Thank you for your inquiry regarding CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). In alignment with clinical best practice, the measure intends to capture the time from ED arrival to balloon inflation (i.e. intervention time). Attempted PCI should not be captured, since it does not align with the measure’s intent. It is ideal to capture the time of balloon inflation or reperfusion, and map to the relevantPeriod.startTime attribute of the “Procedure, Performed” QDM data element. The value set for Percutaneous Coronary Intervention (2.16.840.1.113883.3.3157.2000.5) includes CPT codes for balloon dilation. With regard to timestamps in the electronic health record (EHR), we recommend working with your EHR vendor on determining the best way to capture this information since we are aware that it is captured in other ways clinically. We will consider refinements in a future Annual Update.