Thank you for your inquiry regarding CMS819v3, Hospital Harm - Opioid-Related Adverse Events. In terms of measure intent, Patient Controlled Administration (PCA) is considered by the measure. In the scenario you mention, the Narcan was administered within 12 hours of the Morphine, therefore the patient would be included in the numerator. When the administration event occurred over a time interval, we encourage you to work with your EHR vendor to ensure these patients are included in the numerator for purposes of reporting. Please see below for the logic for Encounter with NonOperating Room Opioid and Antagonist Administration:     from     "Non Enteral Opioid Antagonist Administration" NonEnteralOpioidAntagonistGiven,     "Opioid Administration" OpioidGiven,     "Denominator" InpatientHospitalization     let NonEnteralOpioidAntagonistGivenTime: Global."NormalizeInterval" ( NonEnteralOpioidAntagonistGiven.relevantDatetime, NonEnteralOpioidAntagonistGiven.relevantPeriod ),     OpioidGivenTime: Global."NormalizeInterval" ( OpioidGiven.relevantDatetime, OpioidGiven.relevantPeriod ),     HospitalPeriod: Global."HospitalizationWithObservation" ( InpatientHospitalization )     where not exists ( InpatientHospitalization.facilityLocations EncounterLocation         where EncounterLocation.code ~ "Operating Room/Suite"           and NonEnteralOpioidAntagonistGivenTime starts during EncounterLocation.locationPeriod     )       and not exists ( InpatientHospitalization.facilityLocations EncounterLocation           where EncounterLocation.code ~ "Operating Room/Suite"             and OpioidGivenTime starts during EncounterLocation.locationPeriod       )       and NonEnteralOpioidAntagonistGivenTime starts during HospitalPeriod       and OpioidGivenTime starts during HospitalPeriod       and OpioidGivenTime ends 12 hours or less before start of NonEnteralOpioidAntagonistGivenTime     return InpatientHospitalization