Comprehensive Documentation of Indications for PCI Comprehensive documentation of the indication for PCI is an absolute requirement for performing the procedure. This should include an appropriate description of the key features of the clinical presentation, along with documentation of noninvasive stress testing and functional assessments (if clinically indicated and performed) and the severity of angiographic stenosis for the treated lesion. PCIs are per- formed to improve symptoms or survival. Documentation of these elements allows for an evaluation of the patient s indication for the procedure and also provides prognostic utility. This ultimately permits an appropriate risk/bene t ratio to be inferred for the procedure. In addition, ful llment of this measure will enable assessment of other important quality indicators derived from the ACC/AHA/SCAI guideline for PCI (4) and the appropriate use criteria for coronary revascularization documents (11,12). The docu- mentation for many PCIs performed in the United States lacks essential data to determine the procedure s appropri- ateness, making this a measure with a possibly important gap in care (19). A potential concern is that several of the features pertaining to the indication for PCI are attributable to both the physician referring the patient for PCI and the physician performing the procedure, which leads to chal- lenges with attribution. Nonetheless, the writing commit- tee s opinion is that compiling all the required elements at the level of the therapeutic intervention is a process of care that is linked to desirable outcomes for patients undergoing PCI. It is therefore the ultimate responsibility of the physician performing the PCI and of the physician s insti- tution to accurately document key features. 5.2. 