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Clinical Quality Measures

CMS146 - Appropriate Testing for Children with Pharyngitis

Measure Description: Percentage of children 3-18 years of age who were diagnosed with pharyngitis, ordered an antibiotic and received a group A streptococcus (strep) test for the episode

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

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

Measure Calculation in ChARM EHR: AUTOMATIC

This measure is automatically calculated in ChARM EHR based on the laboratory test of Group A Streptococcus Test.

To satisfy this measure, for patient with Age >= 3 and < 18 years with active diagnosis of 'Acute Pharyngitis' or 'Acute Tonsillitis'(Example ICD 10 codes : J02.0 , J02.9 , J03.00), antibiotic medications for Pharyngitis should be ordered within three days of the diagnoses. In addition, laboratory test for group A streptococcus (Sample Loinc codes : 11268-0, 18481-2, 626-2) should be done 3 days prior or after the diagnoses date.

Note: Sample LOINC codes for group A streptococcus test are 11268-0, 18481-2, 626-2. Before start recording the result, make sure you have updated the LOINC code '11268-0, ' for group A streptococcus test parameter under 'Settings > Labs > Customize Labs' section. While entering group A streptococcus lab result for patient, choose this particular parameter (that has loinc code configured in settings) and input the value, otherwise it will not be considered for CQM calculation.

Denominator Exclusion: Patients will be automatically excluded from denominator, if they are already taking Antibiotic medications for Pharyngitis with in 30 days before start of Diagnosis ‘Acute Pharyngitis' or 'Acute Tonsillitis’.

In addition, you can manually exclude a patient from denominator, based on other conditions listed below under 'Encounter > MU' section.