Thank you for your inquiry regarding CMS832v3 (Hospital Harm – Acute Kidney Injury). The denominator exclusion is for inpatient hospitalizations for patients with the index eGFR value of < 60 mL/min within 48 hours of the encounter start. The "index" eGFR is calculated using the "index" serum creatinine, patient sex, and patient age based on the CKD-EPI creatinine equation. This denominator exclusion definition ‘Encounter with Index eGFR Less Than 60 within First 48 Hours’ and the two definitions nested within the logic, ‘Male Encounter with eGFR Less Than 60’ and ‘Female Encounter with eGFR Less Than 60’, do not use the Round() function. This means that the eCQM conducts a comparison of numerals to evaluate whether the numbers/measurements used for these definitions are less than 60 mL/min. Specific to your individual questions: - What if the patient has an eGFR value of between 60.1-60.9? If a patient has an index eGFR value that is greater than 60, whether it be 60.0, 60.001, 60.01, 60.1, 60.9 etc.…, the criteria to meet the denominator exclusion will not be met. - How should those be handled? The values included in your inquiry (values between 60.1 – 60.9), and all values should be reported as is (as a Decimal). - How is rounding handled? The eCQM does not leverage the Round() function, and therefore, the eCQM takes the reported values, whatever the decimal precision, when evaluating the measure logic.