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CMS 146 - Appropriate Testing for Children with Pharyngitis

Updated: 11/11/2020
Views: 586

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: Children 3 to 18 years of age at the start of the measurement period who had an outpatient visit with a diagnosis of pharyngitis during the measurement period and an antibiotic ordered on or three days after the visit.
  • 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.
  • Add a Start Date to the problem.
  • An antibiotic was prescribed in Medications with a Start Date on or three days after the visit.
Denominator Exclusions: Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis:
  • 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.

If patient was in Hospice during the measurement period:

Exclude children who had an encounter with a competing diagnosis such as Upper Respiratory Infection (URI) within 3 days after the initial diagnosis of pharyngitis.

  • The diagnosis of the competing diagnosis is documented in Problems with a Start Date. These patients will be excluded from the denominator.
Numerator: Children with a group A streptococcus test in the 7-day period from 3 days prior through 3 days after the diagnosis of pharyngitis.
  • "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