Thank you for your question regarding CMS871v3, Hospital Harm – Severe Hyperglycemia. This measure's Numerator identifies inpatient hospitalizations with a hyperglycemic event within the first 10 days of the encounter minus the first 24 hours, and minus the last period before discharge from the hospital if less than 24 hours. The first 24-hour period after admission to the hospital is not evaluated to account for potentially poor glucose control outside of the hospital setting or that preceded the start of hospital care. The measure defines a hyperglycemic event as (1) a day with at least one glucose value >300 mg/dL or (2) a day where a glucose test and result was not found, and it was immediately preceded by two contiguous, consecutive days where at least one glucose value during each of the two days was >=200 mg/dL. In the scenario provided, it appears that Day 3, a day with no glucose test and result, is not immediately preceded by two contiguous, consecutive days where at least one glucose value during each of the two days was >=200 mg/dL. This is because the day that immediately precedes Day 3 (Day 2) is also a day with no glucose test and result. Therefore, based on the information provided in this scenario, the encounter would not meet the Numerator criteria. However, please note that for this measure, hospital days are not defined as midnight-to-midnight. Rather, they are defined as full 24-hour periods that start at the time of admission to the hospital (including emergency department and observation), excluding the last period before inpatient discharge from the hospital if that period is less than 24 hours. Please see the attached table for an illustration of how the measure determines hospital days.