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.

• 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

Source(s)

Medical Codify