Thank you for your inquiry regarding CMS108v13: Venous Thromboembolism Prophylaxis. To clarify your question, there is no exclusion criteria in the eCQM version for documentation of mechanical or pharmacological prophylaxis. For the VTE-1 eCQM, if a medical reason for both mechanical and pharmacological prophylaxis, OR patient refusal for mechanical or pharmacological prophylaxis, and the reason was documented in a discrete field within the qualifying time frame, this patient will meet the numerator. Reasons for no pharmacological and no mechanical VTE prophylaxis must be explicitly documented by the medical doctor, advanced practice registered nurse, physician assistant, or pharmacist and linked with VTE prophylaxis. The only exception is that patient refusal may be documented by a nurse. Please check with your local IT department or EHR vendor on how and where your EHR system is reporting the reason for no mechanical and pharmacological prophylaxis.