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Appropriate Testing for Children with Pharyngitis (CWP)

HEDIS Measure

Appropriate Testing for Children with Pharyngitis (CWP)

Line of business: Commercial Medicaid Medicare

Data Collection Method: Administrative

Measure Description

The percentage of episodes for members 3 years and older where the member was diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode.

Numerator Compliance

A group A streptococcus test (Group A Strep Tests Value Set) in the seven-day period from three days prior to the Episode Date through three days after the Episode Date.

Best Practices

  • The CDC's recommended actions for health care professionals and health care offices:
  • Evaluate your prescribing habits and form a plan for antibiotic stewardship activities, such as watchful waiting or delayed prescribing.
  • Within your networks, provide communications training, clinical decision support, patient/provider education, and feedback to providers on their performances.
  • Reference the Centers for Disease Control and Prevention cdc.gov/antibiotic-use/stewardship-report/index.html.

Quality Value Set Directory Coding Tips

Group A Strep Tests

CPT

  • 87070
  • 87071
  • 87081
  • 87430
  • 87650
  • 87651
  • 87652
  • 87880

LOINC

  • 11268-0
  • 17656-0
  • 17898-8
  • 18481-2
  • 31971-5
  • 49610-9
  • 5036-9
  • 60489-2
  • 626-2
  • 6557-3
  • 6558-1
  • 6559-9
  • 68954-7
  • 78012-2

SNOMED CT US Edition

  • 122121004
  • 122205003
  • 122303007