CMS146v8 – Appropriate Testing for Children with Pharyngitis

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.

– 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 EXCLUSION

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

Exclude patients whose hospice care overlaps the measurement period.

Exclude children who had an encounter with a competing diagnosis within three days after the initial  diagnosis of pharyngitis

For 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 are included in the denominator. The following must be documented:

• Ambulatory/ED Visit (Patient > Provider Note)
• Antibiotic Medications for Pharyngitis (Patient > Clinical > Medications)
• Acute Pharyngitis (Patient > Clinical > Diagnosis)

To document medications, navigate to the medications workflow shown above.

For 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 are included in the numerator for this measure. Moreover, a lab result is to be added for a patient to be counted in numerator. To record lab results, navigate to Patient > Clinical > Orders and Results > Labs.

Denominator Exclusion:
Children who are taking antibiotics in the 30 days prior to the diagnosis of pharyngitis are included in denominator exclusion. Exclude patients who were in hospice care during the measurement year. To record lab results, navigate to Patient > Clinical > Evaluations.