Thank you for question on CMS1028v1: Severe Obstetric Complications. The ICD-10 code of O14.14 Severe pre-eclampsia complicating childbirth is a risk variable that when present on admission (POA) for a patient that qualifies for the numerator, would be taken into consideration for the risk-adjusted measure rate. The ICD-10 code of O72.2 delayed and secondary postpartum hemorrhage is not included in the Severe Maternity Morbidity (SMM) Diagnoses grouping value set, and therefore would not qualify the patient to be included in the numerator. The included codes for the SMM Diagnoses value set (2.16.840.1.113762.1.4.1029.255), as well as all other value sets, can be found in the Value Set Authority Center (VSAC). Please ensure that the correct versions are viewed for the reporting year of interest. All patients that receive a blood transfusion during the delivery encounter would qualify as an SMM Procedure for the numerator rate, but if blood transfusion is the only severe obstetric complication, the patient would not be included in Stratum 1. Pre-existing variables POA are risk variables and considered separately. The risk variables considered for this measure are clinically relevant patient-level factors. The patient-level risk variables in the numerator that are POA, have strong relationships with the measure's outcome. Risk-adjusted scores will be reported for this measure for better comparisons in the analysis of measure results. For more information, please reference the Severe Obstetric Complications Methodology Report posted on the eCQI Resource Center.