Our questions to better understand the CMS IQR Hybrid HWR/HWM Measures specifications are the following: 1. We are an Orthopaedic Hospital; majority of our patients are surgical. In the Hybrid Measure specifications, it states that hospitals are to submit the lab test results for 90% or more of discharges for non-surgical patients, meaning those not included in the surgical specialty cohort of the Hybrid HWR measure. How do we know who is included in the specialty cohort, is there a list of surgical ICD-10 Codes we could reference? We do not see this included anywhere on CMS Quality Net website or the eCQI Resource Center. 2. Because we are an Orthopaedic Hospital our patients are required to have a Pre-Op Physical (including lab work) done prior to the admission, surgery. Therefore, we don't routinely redraw lab work on admission, resulting in us not meeting the required Lab test results for 90% or more of discharges. 3. Is the intent of the Hybrid HWR/HWM Measure that the hospitals are required to obtain these lab values on every Inpatient? When we refer to the eCQI Resource Center Hybrid Measure Core Clinical Data Elements it states, "the logic is not meant to guide or alter the care patients receive." And "It is not intended to require that clinical staff perform additional measurements or tests that are not needed for diagnostic assessments or treatment of patients." 4. At times we may have a patient that is admitted to our facility as an Observation encounter, but due to a change in their health condition, the patient is switched to an Inpatient encounter. Will the CCDE results that were captured in the 24 hours that immediately preceded the Inpatient encounter count?