I have 10 patients that meet the denominator for the CMS Measure: 122 - Hemoglobin A1c > 9.0% in Adults
All 10 patients have a Hemoglobin A1c < 9%
Therefore none of the patients meet the numerator as defined by the measure author
The desirable outcome of a Hemoglobin A1c test is a value lower than 9%
For doctors that are managing diabetes their goal is to have zero patients in the numerator - this means good care
For a doctor that is meeting the goal in this case the denominator would be 10 and the numerator would be zero

There are 2 choices
1) Should we report a numerator of zero - if yes, is this allowed - will the file pass with a numerator value of zero for this measure
OR
2) Should we report a numerator of 10 (the inverse)

Please respond by simply stating choice 1 or choice 2