Query 1: Thank you for your inquiry regarding CMS871v3 Hospital Harm – Severe Hyperglycemia. To clarify, the denominator exclusion criteria is: Inpatient hospitalizations for patients with an initial glucose result of >=1000 mg/dL anytime between 1 hour prior to the start of the encounter to 6 hours after the start of the encounter. For this measure, the encounter starts in the ED and/or Observation when the transition between these encounters (if they exist) and the inpatient encounter are within an hour or less of each other. Scenario 1 does not meet the denominator exclusion because the initial glucose test on 5/10 at 7:35 was within 1 hour prior to the start of the encounter with a result value of only 800mg/dL (<1000 mg/dL). Scenario 2 meets the denominator exclusion because the initial glucose test on 11/12 at 2:20 occurred within 1 hour prior to the start of the encounter (i.e., 11/12 at 3:00) and 6 hours after the start of the encounter and had a result value of 1000mg/dL. Query 2: Glucose tests that are evaluated for the denominator exclusion are not necessarily limited to only those performed during the IP encounter. The Global.HospitalizationWithObservation function returns the interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given inpatient encounter. Therefore, if the encounter starts in the ED and/or Observation when the transition between these encounters and the IP encounter are within an hour or less of each other, then any glucose tests done between 1 hour prior to the start of the ED and/or Observation to 6 hours after the start of the ED and/or Observation will be evaluated for the exclusion logic. Query 3: The CQLIT-362 ticket ( https://oncprojectracking.healthit.gov/support/browse/CQLIT-362 ) provides more in-depth detail on how the function determines which timing element is evaluated and what is returned. Specifically, the ‘Global.EarliestOf’ function helps return the earliest glucose test based on relevantDatetime or relevantPeriod. To clarify further, the EarliestOf function in conjunction with other logic nested within the denominator exclusion definition ‘Encounter with First Glucose Greater Than or Equal to 1000’ checks for and evaluates the initial, or first, glucose test within the qualifying 7- hour time frame.