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
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