Hi Team,

We have a query wrt CMS996v3 measure.

Consider a scenario given below :

Patient A aged 20 years has documented ED Encounter with STEMI Diagnosis and has codes 4525004 and 401303003 respectively with 

Admit Date : 2023-01-17 08:00:00.000
Discharge Date : 2023-01-17 10:15:00.000

diagnosis start date : 2023-01-17T08:00:00.000

Also, the Patient has documented ED visit location code 4525004 with 

arrival date : 2023-01-17 08:00:00.000

departure date : 2023-01-17 10:15:00.000

and has documented 1008478 code for Fibrinolytic Therapy with

start date:  2023-01-17 08:05:00.000

#Query:

For the scenario mentioned above we anticipate that patient will not qualify for numerator as departure time for ED visit is not 1 hour or less on or before start of ED Encounter with STEMI Diagnosis.

Request you to confirm if our understanding is correct.

The understanding is based on following statements:

Fibrinolytic Therapy Within 30 Minutes of Arrival:
/The definition "ED Encounter with STEMI Diagnosis" uses OID 2.16.840.1.113883.3.464.1003.101.12.1010 to define "Emergency Department Visit". Instances of "Emergency Department Visit" associated with the Global Common Library, "Global", should use OID 2.16.840.1.113883.3.117.1.7.1.292/
"ED Encounter with STEMI Diagnosis" EDwSTEMI
  with ["Medication, Administered": "Fibrinolytic Therapy"] Fibrinolytic
    such that Global."NormalizeInterval" ( Fibrinolytic.relevantDatetime, Fibrinolytic.relevantPeriod ) starts 30 minutes or less after Global."EmergencyDepartmentArrivalTime" ( EDwSTEMI )

Global.EmergencyDepartmentArrivalTime(Encounter "Encounter, Performed"):
start of First(("HospitalizationLocations"(Encounter))HospitalLocation
        where HospitalLocation.code in "Emergency Department Visit"
        sort by start of locationPeriod
).locationPeriod

Global.HospitalizationLocations(Encounter "Encounter, Performed"):
Encounter Visit
    let EDVisit: Last(["Encounter, Performed": "Emergency Department Visit"] LastED
            where LastED.relevantPeriod ends 1 hour or less on or before start of Visit.relevantPeriod
            sort by 
            end of relevantPeriod
    )
    return if EDVisit is null then Visit.facilityLocations 
        else flatten { EDVisit.facilityLocations, Visit.facilityLocations }

 
Request you to provide us with the resolution urgently as our client deliverables are dependent on it.