There is a patient that came to the emergency department COVID+.  The principal diagnosis is COVID+ but secondary diagnosis STEMI because the patient had a STEMI 3 weeks prior and was treated at another hospital.  This patient is capturing in the denominator for the Appropriate treatment for STEMI in ED.  Per coding guidelines, myocardial infarction is equal to, or less than, four weeks old, including transfers to another acute setting or a postacute setting, and the myocardial infarction meets the definition for "other diagnoses" may continue to be reported." Is there a way to get patients like this to be excluded?  Pt had already previously been treated for MI at another hospital. Presentation for here was for COVID+.  Also, should the measure only be capturing principal diagnosis of STEMI?