Denominator exception

A denominator exception is a reason to remove a patient, procedure, or unit from the denominator only when the numerator criteria are not met. It adjusts the calculated score for cases with higher risk or valid clinical reasons. It also allows clinicians to use judgment in specific situations.

Measure developers must define denominator exceptions clearly and specify where to capture them in structured data that fits the clinical workflow. The measured entity removes these cases from the denominator but may still report how many valid exceptions occurred.

Denominator exceptions fall into three categories: medical reasons, patient reasons, and system reasons. Only proportion measures use denominator exceptions.