Thank you for your question about CMS1028v3/PC-07, Severe Obstetric Complications. 1. Diagnosis codes that qualify for another condition may be submitted, but if the diagnosis code does not appear in any CMS1028v3/PC-07 value set, the system will ignore it for the measure. If the diagnosis appears in a PC‑07 value set, it should be submitted regardless of whether it is also used by another measure. In the example given, risk-variable obstetric VTE codes contained in the "Venous Thromboembolism in Pregnancy" value set may not be the same as other "Venous Thromboembolism" codes. 2. As noted in the header of the measure specifications, "present on admission codes may be extracted from billing/claims," and claims data contain final diagnoses. When reporting claims data, only final diagnoses would be submitted. We recommend working with your EHR vendor if present on admission is documented elsewhere within the EHR, such as in the problem list. 3. The system would use a valid POA value of "Y" or "1" from the Present On Admission is Yes or Exempt value set for the Risk Standardized Obstetric Complications Rate (RSCR) Calculation. A duplicate entry with a missing POA would not override a valid POA indicator present elsewhere in the record. 4. For CMS1028v3/ePC-07, only QRDA files that meet the Denominator Population (Delivery Encounters At Greater Than Or Equal To 20 Weeks Gestation) would be evaluated for risk adjustment variables. Encounters that do not qualify for the measure's Denominator Population:     - Have no impact on the measure calculation.     - Would have ignored risk variables and POA indicators in their QRDA files.

The following questions are with regards to PC 07 Present on Admission (POA) requirements: 1. Is it okay to submit diagnosis codes that qualify for another condition? (Example submitting VTE dx codes for PC-07 risk variables) 2. Should we be submitting SMM/Risk Variable codes off all Diagnosis Code types (ex. Admitting, discharge, etc. which would never have POA) or only submitting HIM Final Dx? 3. If we submit anemia POA = Yes; anemia POA = blank, would CMS use the POA = Yes for the Risk Standardized Obstetric Complications Rate (RSCR) Calculation? 4. If we submit QRDA files (containing risk adjustment variables) on patients that do not qualify for ePC-07, can CMS confirm those will be ignored based on IPP criteria (delivery encounter) so it should not matter if they have POA – indicators or not?