NQF 0002 - (Additional) Appropriate Testing for Children with Pharyngitis

Measure: NQF 0002 (Additional Measure)

Measure Title:  Appropriate Testing for Children with Pharyngitis

Measure Description: The percentage of children 2–18 years of age who were diagnosed with Pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode.

Quality Measure Documentation Workflow

In order for the Clinical Quality Measure report to generate, the following must be documented in the relevant patient's chart:

1.  The patient's must be between the ages of 2 and 18 and have at least one face-to-face encounter with the provider during the reporting period.

2.  A diagnosis of Pharyngitis (recorded by using any of the ICD9 codes listed below) must be recorded in the SOAPnote Assessment field using one of the following ICD9 codes:

(034.0, 462, 463).

3.  Documentation that the patient was prescribed an antibiotic AND had received a group A streptococcus (strep) test for the episode.  To document this, use the shortcut code "PQRIpha" in the SOAPnote Plan field.  This will insert the picklist header, "Child with pharyngitisQM", which will provide a list of criteria from which to document that an antibiotic was prescribed an a group A strep test was performed.  The following CPT codes must be documented in the SOAPnote Plan field: 4120F and 3210F.  Note: CPT codes 4124F, c3210F-1P, and c3210F-8P will not increase the numerator as they indicated that an antibiotic was not prescribed and group A strep test was not performed.

*  If the above is documented appropriately, this should increase the numerator and denominator for this measure to indicate that the patient who is between the ages of 2 and 18 and had a diagnosis of Pharyngitis during the reporting period, was prescribed an antibiotic and received a group A streptococcus test for the episode.

Measure Calculation Details

Numerator Calculation:

The numerator for this measure is calculated based on the following:

1.  The number of patients in the denominator that have the following CPT codes in the SOAPnote Plan field (in an encounter that is during the reporting period): 4120F and 3210F.  Note: CPT codes 4124F, c3210F-1P, and c3210F-8P will not increase the numerator as they indicated that an antibiotic was not prescribed and group A strep test was not performed.

Denominator Calculation:

The denominator calculation for this measure is calculated based on the following:

1.  The number of patients that were between the ages of 2-18 by the start of the reporting period and have at least one face to face encounter with the physician during the reporting period;

2.  And have a diagnosis of Pharyngitis in the SOAPnote Assessment field using one of the following ICD9 codes: 034.0, 462, 463.

 

Report Clinical Quality Measures to CMS/States

All of the items listed in the above steps need to be documented as structured data (as detailed above) in order to allow the user to capture the numerator, denominator and percentage for this quality measure.

For information on how to export the numerator, denominator and percentage for each Clinical Quality Measure, click here.

For more information on reporting clinical quality measures, click here.