Appropriate Testing for Children with Pharyngitis

Last updated: March 21, 2017

CMS Measure ID: CMS146v4
Version: 4
NQF Number: 0002
Measure Description:

Percentage of children 2-18 years of age who were diagnosed with pharyngitis, ordered an antibiotic and received a group A streptococcus (strep) test for the episode.

Initial Patient Population:

Children 2-18 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 Statement:

Equals Initial Population

Denominator Exclusions:

Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis

Numerator Statement:

Children with a group A streptococcus test in the 7-day period from 3 days prior through 3 days after the diagnosis of pharyngitis

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: National Committee for Quality Assurance
Domain: Efficiency and Cost Reduction
Next Version: Appropriate Testing for Children with Pharyngitis
Previous Version: Appropriate Testing for Children with Pharyngitis
Measure Score: Proportion
Improvement Notation:

Higher score indicates better quality

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, include all episodes in the measure.

Specifications

Release Notes

Header

  • Copyright updated.
  • Disclaimer updated.
  • eMeasure version number incremented.

Logic

  • Added AND/AND NOT expression for Antibiotic Medications for Pharyngitis to capture patients whose antibiotic use starts more than 30 days prior to the Occurrence A of the diagnosis, but the antibiotic use continues into the 30 days prior to the diagnosis.
  • Changed data type of 'result' or 'finding' to 'performed'.
  • Changed the timing logic to use the new temporal operator 'ends after or concurrent with end of' to improve timing precision.
  • Changed the timing logic to use the new temporal operator 'starts before or concurrent with start of' to improve timing precision.
  • Introduced function 'satisfies all' to specify that qualifying events must meet all conditions from a set of conditions or 'satisfies any' to specify that qualifying events must meet at least one condition from a set of conditions to streamline expression logic.
  • Replaced 'ORs' with 'Union of' operator to provide a mechanism for specifying that qualifying event(s) must be a member of at least one of the data elements being unioned (if appropriate for measure intent).
  • Replaced 'Patient Characteristic Birthdate' with 'Age at' operator.
  • Replaced 'starts before or during' (SBOD) with 'starts before end of' (SBE).

Value Sets

  • Value set Antibiotic Medications for Pharyngitis (OID 2.16.840.1.113883.3.464.1003.196.12.10): Deleted 9 RXNORM codes (1113012, 240637, 240639, 312127, 312128, 312130, 476193, 476299, 597194).

External Resources