Chlamydia Screening for Women
Percentage of women 16-24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement period.
National Committee for Quality Assurance
National Committee for Quality Assurance
National Quality Forum
Finalized Date/Time
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Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any CPT or other codes contained in the specifications.
CPT(R) contained in the Measure specifications is copyright 2004-2013 American Medical Association. LOINC(R) copyright 2004-2013 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2013 International Health Terminology Standards Development Organisation. ICD-10 copyright 2013 World Health Organization. All Rights Reserved.
Report a total score, and each of the following strata:
Stratum 1: Patients age 16-20
Stratum 2: Patients age 21-24
None
None
Chlamydia trachomatis is the most common sexually transmitted bacterial infection in the U.S., resulting in over 2.8 million new cases each year (Centers for Disease Control and Prevention 2011 - Chlamydia). It is often known as a “silent” disease because most infected people have no symptoms and therefore are unaware they have an infection (United States Preventive Services Task Force, 2007; Centers for Disease Control and Prevention 2011- Chlamydia). Although chlamydia symptoms are usually mild or nonexistent, untreated infections can lead to serious and irreversible complications (United States Preventive Services Task Force 2007).
Women are particularly vulnerable when infected with chlamydia. Left untreated, chlamydia can cause pelvic inflammatory disease (PID), permanent damage to a woman's fallopian tubes, uterus and surrounding tissue, or Reiter Syndrome, which includes pink eye (conjunctivitis) and skin lesions affecting the lower extremities. Between 10 and 15 percent of untreated chlamydia infections result in PID, which can lead to ectopic pregnancy and infertility (Centers for Disease Control and Prevention 2011 – Chlamydia). As many as 15 percent of women with PID will become infertile (Centers for Disease Control and Prevention 2011 – Pelvic Inflammatory Disease). Additionally, pregnant women might experience premature delivery, miscarriage, low birth weight, infant mortality, or they may pass conjunctivitis or chlamydia pneumonia to their infants (United States Preventive Services Task Force, 2007; Centers for Disease Control and Prevention 2011- Chlamydia). Chlamydia is the leading cause of preventable infertility and, among other adverse pregnancy related problems, can cause preterm birth, miscarriages, infant mortality, and neonatal chlamydia infections (United States Preventive Services Task Force 2007).
Over 900,000 chlamydia infections were reported to the Centers for Disease Control and Prevention (CDC) from 50 states and the District of Columbia in 2004. Since many cases are not reported or even diagnosed, it is estimated that there are actually 2.8 million new cases of chlamydia each year (Centers for Disease Control and Prevention 2010). From 1987 through 2004, the reported rate of chlamydia infection in women increased from 78.5 cases to 485 cases per 100,000 people, though a portion of the increase in prevalence is attributed to continued expansion of chlamydia screening programs (Centers for Disease Control and Prevention 2005).
A significant proportion of sexually active individuals, both male and female, continue to go undiagnosed due to the disease's asymptomatic nature (Wilson et al. 2009). Approximately 75 percent of chlamydia infections in women and 95 percent in men are asymptomatic, resulting in delayed medical care and treatment (Centers for Disease Control and Prevention 2011 – Pelvic Inflammatory Disease). Women whose sexual partners are not screened and appropriately treated are at high risk for re-infection. Multiple chlamydia infections increase a woman’s risk of serious reproductive health complications (Centers for Disease Control and Prevention 2010).
U.S. Preventive Services Task Force (2007):
All sexually active nonpregnant young women age 24 years or younger and older women (pregnant or not) who are at increased risk should be screened for a chlamydial infection.
The USPSTF found fair evidence that nucleic acid amplification tests (NAATs) can identify chlamydial infection in asymptomatic men and women, including asymptomatic pregnant women, with high test specificity.
If clinicians have not concurrently screened for chlamydial infection, the CDC recommends presumptive treatment for chlamydia at the time of treatment for gonorrhea. In order to prevent recurrent transmission, partners of infected individuals should be tested and treated if infected, or treated presumptively.
American Academy of Family Physicians (2009):
The AAFP strongly recommends screening for chlamydia infection for all sexually active non-pregnant young women aged 24 and younger and for older non-pregnant women who are at increased risk.
The AAFP recommends screening for chlamydia infection for all pregnant women aged 24 younger and for older pregnant women who are at increased risk.
Higher score indicates better quality
NQF ID Number
Disclaimer
These performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.
THE MEASURES AND SPECIFICATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND.
Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].
eMeasure Identifier
153
measureStartDate
measureEndDate
Centers for Disease Control and Prevention. 2011. “Chlamydia – CDC Fact Sheet.” http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm
United States Preventive Services Task Force. 2007. Screening for chlamydia infection: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 147(2):128-34.
Wilson, T.E., M. Hogben, E.S. Malka, N. Liddon, W.M. McCormack, S.R. Rubin, M.A. Augenbraun. 2009. “A Randomized Controlled Trial for Reducing Risks for Sexually Transmitted Infections Through Enhanced Patient-Based Partner Notification.” Am J Public Health 99(S1):S104-10.
Centers for Disease Control and Prevention. 2011. “Pelvic Inflammatory Disease (PID) - CDC Fact Sheet.” http://www.cdc.gov/std/PID/STDFact-PID.htm
Centers for Disease Control and Prevention. 2010. "Sexually Transmitted Diseases (STDs): Chlamydia Treatment." http://www.cdc.gov/std/chlamydia/treatment.htm (June 6, 2011).
Centers for Disease Control and Prevention. 2005. Sexually Transmitted Disease Surveillance 2004 Supplement, Chlamydia Prevalence Monitoring Project. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
American Academy of Family Physicians (AAFP). 2009. Summary of recommendations for clinical preventive services. Revision 6.8. Leawood: American Academy of Family Physicians (AAFP).
None
Codes to identify sexually active women include codes for: pregnancy, sexually transmitted infections, contraceptives or contraceptive devices, and infertility treatments.
The denominator exclusion does not apply to patients who qualify for the initial patient population based on services other than the pregnancy test alone.
Transmission Format
None
Initial Patient Population
Women 16 to 24 years of age who are sexually active and who had a visit in the measurement period
Denominator
Equals Initial Patient Population
Denominator Exclusions
Women who received a pregnancy test solely as a safety precaution before ordering an x-ray or specified medications
Numerator
Women with at least one chlamydia test during the measurement period
Numerator Exclusions
Not applicable
Denominator Exceptions
None
Measure Population
Not applicable
Measure Observations
Not applicable
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex.
None
Population criteria
-
Initial Patient Population =
- AND: "Patient Characteristic Birthdate: birth date" >= 16 year(s) starts before start of "Measurement Period"
- AND: "Patient Characteristic Birthdate: birth date" < 24 year(s) starts before start of "Measurement Period"
- AND: "Patient Characteristic Sex: Female"
- AND:
- OR: "Encounter, Performed: Office Visit"
- OR: "Encounter, Performed: Face-to-Face Interaction"
- OR: "Encounter, Performed: Preventive Care Services - Established Office Visit, 18 and Up"
- OR: "Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up"
- OR: "Encounter, Performed: Preventive Care - Established Office Visit, 0 to 17"
- OR: "Encounter, Performed: Preventive Care- Initial Office Visit, 0 to 17"
- OR: "Encounter, Performed: Home Healthcare Services"
- during "Measurement Period"
- AND:
- OR:
- AND: "Occurrence A of Diagnosis, Active: Other Female Reproductive Conditions" starts before or during "Measurement Period"
- AND NOT: "Occurrence A of Diagnosis, Active: Other Female Reproductive Conditions" ends before start of "Measurement Period"
- OR:
- AND: "Occurrence A of Diagnosis, Active: Genital Herpes" starts before or during "Measurement Period"
- AND NOT: "Occurrence A of Diagnosis, Active: Genital Herpes" ends before start of "Measurement Period"
- OR:
- AND: "Occurrence A of Diagnosis, Active: Gonococcal Infections and Venereal Diseases" starts before or during "Measurement Period"
- AND NOT: "Occurrence A of Diagnosis, Active: Gonococcal Infections and Venereal Diseases" ends before start of "Measurement Period"
- OR:
- AND: "Occurrence A of Medication, Active: Contraceptive Medications" starts before or during "Measurement Period"
- AND NOT: "Occurrence A of Medication, Active: Contraceptive Medications" ends before start of "Measurement Period"
- OR:
- AND: "Occurrence A of Diagnosis, Active: Inflammatory Diseases of Female Reproductive Organs" starts before or during "Measurement Period"
- AND NOT: "Occurrence A of Diagnosis, Active: Inflammatory Diseases of Female Reproductive Organs" ends before start of "Measurement Period"
- OR:
- AND: "Occurrence A of Diagnosis, Active: Chlamydia" starts before or during "Measurement Period"
- AND NOT: "Occurrence A of Diagnosis, Active: Chlamydia" ends before start of "Measurement Period"
- OR:
- AND: "Occurrence A of Diagnosis, Active: HIV" starts before or during "Measurement Period"
- AND NOT: "Occurrence A of Diagnosis, Active: HIV" ends before start of "Measurement Period"
- OR:
- AND: "Occurrence A of Diagnosis, Active: Syphilis" starts before or during "Measurement Period"
- AND NOT: "Occurrence A of Diagnosis, Active: Syphilis" ends before start of "Measurement Period"
- OR:
- AND: "Occurrence A of Diagnosis, Active: Complications of Pregnancy, Childbirth and the Puerperium" starts before or during "Measurement Period"
- AND NOT: "Occurrence A of Diagnosis, Active: Complications of Pregnancy, Childbirth and the Puerperium" ends before start of "Measurement Period"
- OR:
- OR: "Laboratory Test, Order: Pregnancy Test"
- OR: "Laboratory Test, Order: Pap Test"
- OR: "Procedure, Performed: Delivery Live Births"
- OR: "Laboratory Test, Order: Lab Tests During Pregnancy"
- OR: "Laboratory Test, Order: Lab Tests for Sexually Transmitted Infections"
- OR: "Medication, Order: Contraceptive Medications"
- OR: "Diagnostic Study, Order: Diagnostic Studies During Pregnancy"
- OR: "Procedure, Performed: Procedures During Pregnancy"
- OR: "Procedure, Performed: Procedures Involving Contraceptive Devices"
- during "Measurement Period"
-
Denominator =
- AND: "Initial Patient Population"
-
Denominator Exclusions =
- AND: "Occurrence A of Laboratory Test, Order: Pregnancy Test" during "Measurement Period"
- AND:
- OR: "Medication, Order: Isotretinoin"
- OR: "Diagnostic Study, Order: X-Ray Study (all inclusive)"
- <= 7 day(s) starts after end of "Occurrence A of Laboratory Test, Order: Pregnancy Test"
-
Numerator =
- AND: "Laboratory Test, Result: Chlamydia Screening (result)" during "Measurement Period"
-
Denominator Exceptions =
- None
Patient Characteristic Birthdate: birth date
Measurement Period
Patient Characteristic Birthdate: birth date
Measurement Period
Patient Characteristic Sex: Female
Encounter, Performed: Office Visit
Encounter, Performed: Face-to-Face Interaction
Encounter, Performed: Preventive Care Services - Established Office Visit, 18 and Up
Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up
Encounter, Performed: Preventive Care - Established Office Visit, 0 to 17
Encounter, Performed: Preventive Care- Initial Office Visit, 0 to 17
Encounter, Performed: Home Healthcare Services
Measurement Period
Occurrence A of Diagnosis, Active: Other Female Reproductive Conditions
Measurement Period
Occurrence A of Diagnosis, Active: Other Female Reproductive Conditions
Measurement Period
Occurrence A of Diagnosis, Active: Genital Herpes
Measurement Period
Occurrence A of Diagnosis, Active: Genital Herpes
Measurement Period
Occurrence A of Diagnosis, Active: Gonococcal Infections and Venereal Diseases
Measurement Period
Occurrence A of Diagnosis, Active: Gonococcal Infections and Venereal Diseases
Measurement Period
Occurrence A of Medication, Active: Contraceptive Medications
Measurement Period
Occurrence A of Medication, Active: Contraceptive Medications
Measurement Period
Occurrence A of Diagnosis, Active: Inflammatory Diseases of Female Reproductive Organs
Measurement Period
Occurrence A of Diagnosis, Active: Inflammatory Diseases of Female Reproductive Organs
Measurement Period
Occurrence A of Diagnosis, Active: Chlamydia
Measurement Period
Occurrence A of Diagnosis, Active: Chlamydia
Measurement Period
Occurrence A of Diagnosis, Active: HIV
Measurement Period
Occurrence A of Diagnosis, Active: HIV
Measurement Period
Occurrence A of Diagnosis, Active: Syphilis
Measurement Period
Occurrence A of Diagnosis, Active: Syphilis
Measurement Period
Occurrence A of Diagnosis, Active: Complications of Pregnancy, Childbirth and the Puerperium
Measurement Period
Occurrence A of Diagnosis, Active: Complications of Pregnancy, Childbirth and the Puerperium
Measurement Period
Laboratory Test, Order: Pregnancy Test
Laboratory Test, Order: Pap Test
Procedure, Performed: Delivery Live Births
Laboratory Test, Order: Lab Tests During Pregnancy
Laboratory Test, Order: Lab Tests for Sexually Transmitted Infections
Medication, Order: Contraceptive Medications
Diagnostic Study, Order: Diagnostic Studies During Pregnancy
Procedure, Performed: Procedures During Pregnancy
Procedure, Performed: Procedures Involving Contraceptive Devices
Measurement Period
Initial Patient Population
Initial Patient Population
Occurrence A of Laboratory Test, Order: Pregnancy Test
Measurement Period
Medication, Order: Isotretinoin
Diagnostic Study, Order: X-Ray Study (all inclusive)
Occurrence A of Laboratory Test, Order: Pregnancy Test
Denominator
Laboratory Test, Result: Chlamydia Screening (result)
Measurement Period
Data criteria (QDM Data Elements)
-
"Diagnosis, Active: Chlamydia" using "Chlamydia Grouping Value Set (2.16.840.1.113883.3.464.1003.112.12.1003)"
-
"Diagnosis, Active: Complications of Pregnancy, Childbirth and the Puerperium" using "Complications of Pregnancy, Childbirth and the Puerperium Grouping Value Set (2.16.840.1.113883.3.464.1003.111.12.1012)"
-
"Diagnosis, Active: Genital Herpes" using "Genital Herpes Grouping Value Set (2.16.840.1.113883.3.464.1003.110.12.1049)"
-
"Diagnosis, Active: Gonococcal Infections and Venereal Diseases" using "Gonococcal Infections and Venereal Diseases Grouping Value Set (2.16.840.1.113883.3.464.1003.112.12.1001)"
-
"Diagnosis, Active: HIV" using "HIV Grouping Value Set (2.16.840.1.113883.3.464.1003.120.12.1003)"
-
"Diagnosis, Active: Inflammatory Diseases of Female Reproductive Organs" using "Inflammatory Diseases of Female Reproductive Organs Grouping Value Set (2.16.840.1.113883.3.464.1003.112.12.1004)"
-
"Diagnosis, Active: Other Female Reproductive Conditions" using "Other Female Reproductive Conditions Grouping Value Set (2.16.840.1.113883.3.464.1003.111.12.1006)"
-
"Diagnosis, Active: Syphilis" using "Syphilis Grouping Value Set (2.16.840.1.113883.3.464.1003.112.12.1002)"
-
"Diagnostic Study, Order: Diagnostic Studies During Pregnancy" using "Diagnostic Studies During Pregnancy Grouping Value Set (2.16.840.1.113883.3.464.1003.111.12.1008)"
-
"Diagnostic Study, Order: X-Ray Study (all inclusive)" using "X-Ray Study (all inclusive) Grouping Value Set (2.16.840.1.113883.3.464.1003.198.12.1034)"
-
"Encounter, Performed: Face-to-Face Interaction" using "Face-to-Face Interaction Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1048)"
-
"Encounter, Performed: Home Healthcare Services" using "Home Healthcare Services Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1016)"
-
"Encounter, Performed: Office Visit" using "Office Visit Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1001)"
-
"Encounter, Performed: Preventive Care - Established Office Visit, 0 to 17" using "Preventive Care - Established Office Visit, 0 to 17 Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1024)"
-
"Encounter, Performed: Preventive Care Services - Established Office Visit, 18 and Up" using "Preventive Care Services - Established Office Visit, 18 and Up Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1025)"
-
"Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up" using "Preventive Care Services-Initial Office Visit, 18 and Up Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1023)"
-
"Encounter, Performed: Preventive Care- Initial Office Visit, 0 to 17" using "Preventive Care- Initial Office Visit, 0 to 17 Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1022)"
-
"Laboratory Test, Order: Lab Tests During Pregnancy" using "Lab Tests During Pregnancy Grouping Value Set (2.16.840.1.113883.3.464.1003.111.12.1007)"
-
"Laboratory Test, Order: Lab Tests for Sexually Transmitted Infections" using "Lab Tests for Sexually Transmitted Infections Grouping Value Set (2.16.840.1.113883.3.464.1003.110.12.1051)"
-
"Laboratory Test, Order: Pap Test" using "Pap Test Grouping Value Set (2.16.840.1.113883.3.464.1003.108.12.1017)"
-
"Laboratory Test, Order: Pregnancy Test" using "Pregnancy Test Grouping Value Set (2.16.840.1.113883.3.464.1003.111.12.1011)"
-
"Laboratory Test, Result: Chlamydia Screening" using "Chlamydia Screening Grouping Value Set (2.16.840.1.113883.3.464.1003.110.12.1052)"
-
"Medication, Active: Contraceptive Medications" using "Contraceptive Medications Grouping Value Set (2.16.840.1.113883.3.464.1003.196.12.1080)"
-
"Medication, Order: Contraceptive Medications" using "Contraceptive Medications Grouping Value Set (2.16.840.1.113883.3.464.1003.196.12.1080)"
-
"Medication, Order: Isotretinoin" using "Isotretinoin Grouping Value Set (2.16.840.1.113883.3.464.1003.196.12.1143)"
-
"Patient Characteristic Birthdate: birth date" using "birth date LOINC Value Set (2.16.840.1.113883.3.560.100.4)"
-
"Patient Characteristic Sex: Female" using "Female AdministrativeSex Value Set (2.16.840.1.113883.3.560.100.2)"
-
"Procedure, Performed: Delivery Live Births" using "Delivery Live Births Grouping Value Set (2.16.840.1.113883.3.464.1003.111.12.1015)"
-
"Procedure, Performed: Procedures During Pregnancy" using "Procedures During Pregnancy Grouping Value Set (2.16.840.1.113883.3.464.1003.111.12.1009)"
-
"Procedure, Performed: Procedures Involving Contraceptive Devices" using "Procedures Involving Contraceptive Devices Grouping Value Set (2.16.840.1.113883.3.464.1003.111.12.1010)"
Patient Characteristic Birthdate: birth date
Laboratory Test, Result: Chlamydia Screening
Procedure, Performed: Procedures During Pregnancy
Procedure, Performed: Procedures Involving Contraceptive Devices
Procedure, Performed: Delivery Live Births
Patient Characteristic Sex: Female
Medication, Order: Isotretinoin
Laboratory Test, Order: Pap Test
Diagnostic Study, Order: Diagnostic Studies During Pregnancy
Medication, Order: Contraceptive Medications
Laboratory Test, Order: Lab Tests During Pregnancy
Laboratory Test, Order: Lab Tests for Sexually Transmitted Infections
Encounter, Performed: Office Visit
Encounter, Performed: Face-to-Face Interaction
Encounter, Performed: Preventive Care Services - Established Office Visit, 18 and Up
Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up
Encounter, Performed: Home Healthcare Services
Encounter, Performed: Preventive Care - Established Office Visit, 0 to 17
Encounter, Performed: Preventive Care- Initial Office Visit, 0 to 17
Pregnancy Test
Diagnostic Study, Order: X-Ray Study (all inclusive)
Other Female Reproductive Conditions
Genital Herpes
Gonococcal Infections and Venereal Diseases
Contraceptive Medications
Inflammatory Diseases of Female Reproductive Organs
Chlamydia
HIV
Syphilis
Complications of Pregnancy, Childbirth and the Puerperium
Laboratory Test, Order: Pregnancy Test
Diagnosis, Active: Other Female Reproductive Conditions
Diagnosis, Active: Genital Herpes
Diagnosis, Active: Gonococcal Infections and Venereal Diseases
Medication, Active: Contraceptive Medications
Diagnosis, Active: Inflammatory Diseases of Female Reproductive Organs
Diagnosis, Active: Chlamydia
Diagnosis, Active: HIV
Diagnosis, Active: Syphilis
Diagnosis, Active: Complications of Pregnancy, Childbirth and the Puerperium
Reporting Stratification
-
Reporting Stratum 1 =
- AND: "Patient Characteristic Birthdate: birth date" >= 16 year(s) starts before start of "Measurement Period"
- AND: "Patient Characteristic Birthdate: birth date" <= 20 year(s) starts before start of "Measurement Period"
-
Reporting Stratum 2 =
- AND: "Patient Characteristic Birthdate: birth date" >= 21 year(s) starts before start of "Measurement Period"
- AND: "Patient Characteristic Birthdate: birth date" < 24 year(s) starts before start of "Measurement Period"
Stratum
Patient Characteristic Birthdate: birth date
Measurement Period
Patient Characteristic Birthdate: birth date
Measurement Period
Stratum
Patient Characteristic Birthdate: birth date
Measurement Period
Patient Characteristic Birthdate: birth date
Measurement Period
Supplemental Data Elements
-
"Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity CDCREC Value Set (2.16.840.1.114222.4.11.837)"
-
"Patient Characteristic Payer: Payer" using "Payer SOP Value Set (2.16.840.1.114222.4.11.3591)"
-
"Patient Characteristic Race: Race" using "Race CDCREC Value Set (2.16.840.1.114222.4.11.836)"
-
"Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex AdministrativeSex Value Set (2.16.840.1.113762.1.4.1)"
Patient Characteristic Ethnicity: Ethnicity
Patient Characteristic Sex: ONC Administrative Sex
Patient Characteristic Payer: Payer
Patient Characteristic Race: Race