Brief description of measure ​CMS986: Global Malnutrition Composite Score: This measure assesses the percentage of hospitalizations for adults aged 65 years and older prior to the start of the measurement period with a length of stay equal to or greater than 24 hours who received optimal malnutrition care during the current inpatient hospitalizations where care performed was appropriate to the patient's level of malnutrition risk and severity. Malnutrition care best practices recommend that for each hospitalization, adult inpatients are screened for malnutrition risk, assessed to confirm findings of malnutrition risk, and if identified with a "moderate" or "severe"  malnutrition status in the current performed malnutrition assessment, receive a current "moderate" or "severe" malnutrition diagnosis and have a current nutrition care plan performed. Description of issue ​The "Malnutrition Risk Screening" Value Set contains SNOMED-CT and ICD-10-CM codes for Assessment, Performed, which is not allowed per the CMS Measures Blueprint. LOINC codes will be added. Goal of review Obtain technical feedback

Proposed solution Remove SNOMED-CT and ICD-10-CM codes from the "Malnutrition Risk Screening" Value Set (OID: 2.16.840.1.113762.1.4.1095.40). Add a new extensional value set for the LOINC codes:     - 98967-3 Nutritional Risk Screening 2002 panel     - 98968-1 Initial screening NRS_2002     - 98972-3 Final screening NRS_2002 Rationale for change Replacing the SNOMED-CT and ICD-10-CM codes from the "Malnutrition Risk Screening" Value Set with appropriate LOINC codes aligns with the Clinical Vocabulary Standards recommendations of the CMS Measures Blueprint Recommended Vocabularies. For "Assessment Instrument Questions": "Assessment, Performed", LOINC codes are required.