​​Thank you for your inquiry for CMS165v11 (2023 Performance Period). Correct, the addition of the 'day of' in this logic would allow BP readings taken on the same day as the ED visit to be excluded, so in your example, the BP taken in the afternoon of the ED visit would be excluded. The intent is to exclude BPs not representative of the patient's overall chronic hypertension. Note that measure specifications are evaluated by the measure developer on a yearly basis to ensure intent is met.

Would like to understand the intent of adding the "day of" measure logic to the CMS 165 numerator to help understand the impact of the change. For example, if a patient was seen in the ED in the morning of day 1, then in the afternoon had an office visit, would the BP taken during the office visit count or not? as it will be the same day as ED encounter, correct? ["Physical Exam, Performed": "Diastolic blood pressure"] DiastolicBP   without ( ["Encounter, Performed": "Encounter Inpatient"]     union ["Encounter, Performed": "Emergency Department Visit"] ) DisqualifyingEncounter     such that Global."LatestOf" ( DiastolicBP.relevantDatetime, DiastolicBP.relevantPeriod ) during day of DisqualifyingEncounter.relevantPeriod   where DiastolicBP.result.unit = 'mm[Hg]'     and Global."LatestOf" ( DiastolicBP.relevantDatetime, DiastolicBP.relevantPeriod ) during day of "Measurement Period"