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CMS 146 - Appropriate Testing for Children with Pharyngitis

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Updated: 12/09/2021
Views: 1133

CMS 146 / Quality ID #006

Percentage of children 3 to 18 years of age who were diagnosed with pharyngitis, ordered an antibiotic and received a group A streptococcus (strep) test for the episode.

Denominator: Outpatient, telephone, online assessment, observation, or emergency department (ED) visits with a diagnosis of pharyngitis and an antibiotic dispensing event among patients 3 years or older.
  • Patient’s age is calculated based on the patient’s Date of Birth, which was entered when you created the patient’s account.
  • Create a note detailing the patient’s office visit.
  • The diagnosis of "Pharyngitis" or "Tonsillitis" is entered in the patient’s Problem List with a Start Date.
  • An antibiotic was prescribed in Medications with a Start Date on or three days after the visit.
Denominator Exclusions: Exclude episodes where the patient is taking antibiotics in the 30 days prior to the episode date.
  • An antibiotic was prescribed in Medications with a Start Date that is up to 30 days prior to the diagnosis of pharyngitis. These patients will be excluded from the denominator.

Exclude episodes where the patient had a competing comorbid condition during the 12 months prior to or on the episode date.

  • The diagnosis of the competing diagnosis is documented in Problems with a Start Date. These patients will be excluded from the denominator.

Exclude episodes when the patient had hospice care overlapping with the measurement period.

Exclude episodes where the patient had a competing diagnosis within three days after the episode date.

  • The diagnosis of the competing diagnosis is documented in Problems with a Start Date. These patients will be excluded from the denominator.
Numerator: A group A streptococcus test in the seven-day period from three days prior to the episode date through three days after the episode date.
  • "Group A streptococcus test" order is created under Labs/Studies.
  • The clinician will have to sign the results when received. If results are not received via eLabs, the results will have to be manually added on the order created in Labs/Studies.
Office Visit Documentation:

Once all steps have been completed, the measure will be added to the Quality Measures Report.
Guidance: This is an episode of care measure that examines all eligible episodes for the patient during the measurement period. If the patient has more than one episode, all episodes are included in the measure.
Measure type: Process
High Priority Measure: No
Telehealth Eligible: Yes