpose. The purpose of this chapter is to identify the statewide stroke database where nationally certified comprehensive stroke centers and nationally certified primary stroke centers in the state are required to report stroke care data in accordance with Iowa Code chapter 135.
[ARC 3748C, IAB 4/11/18, effective 5/16/18]
641—146.2(135) Definitions.
“Comprehensive stroke center” means a hospital certified as a comprehensive stroke center by a nationally recognized certifying body with certification criteria consistent with the most current nationally recognized, evidence-based stroke guidelines related to reducing the occurrence of and disabilities and death associated with stroke.
“Department” means the Iowa department of public health.
“Primary stroke center” means a hospital certified as a primary stroke center by a nationally recognized certifying body with certification criteria consistent with the most current nationally recognized, evidence-based stroke guidelines related to reducing the occurrence of and disabilities and death associated with stroke.
“Stroke” means a clinical diagnosis of acute stroke or principal International Classification of Disease, 10th Revision, Clinical Modification (ICD-10-CM) discharge code of “stroke,” or “transient ischemic attack,” or “cerebral infarction,” or “cerebral hemorrhage.”
“Stroke care” means care provided to individuals with confirmed cases of stroke.
[ARC 3748C, IAB 4/11/18, effective 5/16/18]
641—146.3(135) Stroke care reporting.
	146.3(1) Iowa statewide stroke database. The department designates the Get with the Guidelines stroke module of the American Heart Association/American Stroke Association as the Iowa stroke database established in Iowa Code section 135.191.
	146.3(2) Who is required to report. All nationally certified comprehensive stroke centers and all nationally certified primary stroke centers operating in the state of Iowa are required to report stroke data. Nationally certified acute stroke-ready hospitals and emergency medical services operating in the state of Iowa are encouraged to report stroke care data.
	146.3(3) What is required to be reported. Reportable data of stroke care are required to be reported. Reportable data are those data identified by a clinical diagnosis of acute stroke or by the following ICD-10 coding:

ICD-10-CM Code	Short Description	
I60.00 - I60.9	Nontraumatic subarachnoid hemorrhage	
I61.0 - I61.9	Nontraumatic intracerebral hemorrhage	
I63.00 - I63.9	Cerebral infarction (occlusion and stenosis of cerebral and precerebral arteries, resulting in cerebral infarction)	
G45.0 - G45.2	TIA and related syndromes	
G45.8 - G45.9	TIA and related syndromes	
O99.411 - O99.43	Diseases of the circulatory system complicating pregnancy, childbirth and puerperium	
G97.31 - G97.32	Intraoperative hemorrhage and hematoma of a nervous system organ or structure complicating a procedure	
G97.51 - G97.52	Postprocedural hemorrhage and hematoma of a nervous system organ or structure following a procedure	
I97.810 - I97.821	Intraoperative and postoperative cerebrovascular infarction	
[ARC 3748C, IAB 4/11/18, effective 5/16/18]
641—146.4(135) Method and frequency of reporting.
	146.4(1) Stroke centers shall report the required stroke care information for any reportable stroke case no later than 120 days after the patient was discharged, transferred to another hospital, or pronounced dead.
	146.4(2) Reports shall meet the data quality, format, and timeliness standards prescribed by the Iowa statewide stroke database.
[ARC 3748C, IAB 4/11/18, effective 5/16/18]
641—146.5(135) Confidentiality. The Iowa statewide stroke database shall comply with federal and state law and other health information and data collection, storage, and sharing requirements of the department.
[ARC 3748C, IAB 4/11/18, effective 5/16/18]
641—146.6(135) Penalties and enforcement. If a stroke center required to report under this chapter does not comply with the reporting requirements, the department may request a review of the certification of the comprehensive stroke center or the primary stroke center by the certifying entity.
[ARC 3748C, IAB 4/11/18, effective 5/16/18]
These rules are intended to implement Iowa Code section 135.191.
[Filed ARC 3748C (Notice ARC 3575C, IAB 1/17/18), IAB 4/11/18, effective 5/16/18]