#093: Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy – Avoidance of Inappropriate Use

Quality ID

093

NQF

0654

High Priority Measure

Yes

Specifications

Registry

Measure Type

Process

Specialty

Emergency Medicine Family Medicine Infectious Disease Internal Medicine Otolaryngology Pediatrics

Measure description

Percentage of patients aged 2 years and older with a diagnosis of AOE who were not prescribed systemic antimicrobial therapy

 

Instructions

This measure may be submitted based on the actions of the submitting 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 submitted once for each occurrence of AOE during the performance period. For the purpose of submitting this measure, only unique occurrences with an onset of AOE diagnosing within the current performance period will be submitted. A unique occurrence of AOE is defined as the period of time that begins with the onset of AOE diagnosing and ends 30 days after the onset of diagnosing.

Eligible clinicians who submitted this measure may also find Quality ID #91: Acute Otitis Externa: Topical Therapy to be clinically relevant. The measure developer intended for Quality ID #91: Acute Otitis Externa: TopicalTherapy and Quality ID #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.

Measure Submission:

The listed denominator criteria are used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions allowed by the measure. The quality-data codes listed do not need to be submitted for registry-based submissions; however, these codes may be submitted for those registries that utilize claims data.

 

Denominator

All patients aged 2 years and older with a diagnosis of AOE

DENOMINATOR NOTE: A new diagnosis code indicates a new occurrence of AOE. If a patient presents with right ear AOE then returns with new onset of left ear AOE symptoms, then the left ear AOE would be considered a new unique occurrence, separate from the right ear AOE.

Denominator Criteria (Eligible Cases):

Patients aged ≥ 2 years on date of encounter

AND

Diagnosis for AOE (ICD-10-CM): 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, H60.8X3, H62.40, H62.41, H62.42, H62.43,

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, 95, POS 02

 

Numerator

Patients who were not prescribed systemic antimicrobial therapy

NUMERATOR NOTE: Denominator Exception is determined on the date of the denominator eligible encounter/diagnosis.

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 (4131F with 1P)

OR

Performance Not Met: Systemic antimicrobial therapy prescribed (4131F)

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