Thank you for your inquiry about CMS153v12. The logic specification does not require medications to be ordered by a specific provider. It is specified such that if the providers are sharing EHRs or sharing data through Health Information Exchange, all providers that have access to the data could use for reporting. The denominator exclusion identifies “patients who are only eligible for the initial population due to a pregnancy test during the measurement period, and who had an order for an x-ray or for a specified medication on the date of the pregnancy test or the six days after the pregnancy test.” With regards to details of the ‘medication exclusions’, below are relevant data criteria required in the logic for evaluation. If a patient had a medication order of isotretinoin within six days of a pregnancy test, and did NOT have an active or ordered contraceptive medication during the measurement period, they would be excluded from the measure. Please refer to the measure specification for complete requirements of the denominator exclusions. - "Medication, Order" using a code from "Isotretinoin" value set (2.16.840.1.113883.3.464.1003.196.12.1143) - "Medication, Order" using a code from "Contraceptive Medications" value set (2.16.840.1.113883.3.464.1003.196.12.1080) - "Medication, Active" using a code from "Contraceptive Medications" value set (2.16.840.1.113883.3.464.1003.196.12.1080) For additional guidance on reading/reporting eCQM specifications, please refer to the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=0 . You may reference the applicable codes containing these value sets mentioned below on the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/ . Click on the “Search Value Sets” tab and enter the value set ID (listed above) to review codes included in the respective value set.