For risk variable adjustments involving heart rate, systolic blood pressure, and the lab tests hematocrit and white blood cell count:

If the resulting physical exams and lab results occur within 24 hours prior to the start of the encounter, but are documented outside of the CCN where the qualifying TwentyWeeksPlusEncounter takes place, should these be considered the “first” values for risk variable adjustment purposes?

For instance, a patient that is seen at an OB clinic outside of the CCN where the qualifying TwentyWeeksPlusEncounter occurs, and the exams and labs resulted within 24 hours prior to the start of that encounter, should these results be reported as the "first" values for risk variable adjustment purposes?