In researching this issue, I came across this ticket:
https://oncprojectracking.healthit.gov/support/browse/CQM-5846

The answer provided indicates that the denominator exclusion logic uses "Inpatient Encounters with an Opioid or Benzodiazepine at Discharge", not "Inpatient Encounter with Age Greater than or Equal to 18". This is not accurate. According to the measure logic as provided from eCQI and described in the attached html file, the denominator exclusion is clearly referencing "Inpatient Encounter with Age Greater than or Equal to 18" (screenshot below).

This logic conflicts with the measure flow as represented in the flow chart. The flow states that only denominator encounters – meaning inpatient encounters where an opioid or benzo was provided at discharge – should be evaluated for the exclusion. But the actual logic does not reference denominator encounters, it references any inpatient encounter where the patient is >= 18.

To sum up, this measure's logic does not match the intended flow in the flow chart. This is causing some inpatient encounters that were not in the denominator to be included in the denominator exclusion, which should not be possible. Please advise.