| Name |
Appropriate Treatment for Upper Respiratory Infection (URI)
|
Appropriate Treatment for Upper Respiratory Infection (URI)
|
Appropriate Treatment for Upper Respiratory Infection (URI)
|
| CMS Measure ID |
CMS154v9
|
CMS154v10
|
CMS154v11
|
| NQF Number |
Not Applicable
|
Not Applicable
|
Not Applicable
|
| Description |
Percentage of episodes for patients 3 months of age and older with a diagnosis of upper respiratory infection (URI) that did not result in an antibiotic dispensing event.
|
Percentage of episodes for patients 3 months of age and older with a diagnosis of upper respiratory infection (URI) that did not result in an antibiotic dispensing event.
|
Percentage of episodes for patients 3 months of age and older with a diagnosis of upper respiratory infection (URI) that did not result in an antibiotic order
|
| Initial Population |
Outpatient visits, telephone visits, online assessments, observation stays or emergency department visits with a diagnosis of URI during the measurement period among patients 3 months of age and older.
|
Outpatient visits, telephone visits, online assessments (i.e. e-visit or virtual check-in), observation stays or emergency department visits with a diagnosis of URI during the measurement period among patients 3 months of age and older.
|
Outpatient visits, telephone visits, online assessments (i.e. e-visit or virtual check-in), observation stays or emergency department visits with a diagnosis of URI during the measurement period among patients 3 months of age and older
|
| Denominator |
Equals Initial Population
|
Equals Initial Population
|
Equals Initial Population
|
| Denominator Exclusions |
Exclude URI episodes when the patient had a competing comorbid condition during the 12 months prior to or on the episode date.
Exclude URI episodes when the patient had a new or refill prescription of antibiotics in the 30 days prior to or on the episode date.
Exclude URI episodes when the patient had competing diagnosis on or three days after the episode date.
Exclude URI episodes when the patient had hospice care overlapping with the measurement period.
|
Exclude URI episodes when the patient had a comorbid condition during the 12 months prior to or on the episode date.
Exclude URI episodes when the patient had an active prescription of antibiotics in the 30 days prior to the episode date, including the episode date up until the time of the encounter.
Exclude URI episodes when the patient had competing diagnosis on or three days after the episode date.
Exclude URI episodes when the patient had hospice care for any part of the measurement period.
|
Exclude URI episodes when the patient had a comorbid condition during the 12 months prior to or on the episode date. Exclude URI episodes when the patient had an active prescription of antibiotics in the 30 days prior to the episode date but is still active the same day of the encounter.Exclude URI episodes when the patient had competing diagnosis on or three days after the episode date.Exclude URI episodes when the patient had hospice care for any part of the measurement period.
|
| Numerator |
URI episodes without a prescription for antibiotic medication on or 3 days after the outpatient visit, telephone visit, online assessment, observation stay or emergency department visit for an upper respiratory infection
|
URI episodes without a prescription for antibiotic medication on or 3 days after the outpatient visit, telephone visit, online assessment, observation stay or emergency department visit for an upper respiratory infection
|
URI episodes without a prescription for antibiotic medication on or 3 days after the outpatient visit, telephone visit, online assessment, observation stay or emergency department visit for an upper respiratory infection
|
| Numerator Exclusions |
Not Applicable
|
Not Applicable
|
Not Applicable
|
| Denominator Exceptions |
None
|
None
|
None
|
| Measure Steward |
National Committee for Quality Assurance
|
National Committee for Quality Assurance
|
National Committee for Quality Assurance
|
| Quality Domain |
Efficiency and Cost Reduction
|
Efficiency and Cost Reduction
|
Efficiency and Cost Reduction
|
| Measure Scoring |
Proportion measure
|
Proportion measure
|
Proportion measure
|
| Measure Type |
Process measure
|
Process measure
|
Process measure
|
| Improvement Notation |
Higher score indicates better quality
|
Higher score indicates better quality
|
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.
This eCQM is a episode-based measure.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.
|
This is an episode of care measure that examines all eligible episodes for the patient during the measurement period.
This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients aged 3 months of age and older with a diagnosis of upper respiratory infection during the measurement period.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.
|
This is an episode of care measure that examines all eligible episodes for the patient during the measurement period. This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients aged 3 months of age and older with a diagnosis of upper respiratory infection during the measurement period. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.
|
| MIPS Quality ID |
065
|
065
|
065
|
| Meaningful Measure |
Appropriate Use of Healthcare
|
Appropriate Use of Healthcare
|
Appropriate Use of Healthcare
|
| Telehealth Eligible |
Yes
|
Yes
|
Yes
|
| Next Version |
CMS154v10
|
CMS154v11
|
No Version Available
|
| Previous Version |
No Version Available
|
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