Our team has had some confusion related to the timing of the > or = 1000 glucose level one hour before the start of the encounter to 6 hours after the start of the encounter.  Reading the html specs and the eCQM flow appear to have different specs.  

The above (from the HTML part of measure specs) appears to state the "Earliest" glucose test in that 7 hour timeframe is the glucose test to be reviewed and not look at the rest during the timeframe.  

The eCQM flow says "test time during 1 hour prior to and up to 6 hours after start inpt hospitalization".

Can you confirm if any glucose > or = 1000 during the 7 hour timeframe would meet denominator exclusion or if the earliest or first during the time frame is the one evaluated and determine exclusion or not?  

Thank you!