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CMS146v6 Code List

Code List: CMS146v6, Appropriate Testing for Children with Pharyngitis

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Item Codes
Active Diagnosis Codes
Diagnosis: Acute Pharyngitis: ICD-10 J02.0, J02.8, J02.9
Diagnosis: Acute Pharyngitis: SNOMED 1532007, 195655000, 195656004, 195657008, 195658003, 195659006, 195660001, 195662009, 232399005, 232400003, 363746003, 40766000, 43878008, 58031004
Diagnosis: Acute Tonsillitis: ICD-10 J03.00, J03.01, J03.80, J03.81, J03.90, J03.91
Diagnosis: Acute Tonsillitis: SNOMED 10629271000119107, 17741008, 195666007, 195668008, 195669000, 195670004, 195671000, 195672007, 195673002, 195676005, 195677001, 302911003
Encounter Codes
Encounter, Performed: Ambulatory/ED Visit: CPT 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99281, 99282, 99283, 99284, 99285, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99429, 99455, 99456
Encounter, Performed: Ambulatory/ED Visit: SNOMED 12843005, 18170008, 185349003, 185463005, 185465003, 19681004, 207195004, 270427003, 270430005, 308335008, 390906007, 406547006, 439708006, 87790002, 90526000
Laboratory LOINC Codes
Laboratory Test, Performed: Group A Streptococcus Test: LOINC 626-2, 5036-9, 6559-9, 6557-3, 6558-1, 11268-0, 17656-0, 17898-8, 18481-2, 31971-5, 49610-9, 60489-2, 68954-7, 78012-2
Medications
Medications: Antibiotic Medications for Pharyngitis: Description (RXNORM code) {14 (24 HR Clarithromycin 500 MG Extended Release Oral Tablet) } Pack (835341); {3 (Azithromycin 500 MG Oral Tablet) } Pack (749780); {30 (Doxycycline Monohydrate 150 MG Oral Tablet) } Pack (835700); {31 (Doxycycline Monohydrate 100 MG Oral Tablet) } Pack (757460); {31 (Doxycycline Monohydrate 75 MG Oral Tablet) } Pack (757464); {5 (moxifloxacin 400 MG Oral Tablet) } Pack (761979); {6 (Azithromycin 250 MG Oral Tablet) } Pack (749783); {6 (Azithromycin 500 MG Oral Tablet) } Pack (1148107); {60 (Doxycycline Monohydrate 100 MG Oral Tablet) } Pack (757466); 1 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe (731564); 1 ML penicillin G procaine 600000 UNT/ML Prefilled Syringe (745560); 10 ML Gentamicin 10 MG/ML Injection (1870686); 100 ML Ciprofloxacin 2 MG/ML Injection (1665210); 100 ML Gentamicin 1.2 MG/ML Injection (1870631); 100 ML Levofloxacin 5 MG/ML Injection (1665507); 100 ML Tobramycin 0.8 MG/ML Injection (315209); 100 ML Vancomycin 5 MG/ML Injection (1807511); 12 HR Amoxicillin 1000 MG / Clavulanate 62.5 MG Extended Release Oral Tablet (617995); 12 HR Cefaclor 500 MG Extended Release Oral Tablet (309043); 150 ML Levofloxacin 5 MG/ML Injection (1665515); 150 ML Vancomycin 5 MG/ML Injection (1807510); 2 ML Amikacin 250 MG/ML Injection (1723156); 2 ML Amikacin 50 MG/ML Injection (1727174); 2 ML Clindamycin 150 MG/ML Injection (1737244); 2 ML Gentamicin 10 MG/ML Injection (1870676); 2 ML Gentamicin 40 MG/ML Injection (1870650); 2 ML penicillin G benzathine 300000 UNT/ML / penicillin G procaine 300000 UNT/ML Prefilled Syringe (731538); 2 ML penicillin G benzathine 450000 UNT/ML / penicillin G procaine 150000 UNT/ML Prefilled Syringe (836306); 2 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe (731567); 2 ML penicillin G procaine 600000 UNT/ML Prefilled Syringe (745462); 20 ML Ciprofloxacin 10 MG/ML Injection (1665227); 20 ML Levofloxacin 25 MG/ML Injection (1665517); 200 ML Ciprofloxacin 2 MG/ML Injection (1665212); 200 ML linezolid 2 MG/ML Injection (1662283); 200 ML Vancomycin 5 MG/ML Injection (1807508); 24 HR Ciprofloxacin 1000 MG Extended Release Oral Tablet (403921); 24 HR Ciprofloxacin 500 MG Extended Release Oral Tablet (359383); 24 HR Clarithromycin 500 MG Extended Release Oral Tablet (359385); 24 HR Metronidazole 750 MG Extended Release Oral Tablet (636559); 24 HR Minocycline 105 MG Extended Release Oral Tablet (1013659); 24 HR Minocycline 112.5 MG Extended Release Oral Capsule (1302669); 24 HR Minocycline 115 MG Extended Release Oral Tablet (858062); 24 HR Minocycline 135 MG Extended Release Oral Capsule (1302674); 24 HR Minocycline 135 MG Extended Release Oral Tablet (629695); 24 HR Minocycline 45 MG Extended Release Oral Capsule (1302650); 24 HR Minocycline 45 MG Extended Release Oral Tablet (629697); 24 HR Minocycline 55 MG Extended Release Oral Tablet (1013662); 24 HR Minocycline 65 MG Extended Release Oral Tablet (858372); 24 HR Minocycline 67.5 MG Extended Release Oral Capsule (1302659); 24 HR Minocycline 80 MG Extended Release Oral Tablet (1013665); 24 HR Minocycline 90 MG Extended Release Oral Capsule (1302664); 24 HR Minocycline 90 MG Extended Release Oral Tablet (629699); 250 ML moxifloxacin 1.6 MG/ML Injection (351156); 30 ML Levofloxacin 25 MG/ML Injection (1665519); 300 ML linezolid 2 MG/ML Injection (1662285); 4 ML Amikacin 250 MG/ML Injection (1723160); 4 ML Clindamycin 150 MG/ML Injection (1737578); 4 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe (731570); 40 ML Ciprofloxacin 10 MG/ML Injection (1665229); 50 ML Cefotaxime 20 MG/ML Injection (1747115); 50 ML Cefotaxime 40 MG/ML Injection (1747121); 50 ML Clindamycin 12 MG/ML Injection (309335); 50 ML Clindamycin 18 MG/ML Injection (309336); 50 ML Clindamycin 6 MG/ML Injection (309339); 50 ML Gentamicin 1.2 MG/ML Injection (1870633); 50 ML Levofloxacin 5 MG/ML Injection (1665497); 50 ML Oxacillin 20 MG/ML Injection (312128); 50 ML Oxacillin 40 MG/ML Injection (240637); 50 ML Penicillin G Potassium 20000 UNT/ML Injection (207390); 50 ML Penicillin G Potassium 40000 UNT/ML Injection (204466); 50 ML Penicillin G Potassium 60000 UNT/ML Injection (207391); 50 ML Tobramycin 1.2 MG/ML Injection (242825); 6 ML Clindamycin 150 MG/ML Injection (1737581); 6 ML Gentamicin 10 MG/ML Injection (1870681); 8 ML Gentamicin 10 MG/ML Injection (1870685); Amoxicillin 120 MG/ML / Clavulanate 8.58 MG/ML Oral Suspension (617993); Amoxicillin 125 MG Chewable Tablet (308177); Amoxicillin 200 MG / Clavulanate 28.5 MG Chewable Tablet (617309); Amoxicillin 200 MG Chewable Tablet (308181); Amoxicillin 25 MG/ML / Clavulanate 6.25 MG/ML Oral Suspension (617302); Amoxicillin 25 MG/ML Oral Suspension (313797); Amoxicillin 250 MG / Clavulanate 125 MG Oral Tablet (562251); Amoxicillin 250 MG Chewable Tablet (598025); Amoxicillin 250 MG Oral Capsule (308182); Amoxicillin 40 MG/ML / Clavulanate 5.7 MG/ML Oral Suspension (617423); Amoxicillin 40 MG/ML Oral Suspension (313850); Amoxicillin 400 MG / Clavulanate 57 MG Chewable Tablet (617316); Amoxicillin 400 MG Chewable Tablet (308188); Amoxicillin 50 MG/ML / Clavulanate 12.5 MG/ML Oral Suspension (617322); Amoxicillin 50 MG/ML Oral Suspension (239191); Amoxicillin 500 MG / Clavulanate 125 MG Oral Tablet (617296); Amoxicillin 500 MG Oral Capsule (308191); Amoxicillin 500 MG Oral Tablet (308192); Amoxicillin 775 MG Extended Release Oral Tablet (802550); Amoxicillin 80 MG/ML / Clavulanate 11.4 MG/ML Oral Suspension (617430); Amoxicillin 80 MG/ML Oral Suspension (308189); Amoxicillin 875 MG / Clavulanate 125 MG Oral Tablet (562508); Amoxicillin 875 MG Oral Tablet (308194); Ampicillin 100 MG/ML / Sulbactam 50 MG/ML Injectable Solution (240984); Ampicillin 100 MG/ML Injectable Solution (789980); Ampicillin 1000 MG / Sulbactam 500 MG Injection (1659592); Ampicillin 1000 MG Injection (1721475); Ampicillin 125 MG Injection (308207); Ampicillin 125 MG Oral Tablet (226633); Ampicillin 2000 MG / Sulbactam 1000 MG Injection (1659598); Ampicillin 2000 MG Injection (1721476); Ampicillin 25 MG/ML Oral Suspension (313799); Ampicillin 250 MG Injection (1721473); Ampicillin 250 MG Oral Capsule (313800); Ampicillin 50 MG/ML Oral Suspension (308210); Ampicillin 500 MG Injection (1721474); Ampicillin 500 MG Oral Capsule (308212); Azithromycin 20 MG/ML Oral Suspension (308459); Azithromycin 250 MG Oral Tablet (308460); Azithromycin 33.3 MG/ML Extended Release Suspension (577378); Azithromycin 40 MG/ML Oral Suspension (141963); Azithromycin 500 MG Injection (1668238); Azithromycin 500 MG Oral Tablet (248656); Azithromycin 600 MG Oral Tablet (204844); Aztreonam 1000 MG Injection (1664981); Aztreonam 2000 MG Injection (1664986); Cefaclor 25 MG/ML Oral Suspension (309044); Cefaclor 250 MG Oral Capsule (309045); Cefaclor 37.4 MG/ML Oral Suspension (309040); Cefaclor 50 MG/ML Oral Suspension (313888); Cefaclor 500 MG Oral Capsule (197449); Cefadroxil 100 MG/ML Oral Suspension (105171); Cefadroxil 1000 MG Oral Tablet (309047); Cefadroxil 50 MG/ML Oral Suspension (309048); Cefadroxil 500 MG Oral Capsule (309049); Cefazolin 1000 MG Injection (1665050); Cefazolin 200 MG/ML Injectable Solution (313920); Cefazolin 2000 MG Injection (1665060); Cefazolin 500 MG Injection (1665052); cefdinir 25 MG/ML Oral Suspension (309054); cefdinir 300 MG Oral Capsule (200346); cefdinir 50 MG/ML Oral Suspension (476576); cefditoren pivoxil 200 MG Oral Tablet (351127); cefditoren pivoxil 400 MG Oral Tablet (847360); cefepime 1000 MG Injection (1665093); cefepime 2000 MG Injection (1665088); cefepime 500 MG Injection (1665097); Cefixime 100 MG Chewable Tablet (1043022); Cefixime 100 MG/ML Oral Suspension (1373014); Cefixime 150 MG Chewable Tablet (1043027); Cefixime 20 MG/ML Oral Suspension (309058); Cefixime 200 MG Chewable Tablet (1043030); Cefixime 40 MG/ML Oral Suspension (419849); Cefixime 400 MG Oral Capsule (409823); Cefixime 400 MG Oral Tablet (197451); Cefotaxime 1000 MG Injection (1656313); Cefotaxime 200 MG/ML Injectable Solution (309065); Cefotaxime 2000 MG Injection (1656318); Cefotaxime 500 MG Injection (309068); Cefotetan 1000 MG Injection (1722919); Cefotetan 180 MG/ML Injectable Solution (1722916); Cefotetan 2000 MG Injection (1722921); Cefoxitin 100 MG/ML Injectable Solution (1739890); Cefoxitin 1000 MG Injection (1665102); Cefoxitin 200 MG/ML Injectable Solution (309072); Cefoxitin 2000 MG Injection (1665107); cefpodoxime 10 MG/ML Oral Suspension (309079); cefpodoxime 100 MG Oral Tablet (309076); cefpodoxime 20 MG/ML Oral Suspension (309077); cefpodoxime 200 MG Oral Tablet (309078); cefprozil 25 MG/ML Oral Suspension (309080); cefprozil 250 MG Oral Tablet (197452); cefprozil 50 MG/ML Oral Suspension (309081); cefprozil 500 MG Oral Tablet (197453); Ceftazidime 1000 MG Injection (1659283); Ceftazidime 200 MG/ML Injectable Solution (242800); Ceftazidime 2000 MG Injection (1659287); Ceftazidime 500 MG Injection (1659278); ceftibuten 18 MG/ML Oral Suspension (309087); ceftibuten 36 MG/ML Oral Suspension (309085); ceftibuten 400 MG Oral Capsule (309086); Ceftriaxone 100 MG/ML Injectable Solution (309090); Ceftriaxone 1000 MG Injection (1665021); Ceftriaxone 2000 MG Injection (1665046); Ceftriaxone 250 MG Injection (309092); Ceftriaxone 500 MG Injection (1665005); Cefuroxime 125 MG Oral Tablet (309095); Cefuroxime 1500 MG Injection (1665444); Cefuroxime 25 MG/ML Oral Suspension (309096); Cefuroxime 250 MG Oral Tablet (309097); Cefuroxime 50 MG/ML Oral Suspension (313926); Cefuroxime 500 MG Oral Tablet (309098); Cefuroxime 750 MG Injection (1665449); Cefuroxime 95 MG/ML Injectable Solution (309101); Cephalexin 25 MG/ML Oral Suspension (309110); Cephalexin 250 MG Oral Capsule (309112); Cephalexin 250 MG Oral Tablet (309115); Cephalexin 333 MG Oral Capsule (645617); Cephalexin 50 MG/ML Oral Suspension (309113); Cephalexin 500 MG Oral Capsule (309114); Cephalexin 500 MG Oral Tablet (197454); Cephalexin 750 MG Oral Capsule (637173); Ciprofloxacin 100 MG Oral Tablet (199370); Ciprofloxacin 100 MG/ML Oral Suspension (309310); Ciprofloxacin 250 MG Oral Tablet (197511); Ciprofloxacin 50 MG/ML Oral Suspension (309308); Ciprofloxacin 500 MG Oral Tablet (309309); Ciprofloxacin 750 MG Oral Tablet (197512); Clarithromycin 1000 MG Extended Release Oral Tablet (597455); Clarithromycin 25 MG/ML Oral Suspension (240741); Clarithromycin 250 MG Oral Tablet (197516); Clarithromycin 50 MG/ML Oral Suspension (309322); Clarithromycin 500 MG Oral Tablet (197517); Clindamycin 15 MG/ML Oral Solution (562266); Clindamycin 150 MG Oral Capsule (197518); Clindamycin 150 MG/ML Injectable Solution (205964); Clindamycin 300 MG Oral Capsule (284215); Clindamycin 75 MG Oral Capsule (309329); dalfopristin 350 MG / quinupristin 150 MG Injection (259290); Daptomycin 500 MG Injection (403920); Dicloxacillin 250 MG Oral Capsule (197595); Dicloxacillin 500 MG Oral Capsule (197596); doxycycline anhydrous 40 MG Delayed Release Oral Capsule (901399); Doxycycline Calcium 10 MG/ML Oral Suspension (310026); doxycycline hyclate 100 MG Delayed Release Oral Capsule (348869); doxycycline hyclate 100 MG Delayed Release Oral Tablet (434018); doxycycline hyclate 100 MG Injection (310027); doxycycline hyclate 100 MG Oral Capsule (1649988); doxycycline hyclate 100 MG Oral Tablet (1650143); doxycycline hyclate 120 MG Delayed Release Oral Tablet (1801138); doxycycline hyclate 150 MG Delayed Release Oral Tablet (799048); doxycycline hyclate 150 MG Oral Tablet (1650446); doxycycline hyclate 20 MG Oral Capsule (310028); doxycycline hyclate 20 MG Oral Tablet (283535); doxycycline hyclate 200 MG Delayed Release Oral Tablet (1423080); doxycycline hyclate 50 MG Delayed Release Oral Tablet (1653433); doxycycline hyclate 50 MG Oral Capsule (1649405); doxycycline hyclate 50 MG Oral Tablet (1652674); doxycycline hyclate 60 MG Delayed Release Oral Tablet (1801142); doxycycline hyclate 75 MG Delayed Release Oral Capsule (348870); doxycycline hyclate 75 MG Delayed Release Oral Tablet (406524); doxycycline hyclate 75 MG Oral Capsule (1791505); doxycycline hyclate 75 MG Oral Tablet (1649425); Doxycycline Monohydrate 100 MG Oral Capsule (1649990); Doxycycline Monohydrate 100 MG Oral Tablet (1650142); Doxycycline Monohydrate 150 MG Oral Capsule (728207); Doxycycline Monohydrate 150 MG Oral Tablet (1650444); Doxycycline Monohydrate 5 MG/ML Oral Suspension (1650030); Doxycycline Monohydrate 50 MG Oral Capsule (1649401); Doxycycline Monohydrate 50 MG Oral Tablet (1652673); Doxycycline Monohydrate 75 MG Oral Capsule (700408); Doxycycline Monohydrate 75 MG Oral Tablet (1649429); Erythromycin 250 MG Delayed Release Oral Capsule (310154); Erythromycin 250 MG Delayed Release Oral Tablet (310155); Erythromycin 250 MG Oral Tablet (598006); Erythromycin 333 MG Delayed Release Oral Capsule (245240); Erythromycin 333 MG Delayed Release Oral Tablet (315090); Erythromycin 500 MG Delayed Release Oral Tablet (310157); Erythromycin 500 MG Oral Tablet (197650); Erythromycin Ethylsuccinate 40 MG/ML / Sulfisoxazole 120 MG/ML Oral Suspension (686383); Erythromycin Ethylsuccinate 40 MG/ML Oral Suspension (686400); Erythromycin Ethylsuccinate 400 MG Oral Tablet (686405); Erythromycin Ethylsuccinate 80 MG/ML Oral Suspension (686418); erythromycin lactobionate 500 MG Injection (1668264); erythromycin stearate 250 MG Oral Tablet (686355); erythromycin stearate 500 MG Oral Tablet (686406); gemifloxacin 320 MG Oral Tablet (637560); Gentamicin 10 MG/ML Injectable Solution (239204); Gentamicin 40 MG/ML Injectable Solution (313996); Levofloxacin 25 MG/ML Oral Solution (477391); Levofloxacin 250 MG Oral Tablet (199884); Levofloxacin 500 MG Oral Tablet (199885); Levofloxacin 750 MG Oral Tablet (311296); Metronidazole 250 MG Oral Tablet (314106); Metronidazole 375 MG Oral Capsule (199055); Metronidazole 400 MG Oral Tablet (199327); Metronidazole 500 MG Oral Capsule (247673); Metronidazole 500 MG Oral Tablet (311681); Minocycline 100 MG Injection (317127); Minocycline 100 MG Oral Capsule (197984); Minocycline 100 MG Oral Tablet (207364); Minocycline 50 MG Oral Capsule (197985); Minocycline 50 MG Oral Tablet (207362); Minocycline 75 MG Oral Capsule (314108); Minocycline 75 MG Oral Tablet (403840); moxifloxacin 400 MG Oral Tablet (311787); Nafcillin 100 MG/ML Injectable Solution (239189); Nafcillin 1000 MG Injection (1721458); Nafcillin 2000 MG Injection (1721460); Nitrofurantoin 5 MG/ML Oral Suspension (311989); Nitrofurantoin 50 MG Oral Tablet (311991); NITROFURANTOIN, MACROCRYSTALS 100 MG Oral Capsule (1648759); NITROFURANTOIN, MACROCRYSTALS 25 MG / Nitrofurantoin, Monohydrate 75 MG Oral Capsule (1648755); NITROFURANTOIN, MACROCRYSTALS 25 MG Oral Capsule (311994); NITROFURANTOIN, MACROCRYSTALS 50 MG Oral Capsule (311995); Norfloxacin 400 MG Oral Tablet (198044); Ofloxacin 200 MG Oral Tablet (198048); Ofloxacin 300 MG Oral Tablet (198049); Ofloxacin 400 MG Oral Tablet (198050); Ofloxacin 600 MG Oral Tablet (877486); Oxacillin 100 MG/ML Injectable Solution (312127); Oxacillin 1000 MG Injection (1743547); Oxacillin 2000 MG Injection (1743549); Penicillin G Potassium 1000000 UNT/ML Injectable Solution (863538); Penicillin G Sodium 100000 UNT/ML Injectable Solution (745302); Penicillin V Potassium 25 MG/ML Oral Solution (834046); Penicillin V Potassium 250 MG Oral Capsule (1088677); Penicillin V Potassium 250 MG Oral Tablet (834061); Penicillin V Potassium 50 MG/ML Oral Solution (834040); Penicillin V Potassium 500 MG Oral Tablet (834102); Piperacillin 200 MG/ML / tazobactam 25 MG/ML Injectable Solution (312447); Piperacillin 2000 MG / tazobactam 250 MG Injection (1659131); Piperacillin 3000 MG / tazobactam 375 MG Injection (1659137); Piperacillin 4000 MG / tazobactam 500 MG Injection (1659149); Rifampin 150 MG Oral Capsule (198201); Rifampin 300 MG Oral Capsule (198202); Rifampin 450 MG Oral Tablet (199802); Rifampin 600 MG Oral Tablet (199620); Streptomycin 1000 MG Injection (313115); Sulfadiazine 410 MG / Trimethoprim 90 MG Oral Tablet (245837); Sulfamethoxazole 100 MG / Trimethoprim 20 MG Oral Tablet (142118); Sulfamethoxazole 40 MG/ML / Trimethoprim 8 MG/ML Oral Suspension (313134); Sulfamethoxazole 400 MG / Trimethoprim 80 MG Oral Tablet (198334); Sulfamethoxazole 80 MG/ML / Trimethoprim 16 MG/ML Injectable Solution (313137); Sulfamethoxazole 800 MG / Trimethoprim 160 MG Oral Tablet (198335); telavancin 250 MG Injection (1728087); telavancin 750 MG Injection (1728082); telithromycin 300 MG Oral Tablet (597761); telithromycin 400 MG Oral Tablet (388510); Tetracycline 250 MG Oral Capsule (198250); Tetracycline 500 MG Oral Capsule (198252); Tobramycin 10 MG/ML Injectable Solution (313416); Tobramycin 40 MG/ML Injectable Solution (597823); Trimethoprim 10 MG/ML Oral Solution (562707); Trimethoprim 100 MG Oral Tablet (198332); Trimethoprim 300 MG Oral Tablet (199332); Vancomycin 100 MG/ML Injectable Solution (239209); Vancomycin 1000 MG Injection (1807513); Vancomycin 125 MG Oral Capsule (313570); Vancomycin 250 MG Oral Capsule (313571); Vancomycin 50 MG/ML Injectable Solution (313572); Vancomycin 500 MG Injection (1807516); Vancomycin 750 MG Injection (1807518)
Hospice Exclusion Codes
Encounter, Performed: Encounter Inpatient 183452005, 32485007, 8715000
Intervention, Order: Hospice Care 385763009, 385765002
Discharge Codes to Health Care Facility for Hospice Care 428371000124100
Discharge Codes to Home for Hospice Care 428361000124107

Last updated: June 6, 2018 at 3:27 pm