Appropriate Treatment for Children with Upper Respiratory Infection (URI)

Last updated: May 3, 2018

CMS Measure ID: CMS154v3
Version: 3
NQF Number: 0069
Measure Description:

Percentage of children 3 months-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.

Initial Patient Population:

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

Denominator Statement:

Equals Initial Patient Population

Denominator Exclusions:
  • Exclude children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established.
  • Exclude children who had an encounter with a competing diagnosis within three days after the initial diagnosis of URI.
Numerator Statement:

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

Numerator Exclusions:

Not Applicable

Denominator Exceptions:


Measure Steward: National Committee for Quality Assurance
Domain: Efficiency and Cost Reduction Use of Healthcare Resources
Next Version:
Measure Score: Proportion
Score Type: Process
Improvement Notation:

Higher scores indicates better quality


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.


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