Thank you for your inquiry on the Global Malnutrition Composite Score measure, CMS986v4. For accurate abstraction for Performance/Reporting Period 2025: The documentation of "Nutritional Risk Factors: Criteria Not Met/No Consult Needed" must be mapped explicitly to the approved value set for "Malnutrition Risk Screening" (MO1) as defined in the CMS measure specifications available here www.ecqi.healthit.gov/mcw/2025/ecqm-dataelement/assessmentperformedmalnutritionriskscreening.html, If your electronic medical record (EMR) documentation aligns with these criteria and is mapped correctly, you would abstract this as MO1=1 ("Not at Risk"). Since the patient is identified as "Not at Risk," and no Dietitian Referral (MO2-MO4) is ordered, then the measure calculation correctly stops at MO1. The measure developer (MD) does recommend the use of a valid and reliable malnutrition risk screening tool.   In this scenario, your final measure calculation would indeed be: MO1 = 1 (Not at Risk, no Dietitian Referral), MO2-MO4 = N/A, thus the resulting score = (1/1) x 100% = 100%. Please ensure your facility's EMR mapping explicitly aligns with the CMS value sets for accurate reporting. We are unable to provide specific guidance related to the mapping of codes. We recommend you consult with your EMR vendor and clinical partners. If mapping is conducted, you should maintain documentation in case of a CMS audit.