In the update that was provided on April 1, 2013, the measure stewards “Added an alternative measure PC-05a, Exclusive Breast Milk Feeding Considering Mothers Choice. The Release notes state that “The population criteria is replicated for PC-5a with the only difference in the Denominator Exclusion in PC-05a by adding:”

“OR: "Substance, Administered not done: Parental Refusal" for "Breast Milk SNOMED-CT Value Set" <= 4 hour(s) starts after start of "Occurrence A of Encounter, Performed: Inpatient Encounter"

This edit provides additional challenges, as there was no guidance provided regarding the selection or reporting of this alternative measure.

1.) Is it assumed that facilities submitting the PC-05 measure will also be required to submit PC-05a? There is currently no method to submit ‘alternative’ measures.

2.) What additional guidance can you provide to address these issues?