Appropriate Testing for Children with HEDIS® Provider ...
[Pages:1]HEDIS? Provider Guide:
Appropriate Testing for Children with Pharyngitis
Measure Description
Children 3-18 years of age diagnosed with pharyngitis and dispensed an antibiotic should have received a Group A strep test within 3 days prior to the diagnosis date through the 3 days after the diagnosis date.
Using Correct Billing Codes
Codes to Identify Pharyngitis
Description Acute Pharyngitis
ICD-9 Code 462
ICD-10 Code* J02.8, J02.9
463 Acute Tonsillitis
Streptococcal 034.0 Sore Throat
J03.00, J03.01, J03.80, J03.81, J03.90, J03.91 J02.0
* ICD-10 -CM codes are to be used on or after 10/1/2015.
Codes to Identify Strep Throat
Description
CPT Code
87070, 87071, 87081,
Strep Test
87430, 87650-87652,
87880**
**Rapid strep tests are reimbursed fee for service when
billed timely with code 87880.
How to Improve HEDIS? Scores
? Perform a rapid strep test or throat culture to confirm diagnosis before prescribing antibiotics. Submit this test to CHA for payment, or as a record that you performed the test. Use the codes above.
? Clinical findings alone do not adequately distinguish Strep vs. non-Strep pharyngitis. ? Submit any co-morbid diagnosis codes that apply on claim/encounter. ? If rapid strep test and/or throat culture is negative, educate parents/caregivers that an antibiotic is
not necessary for viral infections. ? Additional resources for clinicians and parents/caregivers about pharyngitis can be found here:
HEDIS? is a registered trademark for the National Committee of Quality Assurance (NCQA)
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- bringing the 10 him experts to you the him times
- hcc ra basics peninsula professional coders
- icd cm basic coding training workbook nc
- appropriate testing for children with pharyngitis
- pediatric icd 10 cm coding tip sheet
- appropriate testing for children with hedis provider
- pertussis strep throat testing resources
- appropriate testing for pharyngitis hedis provider guide
- icd 10 for throat culture
- coding common respiratory problems in icd 10
Related searches
- apps for children with autism
- children with special educational needs
- free ipad for children with autism
- games for children with autism
- state testing practice testing for 3rd grade
- programs for children with autism
- activities for children with autism
- adderall for children with adhd
- attorneys for children with disabilities
- scholarships for children with disabilities
- clearances for working with children in pa
- toys for children with autism