Thank you for your inquiry about CMS146v12. For this measure, a group A strep test is identified using the QDM datatype "Laboratory Test, Performed" along with the value set "Group A Streptococcus Test." The measure requires a non-null result for the test. There must be a result (any entry) in the electronic health record (EHR). It does not require a specific positive or negative result. The result must occur within the specified timeframe (3 days prior to or 3 days after the encounter). The order date of the test alone cannot be used to meet the numerator criteria.