Thank you for your question related to CMS69v13. The intent of the pregnancy exclusion in this measure is to exclude anyone who is pregnant at any point during the measurement period. The pregnancy exclusion definition uses prevalencePeriod which requires both a start and end date of the pregnancy diagnosis in the medical record. If an older pregnancy diagnosis does not have an end date in a medical record, the prevalencePeriod will remain ongoing for the purpose of the eCQM. In order to prevent patients with older pregnancy diagnoses from being excluded from the measure, the diagnoses must have an end date, thus putting an upper timing boundary on the prevalencePeriod. 

Writing for guidance on how to interpret the exclusions when a diagnosis is being considered current when it is from prior years AND has a NULL end date. A Null end date in most queries, means it is 'Active'. The BMI measure logic defines the exclusions search to "overlap" the measurement year. We have identified some exclusions based on older diagnosis codes that we feel are inaccurate due to having NULL end dates. For example, we have excluded a patient from the denominator due to a pregnancy diagnosis from 2021 with null end dates - Z34.92 (Encounter for supervision of normal pregnancy in second trimester). Again the prevalence period the query is finding is 5/10/2021 - No end, excluding the patient from the measure denominator. Please provide guidance on what to do. Is this technically a correct exclusion or does this need to be corrected?