Thank you for your question related to CMS144v13. The hypotension diagnosis must overlap the encounter date. It can be diagnosed on the date of the encounter or prior, but there must be an active diagnosis with no resolved date. If the hypotension diagnosis has a resolved date in the patient record prior to the date of the Heart Failure Outpatient Encounter, then they would not be considered for the exception. For example, if the patient seen in 2020 was diagnosed with hypotension and in 2022 a clinician removed the diagnosis from the patient diagnoses list that patient would not meet the exception. However, if there is an active diagnosis carried forward from prior years without a resolved date that could be used to meet the exception.