| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Registry | Process | Yes | Efficiency and Cost Reduction | Allergy/Immunology, Internal Medicine, Otolaryngology, General Practice/Family Medicine |
Measure Description
Percentage of patients aged 18 years and older with a diagnosis of acute bacterial sinusitis that were prescribed amoxicillin, with or without clavulanate, as a first line antibiotic at the time of diagnosis
Instruction
This measure may be reported based on the actions of the reporting eligible clinician who performs the quality action, described in the measure, based on services provided within measure-specific denominator coding. This measure is to be reported a minimum of once per performance period for patients with acute bacterial sinusitis during the performance period.
Denominator
All patients aged 18 years and older with a diagnosis of acute bacterial sinusitis who are prescribed an antibiotic
Definition:
Acute Bacterial Rhinosinusitis (ABRS)- Acute rhinosinusitis that is caused by, or is presumed to be caused by, bacterial infection. A clinician should diagnose ABRS when: (a) symptoms or signs of acute rhinosinusitis are present 10 days or more beyond the onset of upper respiratory symptoms, or (b) symptoms or signs of acute rhinosinusitis worsen within 10 days after an initial improvement (double worsening)
nominator Criteria (Eligible Cases):
Patients aged ≥ 18 years on date of encounter
AND
Diagnosis for acute sinusitis (ICD-10-CM): J01.00, J01.01, J01.10, J01.11, J01.20, J01.21, J01.30, J01.31, J01.40, J01.41, J01.80, J01.90
AND
Patient encounter during performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99281, 99282, 99283, 99284, 99285, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
WITHOUT
Telehealth Modifier: GQ, GT
AND
Sinusitis caused by, or presumed to be caused by, bacterial infection: G9364 Antibiotic regimen prescribed: G9498
AND
Antibiotic regimen prescribed: G9498
Numerator
Patients who were prescribed amoxicillin, with or without clavulanate, as a first line antibiotic at the time of diagnosis
Numerator Options:
Performance Met: Amoxicillin, with or without clavulanate, prescribed as a first line antibiotic at the time of diagnosis (G9315)
OR
Denominator Exception: Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis for documented reason (e.g., cystic fibrosis, immotile cilia disorders, ciliary dyskinesia, immune deficiency, prior history of sinus surgery within the past 12 months, anatomic abnormalities, such as deviated nasal septum, resistant organisms, allergy to medication, recurrent sinusitis, chronic sinusitis, or other reasons) (G9313)
OR
Performance Not Met: Amoxicillin, with or without clavulanate, not prescribed as first line antibiotic at the time of diagnosis, reason not given (G9314)