| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Claims, Registry | Process | Yes | Efficiency and Cost Reduction | Emergency Medicine, Otolaryngology, General Practice/Family Medicine, Pediatrics |
Measure Description
Percentage of patients aged 2 years and older with a diagnosis of AOE who were not prescribed systemic antimicrobial therapy
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 once for each occurrence of AOE during the performance period. Each unique occurrence is defined as a 30-day period from onset of AOE. Claims data will be analyzed to determineunique occurrences. If multiple claims are submitted within that 30-day period, only one instance of reporting will be counted.
Eligible clinicians who report on this measure may also find Measure #91: Acute Otitis Externa: Topical Therapy tobe clinically relevant. The measure developer intended for measures #91: Acute Otitis Externa: Topical Therapy and measure #93: Acute Otitis Externa: Systemic Antimicrobial Therapy – Avoidance of Inappropriate Use to be paired measures, as they can both be implemented to measure care provided to patients diagnosed withdiffuse, uncomplicated AOE.
Denominator
All patients aged 2 years and older with a diagnosis ofAOE
Denominator Criteria (Eligible Cases):
Patients aged ≥ 2 years on date of encounter
AND
Diagnosis for AOE (ICD-10-CM): H60.00, H60.01, H60.02, H60.03, H60.10, H60.11, H60.12, H60.13, H60.311, H60.312, H60.313, H60.319, H60.321, H60.322, H60.323, H60.329, H60.331, H60.332, H60.333, H60.339, H60.391, H60.392, H60.393, H60.399, H60.501, H60.502, H60.503, H60.509, H60.511, H60.512, H60.513, H60.519, H60.521, H60.522, H60.523, H60.529, H60.531, H60.532, H60.533, H60.539, H60.541, H60.542, H60.543, H60.549, H60.551, H60.552, H60.553, H60.559, H60.591, H60.592, H60.593, H60.599, H61.90, H61.91, H61.92, H61.93, H62.40, H62.41, H62.42, H62.43, H62.8X1, H62.8X2, H62.8X3,H62.8X9
AND
Patient encounter during the 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, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
WITHOUT
Telehealth Modifier: GQ, GT
Numerator
Patients who were not prescribed systemic antimicrobial therapy
Numerator Instructions: For performance, the measure will be calculated as the number of patients for whom systemic antimicrobial therapy was not prescribed over the number of patients in thedenominator (patients aged 2 years and older with acute otitis externa). A higher score indicates appropriate treatment of patients with AOE (e.g., the proportion for whom systemic antimicrobials were notprescribed).
Numerator Options:
Performance Met: Systemic antimicrobial therapy not prescribed (4132F)
OR
Denominator Exception: Documentation of medical reason(s) for prescribing systemic antimicrobial therapy (eg, coexisting diabetes, immune deficiency) (4131F with 1P)
OR
Performance Not Met: Systemic antimicrobial therapy prescribed (4131F)