CMS 154 - Appropriate Treatment for Children with Upper Respiratory Infection (URI)

CMS154v5 (2017)

CMS154v6 (2018)

CMS154v7 (2019)

Description:  Percentage of children 3 months-18 years of age who were diagnosed with upper respiratory infection (URI) and were not dispensed an antibiotic prescription on or three days after the episode.

Initial Patient Population:  Children age 3 months to 18 years who had an outpatient or emergency department (ED) visit with a diagnosis of upper respiratory infection (URI) during the measurement period.

Denominator:  Equals Initial Population

Numerator: Children without a prescription for antibiotic medication on or 3 days after the outpatient or ED visit for an upper respiratory infection.

Inverse Measure:  No

Clinical Instructions

Tracks children aged 13 months to 18 years who have been diagnosed with an upper respiratory infection, and were not dispensed an antibiotic on or 3 days after the visit for the infection.

  • Ensure patient has a diagnosis of Upper Respiratory Infection.
  • For individuals who have been diagnosed, review medications and ensure an antibiotic was not dispensed on or 3 days after the visit for the infection.


Name Value Set
Diagnosis 2.16.840.1.113883.3.464.1003.102.12.1017
Diagnosis 2.16.840.1.113883.3.464.1003.102.12.1022
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1010
Encounter, Performed 2.16.840.1.113883.3.666.5.307
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1002
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1001
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1024
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1022
Intervention, Order 2.16.840.1.113762.1.4.1108.15
Intervention, Performed 2.16.840.1.113762.1.4.1108.15
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


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