Appropriate Testing for Pharyngitis (CWP)

HEDIS Measure

Appropriate Testing for Pharyngitis (CWP)

Line of business: Commercial Medicaid Medicare

Data Collection Method: Administrative (Claims)

Supplemental Data Submission:

• Non-Standard - Medical Record

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