I'm seeking clarification on the definition of "First SUD Episode During Measurement Period." For purpose of example:

• Patient is age >=13 on 1/1/2025
• Patient has an SUD diagnosis on the problem list with an onset date of 7/1/2024 and no stop date
• Patient's first valid encounter (e.g. office visit) during the measurement period occurs on 2/1/2025, without the presence of an SUD diagnosis on the encounter
• Patient has no valid encounters with an SUD diagnosis during the 60 days prior to the 2/1/205 encounter
• Patient has no documentation of anything from the value sets Intervention, Performed: Substance Use Disorder Treatment or Medication, Order: Substance Use Disorder Long Acting Medication at any time

Does the 2/1/2025 encounter qualify as a First SUD Episode During the Measurement Period? My interpretation is that it does not because of the following CQL statement: SUDDiagnosis.prevalencePeriod starts during ValidEncounters.relevantPeriod. The problem list prevalence period starts on 7/1/2024, and the valid encounter relevant period is 2/1/2025.

What if the 2/1/2025 encounter included an SUD diagnosis? Does that create a First SUD Episode During the Measurement Period because its prevalence period starts 2/1/2025 and "overrides" the problem list prevalence period that starts on 7/1/2024?