CMS 146 - Appropriate Testing for Children with Pharyngitis

CMS146v5 (2017)

CMS146v6 (2018)

CMS146v7 (2019)

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.

Initial Patient Population:  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.

Denominator:  Equals Initial Population

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.

Inverse Measure:  No

Clinical Instructions

Track all children ages 3-18 who had an outpatient or ED visit with a diagnosis of pharyngitis and an antibiotic ordered on or three (3) days after the visit. Compliance requires a group A streptococcus (strep) test be administered within the 7-day period from 3 days prior through 3 days after the initial diagnosis. Use either the Test and Procedures section of the encounter, or add the Lab Results - Set 2 to the encounter template; otherwise, enter the appropriate observation to the chart using the Observations chart tab.

Tip
Regardless of how the strep test observation is added to the chart, clients will need to ensure that the appropriate observation is configured with LOINC 6559-9.  Clients should search the Observation Codes editor for the Strep observations to determine if multiple observations need to be merged.
  • While documenting the Visit encounter, document the results of a Strep test one of two ways:
    • Option 1: Tests and Procedures Section
      • Open the Tests and Procedures section.
      • Using the autocomplete, begin typing Strep A Qual Throat Swab.
      • Click the Add to Exam button.
      • After adding the new section, open the Strep A Qual Throat Swab section and add the result.
      • Click the Next button, or close the section.
    • Option 2: Add Lab Results - Set 2 to Encounter
      • Click the Tools icon in the upper-right corner of the encounter.
      • Click the Lab Results - Set 2 header to add the section to the encounter template. Close the Tools window.
      • Click the Lab Results - Set 2 header to open the section and add the Rapid Strep result.
      • Click the Next button, or close the section.
    • Continue documenting the encounter, as needed.
    • When completed, Close and Archive the encounter
  • Option 3: Add Observation using Observations Chart Tab
    • Navigate to the patient chart.
    • Open the Observations tab of the Medical Records chart tab.
    • Click the Add Observation link in the upper-right corner.
    • Enter the Date the Rapid Strep was observed, its Result, and any relevant Comments.
    • Click the Submit button.

Evidence

Name Value Set
Diagnosis 2.16.840.1.113883.3.464.1003.102.12.1011
Diagnosis 2.16.840.1.113883.3.464.1003.102.12.1012
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1061
Encounter, Performed 2.16.840.1.113883.3.666.5.307
Intervention, Order 2.16.840.1.113762.1.4.1108.15
Intervention, Performed 2.16.840.1.113762.1.4.1108.15
Laboratory Test, Performed 2.16.840.1.113883.3.464.1003.198.12.1012
Medication, Active 2.16.840.1.113883.3.464.1003.196.12.1001
Medication, Order 2.16.840.1.113883.3.464.1003.196.12.1001
Patient Characteristic Ethnicity 2.16.840.1.114222.4.11.837
Patient Characteristic Payer 2.16.840.1.114222.4.11.3591
Patient Characteristic Race 2.16.840.1.114222.4.11.836
Patient Characteristic Sex 2.16.840.1.113762.1.4.1

Source(s)

Medical Codify

WebChart Documentation
Last Build: Wed, 08 Sep 2021 00:25:58 EDT Legacy Documentation