Measure: CMS146
Appropriate Testing for Pharyngitis
Measure Versions
| eMeasure Code | Measure Year | Full Version Number | Title |
|---|---|---|---|
| CMS146v12 | 2024 | 12.0.000 | Appropriate Testing for Pharyngitis |
| CMS146v11 | 2023 | 11 | Appropriate Testing for Pharyngitis |
| CMS146v10 | 2022 | 10.1.000 | Appropriate Testing for Pharyngitis |
| CMS146v9 | 2021 | 9.2.000 | Appropriate Testing for Pharyngitis |
| CMS146v8 | 2020 | 8.2.000 | Appropriate Testing for Children with Pharyngitis |
| CMS146v7 | 2019 | 7.2.000 | Appropriate Testing for Children with Pharyngitis |
| CMS146v6 | 2018 | 6.1.000 | Appropriate Testing for Children with Pharyngitis |
| CMS146v5 | 2017 | 5.1.000 | Appropriate Testing for Children with Pharyngitis |
Description
The percentage of episodes for patients 3 years and older with a diagnosis of pharyngitis that resulted in an antibiotic order and a group A streptococcus (strep) test in the seven-day period from three days prior to the episode date through three days after the episode date.Guidance
Patient Group Definitions
| Group | Description | Instructions Links |
|---|---|---|
| Initial Population | Outpatient, telephone, online assessment (i.e. e-visit or virtual check-in), observation, or emergency department (ED) visits with a diagnosis of pharyngitis or tonsillitis and an antibiotic order on or within 3 days after the episode date among patients 3 years or older | Webchart Instructions |
| Denominator | Equals Initial Population | Webchart Instructions |
| Denominator Exclusions | Exclude episodes where the patient is taking antibiotics in the 30 days prior to the episode date, or had an active prescription on the episode date. Exclude episodes where the patient had a comorbid condition during the 12 months prior to or on the episode date. Exclude episodes when the patient had hospice care for any part of the measurement period. Exclude episodes where the patient had a competing diagnosis on or within three days after the episode date. | Webchart Instructions |
| Numerator | A group A streptococcus test in the seven-day period from three days prior to the episode date through three days after the episode date | Webchart Instructions |
| Numerator Exclusions | Not Applicable | Webchart Instructions |
| Denominator Exceptions | None |
Details
| Full eMeasure Code | eMeasure Identifier | Measure Year | Version | NQF # | GUID |
|---|---|---|---|---|---|
| CMS146v11 | 146 | 2023 | 11 | N/A | beb1c33c-2549-4e7f-9567-05ed38448464 |
| Steward | Developer | Endorsed By |
|---|---|---|
| National Committee for Quality Assurance | National Committee for Quality Assurance | None |
| Scoring Method | Measure Type | Stratification | Risk Adjustment |
|---|---|---|---|
| Proportion | Process | 3-17 years 18-64 years 65 years and older | None |
Rate Aggregation
None
Improvement Notation
Higher score indicates better qualityRationale
Clinical Recommendation Statement
Definition
Transmission Format
Applicable Value Sets
| Category | Value Set | OID |
|---|---|---|
| Diagnosis | Acute Pharyngitis | 2.16.840.1.113883.3.464.1003.102.12.1011 |
| Diagnosis | Acute Tonsillitis | 2.16.840.1.113883.3.464.1003.102.12.1012 |
| Diagnosis | Comorbid Conditions for Respiratory Conditions | 2.16.840.1.113883.3.464.1003.102.12.1025 |
| Diagnosis | Competing Conditions for Respiratory Conditions | 2.16.840.1.113883.3.464.1003.102.12.1017 |
| Encounter, Performed | Emergency Department Visit | 2.16.840.1.113883.3.464.1003.101.12.1010 |
| Encounter, Performed | Encounter Inpatient | 2.16.840.1.113883.3.666.5.307 |
| Encounter, Performed | Home Healthcare Services | 2.16.840.1.113883.3.464.1003.101.12.1016 |
| Encounter, Performed | Hospice Encounter | 2.16.840.1.113883.3.464.1003.1003 |
| Encounter, Performed | Hospital Observation Care - Initial | 2.16.840.1.113883.3.464.1003.101.12.1002 |
| Encounter, Performed | Medical Disability Exam | 2.16.840.1.113883.3.464.1003.101.12.1073 |
| Encounter, Performed | Observation | 2.16.840.1.113883.3.464.1003.101.12.1086 |
| Encounter, Performed | Office Visit | 2.16.840.1.113883.3.464.1003.101.12.1001 |
| Encounter, Performed | Online Assessments | 2.16.840.1.113883.3.464.1003.101.12.1089 |
| Encounter, Performed | Outpatient Consultation | 2.16.840.1.113883.3.464.1003.101.12.1008 |
| Encounter, Performed | Preventive Care - Established Office Visit, 0 to 17 | 2.16.840.1.113883.3.464.1003.101.12.1024 |
| Encounter, Performed | Preventive Care Services - Established Office Visit, 18 and Up | 2.16.840.1.113883.3.464.1003.101.12.1025 |
| Encounter, Performed | Preventive Care Services - Group Counseling | 2.16.840.1.113883.3.464.1003.101.12.1027 |
| Encounter, Performed | Preventive Care Services-Individual Counseling | 2.16.840.1.113883.3.464.1003.101.12.1026 |
| Encounter, Performed | Preventive Care Services-Initial Office Visit, 18 and Up | 2.16.840.1.113883.3.464.1003.101.12.1023 |
| Encounter, Performed | Preventive Care- Initial Office Visit, 0 to 17 | 2.16.840.1.113883.3.464.1003.101.12.1022 |
| Encounter, Performed | Telephone Visits | 2.16.840.1.113883.3.464.1003.101.12.1080 |
| Intervention, Order | Hospice Care Ambulatory | 2.16.840.1.113883.3.526.3.1584 |
| Intervention, Performed | Hospice Care Ambulatory | 2.16.840.1.113883.3.526.3.1584 |
| Laboratory Test, Performed | Group A Streptococcus Test | 2.16.840.1.113883.3.464.1003.198.12.1012 |
| Medication, Active | Antibiotic Medications for Pharyngitis | 2.16.840.1.113883.3.464.1003.196.12.1001 |
| Medication, Order | Antibiotic Medications for Pharyngitis | 2.16.840.1.113883.3.464.1003.196.12.1001 |
| Patient Characteristic Ethnicity | Ethnicity | 2.16.840.1.114222.4.11.837 |
| Patient Characteristic Payer | Payer | 2.16.840.1.114222.4.11.3591 |
| Patient Characteristic Race | Race | 2.16.840.1.114222.4.11.836 |
| Patient Characteristic Sex | ONC Administrative Sex | 2.16.840.1.113762.1.4.1 |