Appropriate Testing for Children with Pharyngitis

eCQM / NQF #: CMS146v7 / XXXX
Measure: Percentage of children 3-18 years of age who were diagnosed with pharyngitis, ordered an antibiotic and received a group A streptococcus (strep) test for the episode.
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.
Denominator: Children 3-18 years of age who had an outpatient or emergency department (ED) visit with a diagnosis of pharyngitis during the measurement period and an antibiotic ordered on or three days after the visit.
Denominator Exclusions: Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis. Exclude patients who were in hospice care during the measurement year.
Domain: Efficiency and Cost Reduction

 

In ChartMaker Clinical:

In order to qualify for this measure, the provider must have seen the patient, aged 3 to 18 years, at least one time during the reporting period and have the appropriate information documented in the chart:

Required Data Elements for the Denominator:

And at least one of the following:

Required Data Elements for the Numerator:

EXCLUSION DETAILS:

Exclusion includes patients who are taking antibiotics in the 30 days prior to the diagnosis of Pharyngitis.  In order to meet the requirements for this exclusion, the appropriate information must be documented in the chart:

ADDITIONAL INFORMATION:

• The patient must be at least 3 years old and younger than 18 prior to the start of the measurement period.

• The Strep A test result LOINC code must be linked to a result code in the conditions table.  The result code can be user-created procedure code or be a result code sent to you by an electronic lab interface.

• The codes used to indicate the Strep A order and the Strep A result should remain separate for tracking and reporting purposes.    There should be two codes:  the result will be marked as a result with the LOINC code and the order will be marked as a Lab procedure and set to track.  

• The Group A Streptococcus Test result must occur within 3 days prior, during, or within 3 days after the first encounter during the measurement period where the diagnosis of Pharyngitis or Acute Tonsillitis occurred. 

• The only data used to determine the denominator is data from the ChartMaker Clinical Module. If a patient encounter was not entered into the ChartMaker Clinical Module, that encounter is not included in the denominator for the statistical calculations on the Meaningful Use Dashboard. Please add these additional patients to the denominator and recalculate the percentage for Attestation purposes