Thank you for your question about CMS1028/PC-07 Severe Obstetric Complications. In this measure, a hysterectomy performed during the delivery hospitalization is classified as a SOC procedure, regardless of the clinical indication (planned versus emergent, including abnormal uterine bleeding). The numerator exclusion is defined as inpatient hospitalizations with a hysterectomy or blood transfusion and a diagnosis of placenta percreta or placenta increta, and no additional severe obstetric complications. Based on this logic, if the patient’s hysterectomy was performed for abnormal uterine bleeding and there is no diagnosis of placenta increta or placenta percreta, the encounter does not meet the numerator exclusion criteria and will remain in the numerator, even if the hysterectomy was clinically indicated or planned.