Patients with a VTE present at admission should not be included in the denominator population for CMS114v3. The exclusion of such patients from the measure population is achieved in several ways:  1. The initial population specifically includes patients who were diagnosed with a VTE (VTE diagnosis start datetime) during the inpatient admission, i.e. diagnoses with a start datetime prior to inpatient admission are implicitly excluded. 2. The denominator logic requires that a confirmatory VTE diagnostic test occurs during the inpatient admission, i.e. only patients who had a VTE confirmatory test during the inpatient admission will be included in the measure population. 3. The denominator exclusions logic accounts for patients who may have had a diagnosis of VTE, a suspicion of VTE or the confirmatory VTE diagnostic test prior to inpatient admission or within one day after inpatient admission. In your specific example, the case would not meet denominator inclusion criteria, and therefore it would not be in the measure population, because the patient did not have a confirmatory VTE diagnostic test during the inpatient admission (scenario 2 above).