Thank you for your question regarding CMS826v3, Hospital Harm - Pressure Injury; CMS832v3, Hospital Harm - Acute Kidney Injury; CMS1017v2, Hospital Harm - Falls with Injury; CMS1218v2, Hospital Harm - Postoperative Respiratory Failure; CMS104v14, Discharged on Antithrombotic Therapy; and CMS1028v4, Severe Obstetric Complications. CMS1028v4 differs from the hospital harm eCQMs in its use of Present on Admission (POA) indicators, as CMS1028v4 does not follow the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ) convention for interpreting POA indicators. Rather, the measure developer of CMS1028v4 relied on results from measure testing to assign meaning to the different POA indicators. That is, in CMS1028v4, codes of “Y” and “1” are accepted indicators of a diagnosis present on admission, while codes of “N”, “U”, and “W” are accepted indicators of a diagnosis not present on admission. Therefore, the two value sets for POA indicators used in CMS1028v4 are grouped differently than the value sets for POA indicators used in the hospital harm eCQMs, and we will not be consolidating the value sets for POA indicators used across the hospital harm eCQMs and CMS1028v4.   In using POA indicators, the four hospital harm eCQMs (CMS826v3, CMS832v3, CMS1017v2, and CMS1218v2) follow the convention established by CMS and AHRQ. That is, CMS and AHRQ convention and the hospital harm eCQMs consider codes of “Y” and “W” as accepted indicators of a diagnosis present on admission and consider codes of “N” and “U” as accepted indicators of a diagnosis that is not present on admission. The hospital harm eCQMs use two separate value sets for POA indicators, grouped by CMS and AHRQ convention: The “Present on Admission or Clinically Undetermined” value set contains codes of “Y” and “W”, while the “Not Present on Admission or Documentation Insufficient to Determine” value set contains codes of “N” and “U”. Across CMS826v3, CMS832v2, CMS1017v2, and CMS1218v2, the “Present on Admission or Clinically Undetermined” value set is used in logic for population criteria and risk adjustment variables intended to identify diagnoses present on admission. The “Not Present on Admission or Documentation Insufficient to Determine” value set is used in logic for population criteria in CMS826v3 and CMS1017v2 intended to identify diagnoses not present on admission. As the intent of each of these two value sets is distinct, we will not be combining the codes across the two value sets into one value set. Specific to CMS1028v4, the measure developer decided to not make any changes to our POA (present-on-admission) value sets and not use the hospital harm value sets for the following reasons:   - When the value sets were first established, U and W were purposely grouped together as they both essentially indicate the same outcome (unable to determine). This rationale is still valid. - It may not be relevant to compare maternal measures to hospital harm measures. Additionally, we understand why the hospital harm measures need to align with the CMS payment model, but this is not relevant to CMS1028/PC07. - Pilot test data showed that codes assigned W represented only 0.5% of all codes, and when we looked at the actual code descriptions, 98% of the W's represented labor and delivery complicated by cord placement. These diagnoses are not used for numerator or risk adjustment, so there's no impact to the measure. Additionally, we concur that for these codes, the provider most likely was unable to clinically determine whether the condition was present at the time of inpatient admission.