Thank you for your question about CMS 72v9/STK-5 “Antithrombotic Therapy By End of Hospital Day 2.” Mechanical thrombectomy is not a contraindication to antithrombotic therapy by end of hospital day 2. Therefore, mechanical thrombectomy on its own will not exclude the case. If IV or IA t-PA is given prior to performing a mechanical thrombectomy, then the case is excluded. The value set you referenced (Procedure Performed- Intravenous or Intra-arterial Thrombolytic (tPA) therapy (2.16.840.1.113762.1.4.1045.21)) is a procedure value set. IV/IA t-PA is considered a treatment or therapy rather than “medication.”