The numerator for CMS65v7 states:
Patients whose follow-up blood pressure is at least 10 mmHg less than their baseline blood pressure or is adequately controlled.
If a follow-up blood pressure reading is not recorded during the measurement year, the patient's blood pressure is assumed "not improved."
And the conditions written in the HTML include:
AND: "Occurrence B of Encounter, Performed: Blood Pressure Visit" satisfies all:
First: >= 6 month(s) starts after end of "Occurrence A of Encounter, Performed: Blood Pressure Visit"
ends during "Measurement Period"
AND:
OR: "Physical Exam, Performed: Delta systolic blood pressure" satisfies all:
(result >= 10 mmHg) starts after or concurrent with end of Most Recent: "Physical Exam, Performed: Systolic Blood Pressure (result)" during "Occurrence B of Encounter, Performed: Blood Pressure Visit"
overlaps "Occurrence B of Encounter, Performed: Blood Pressure Visit"
OR: "Physical Exam, Performed: Systolic Blood Pressure" satisfies all:
Most Recent: (result) during "Occurrence B of Encounter, Performed: Blood Pressure Visit"
(result < 140 mmHg)

As per guidance, the Delta systolic blood pressure (result)" data element is calculated by ubtract the value of "Occurrence B of Physical Exam, Performed: Systolic Blood Pressure (result)" from the value of "Occurrence A of Physical Exam, Performed: Systolic Blood Pressure (result)
Also guidance states that Physical Exam, Performed: Delta systolic blood pressure is a calculation artifact, and there's no requirement to document the delta data element in the medical record.

Is it mandatory to validate the delta systolic blood pressure result for CMS65 since it does not get documented in the medical record?