Clinical Quality Measure
CMS154v2 (NQF 0069) - Pediatric Recommended Core Measure

Appropriate Treatment for Children with Upper Respiratory Infection (URI)

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.

NQS DOMAIN:   Efficient Use of Healthcare Resources




Description and Implementation within the EMR software

Denominator: All patients with at least 1 encounter during the meaningful-use reporting period and having one of the following ICD-10 codes selected in ASSESSMENT/DIAGNOSIS section on the ENCOUNTER form:
J00, J06.0, J06.9

Numerator: Patients in the above mentioned list without a prescription for antibiotic medication on or 3 days after the visit for an upper respiratory infection. UniCharts looks for the custom code QM069A: [Quality Measure] Patient not prescribed antibiotic on or 3 days after visit within the PROCEDURES/SERVICES section on the ENCOUNTER form as the required documentation. If the patient was not prescribed antibiotic on or 3 days after visit due to competing respiratory conditions , select QM069X: [Exclusion] Patient not prescribed antibiotic on or 3 days after visit due to competing respiratory conditions instead. Similarly, if the patient was not prescribed antibiotic on or 3 days after visit due to an antibiotic regimen started 30 days or less ago, select QM069Y: [Exclusion] Patient not prescribed antibiotic on or 3 days after visit due to an antibiotic regimen started 30 days or less ago instead.

Exceptions: None

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