We have a question on the specification(spec) CMS69V10.1: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. The question is related to the lookback period for the Denominator Exception medical reason and patient reason, Spec states: "Patients with a Documented Medical Reason for Not documenting BMI or for not documenting a follow-up plan for a BMI outside normal parameters (e.g., elderly patients 65 years of age or older) for whom weight reduction/weight gain would complicate other underlying health conditions such as illness or physical disability, mental illness, dementia, confusion, or nutritional deficiency such as vitamin/mineral deficiency; patients in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status) - Patient Reason: Patients who refuse measurement of height and/or weight. (Denominator Exception)"   We need clarification of the lookback period for medical reason and patient reason for Denominator Exceptions. In the spec we see " 
"Qualifying Encounter during Measurement Period" QualifyingEncounter
such that NoBMIFollowUp.authorDatetime same day as start of QualifyingEncounter.relevantPeriod
where NoBMIFollowUp.negationRationale in "Medical Reason"
( NoBMI.authorDatetime, NoBMI.relevantPeriod ) ends same day as start of QualifyingEncounter.relevantPeriod
where ( NoBMI.negationRationale in "Medical Reason"
or NoBMI.negationRationale in "Patient Declined"
Our vendor had read it as timeline of " at the qualifying encounter or 12 months prior to the qualifying encounter." We are seeking a clarification of - is there a Denominator exception lookback period? We are reading the specifications for this measure with no lookback period, needs to be on Qualifying encounter date for the Denominator exceptions.  Thank you