Thank you for your questions about CMS1028v3 Severe Obstetric Complications. Please see the following responses to your questions. 1. Should only finalized codes (billing codes) be used by eCQM logic? No, not only finalized billing codes should be used to accommodate the eCQM logic. Please refer to the terminology section within the human readable measure specifications which lists the value sets used by the measure. You can visit the Value Set Authority Center (VSAC) https://vsac.nlm.nih.gov/ to review the terminologies that the eCQM supports and to which your organization local terminology should be mapped. The measure’s value sets refer to several types of terminologies such as SNOMED, ICD-10, LOINC, etc., so the eCQM logic may pull appropriate data from various parts of the EHR, including clinical documentation. For some data points such as determining gestational age (GA), the logic will resort to billing codes if data are not available to first determine calculated gestational age or estimated gestational age.    2. Currently our EHR vendor pulls codes (SNOMED, ICD-10 codes) found in multiple areas of the EHR (example Problem list) that are present during the "encounter" even if those codes are not from the final billing coding. Is this practice correct? For core measures, final coding diagnosis/procedures are the only and primary source of codes. SNOMED and ICD-10 codes should be pulled from multiple areas of the EHR. The problem list may be the best source for existing diagnoses that qualify for risk adjustment variables while the Present-On-Admission (POA) may only be identified in coding. Providers should update the problem list regularly to reflect the true medical history of each patient. 3. Can you clarify what does "qualifying encounter diagnosis" mean? For this measure, the qualifying encounter refers to the inpatient hospitalization of a patient greater than or equal to 8 years and less than 65 years old that delivered at greater than or equal to 20 weeks gestation. The qualifying encounter diagnosis would be a diagnosis that is associated with that delivery inpatient hospitalization. 4. What guidance does CMS provide to EHR vendors to know where to pull codes from? We cannot provide specific mapping guidelines for your system; we recommend that you work with your clinical and quality leaders in addition to your EHR vendors to identify the best data to pull from your system(s).