Thank you for your inquiry. Please see the responses below- Response to Question #1: The possibility of 2 CCNs for a single patient may exist but would not be acceptable for the ED-2 measure. The measure intends to assess the time the decision to admit was made to the time the patient physically departed from that hospital’s ED. If the hospital has an offsite ED with the same CCN as the hospital the patient is being admitted to, it may include these patients in the initial population. If the CCN is not shared by the ED and hospital, including this patient is not acceptable. Response to Question #2: If the CCN is not shared by the ED and its hospital, the patient should not be included in ED-2. Response to Question #3: Both the ED visit and facility location should be defined using the codes in the "Emergency Department Visit" value set (2.16.840.1.113883.3.117.1.7.1.292). The measure intent is to capture the time (in minutes) from when the Decision to Admit was made at the ED visit to when the patient was admitted to a facility for an inpatient encounter. For now, please capture the most recent (last) ED visit within an hour of the inpatient admission. The CMS111v9/ED-2 logic more closely captures the intent: EDDepartureTime(Encounter "Encounter, Performed") /*The time the patient physically departed the Emergency department*/ Last(Encounter.facilityLocations Location     where Location.code in "Emergency Department Visit"       and       end of Location.locationPeriod != maximum DateTime     return     end of Location.locationPeriod     sort ascending ) Response to Question #4: If there are multiple ED visits within an hour of the inpatient admission, select the most recent ED encounter with the Decision to Admit.             ED visit (outpatient) check-in 9/1/2020 lab blood collection @ 0950                 ED visit (outpatient) check-in 9/1/2020 diagnostic study @1000                      Sent to ED for abnormal results ED visit 9/1/2020 @1015                                 ED visit arrival @1020                                 ED Decision to admit @ 1025 Inpatient admission time @ 1030 ED discharge time @1030 ED departure @1045   For CMS111/ED-2, the ED visit on 9/1/2020 @ 1015 should be used. The ED discharge time @ 1030 to Inpatient admission time @ 1030 = 0 minutes, so that would be less than one hour. The Decision to Admit @ 1025 to ED departure @ 1045 = 15 minutes, which would be the measure observation time.

Function is as below : /* The time the patient physically departed the Emergency Department*/ Last(Encounter.facilityLocations Location return end of Location.locationPeriod sort ascending )   1. Is there any possibility of getting 2 CCN for single patient in two QRDA-I files or single QRDA-I file? If Yes, Please clarify how we will get data and how co-relate with two CCN? 2. If a patient is arrived and discharged from an emergency department in CCN 1, and is admitted as an inpatient in CCN 2. Then how it will impact on IPP. Shall we need to match the CCN of the emergency department and Inpatient encounter?Is this case is valid?And will this patient qualify for IPP? 3. How to correlate the ED(emergency department) visit and facility location. 4. Is there any possibility to get more than one emergency department visit in the 60 minutes prior to an inpatient admission? If yes, how to calculate that? Please guide with examples.If clarification is already there please provide reference details for the same.