Thank you for your question regarding CMS108v12: Venous Thromboembolism (VTE) Prophylaxis. The verbiage you presented, attesting to why no VTE prophylaxis was given, is insufficient. Per the measure guidance, “reasons for no pharmacological and no mechanical VTE prophylaxis must be explicitly documented by the MD/APN/PA or pharmacist and linked with VTE prophylaxis.” Therefore, a specific reason must be documented in the order is satisfy the numerator condition - “Encounter with No VTE Prophylaxis Due to Medical Reason,” such as the reason for no mechanical prophylaxis (e.g., leg ulcers), and a reason for no pharmacological prophylaxis (e.g., bleeding).