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Appropriate Treatment for Children with Upper Respiratory Infection (URI)

Updated: 06/15/2020
Views: 435

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 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 ProblemList
  • 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
  • Exclude patients whose hospice care overlaps the measurement period.
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.
Office Visit Documentation:

Once all steps have been completed, the measure will be added to the Quality Report.

Quality ID: 065
CMS Measure ID: CMS154
Measure type: Process
High Priority Measure: Yes
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