Yes. A SNOMED code for one of the acceptable reasons for No VTE Prophylaxis must be present in the record, along with the data elements for either the Medication or Device that was not used.   For further information on the technical implementation of the HQMF, please refer to the following documents:   - Electronic Clinical Quality Measure Logic and Implementation Guidance, Version 1.12 - 2016 CMS QRDA I Implementation Guide for Eligible Professional Programs and Hospital Quality Reporting February 2016 - Section 3.4; Asserting an Act Did Not Occur with a Reason, Volume 1 of the HL7 CDA R2 Implementation Guide: Quality Reporting Document Architecture Category I (QRDA I), Release 1, DSTU Release 3 - US Ream (June 2015): http://www.hl7.org/documentcenter/public/standards/dstu/CDAR2_QRDA_I_R1_DSTU3_2015JUN.zip