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Appropriate Treatment for Children with Upper Respiratory Infection (URI)

Percentage of children 3 months to 18 years of age who were diagnosed with upper respiratory infection (URI) and were NOT dispensed an antibiotic prescription on or three days after the episode.

Denominator:    Children 3 months through 18 years of age who had an outpatient or emergency department (ED) visit with a diagnosis of upper respiratory infection (URI) during the measurement period.

  • Patient’s age is calculated based on the patient’s Date of Birth, which is entered when you created the patient’s account.
  • The diagnosis of Upper Respiratory Infection (URI) is entered in the patient’s Problem List.  See Add Problem to Patient’s Chart.
  • Make sure to add a Start Date to the problem.

Denominator Exclusions

  • If a Competing Condition for Respiratory Conditions (i.e. pneumonia, venereal disease, UTI, acne) is documented in the Problem List, with a Start Date, these patients will be excluded from the denominator
  • If an Antibiotic Medication was prescribed in the previous 30 days and is documented in Medications, these patients will be excluded from the denominator
    • Patient will need to have Pharyngitis in Problems with a Start Date within the previous 30 days.


Numerator:  Children without a prescription for antibiotic medication on or 3 days after the outpatient or ED visit for an upper respiratory infection.

Patients for whom there is no antibiotic listed in Medications with a Start Date on or within 3 days of the Start Date of the Problem


Numerator Exceptions:    None

Office Visit Documentation:

  • Create a Note detailing the patient’s office visits.  See Create a Note.
  • Make sure to include an E&M code under “Procedure Codes” on the Superbill.  Only E&M appropriate for an office visit should be used.  No ED visit codes. See Create a Superbill.
  • Sign the Note.  See Sign Notes.  Once the note is signed, the measure will be added to the Quality Report.


Quality ID #065

Measure type:    Process

High Priority Measure:    Yes

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