Anthem Blue Cross and Blue Shield | CommercialSeptember 1, 2021
Cure for the common cold: Rest, fluids and this free prescription pad
A mother has a sick child and like all good mothers, wants comfort and care for the child. And a prescription for antibiotics. BMJ Journals published a study that rated how many patients with upper respiratory infections (URI) prior to consultation with their physician expected a prescription for antibiotics:1

Evidence-based data does not support the use of antibiotics in the treatment of the common cold because they do not improve symptoms or shorten the course of the illness.2 Instead of putting away the prescription pad, use this one.
Offered by the Centers for Disease Control and Prevention’s (CDC) Be Antibiotics Aware campaign, the “Relief for common symptoms of colds and cough” prescription pad provides an alternative to unnecessary antibiotics. Get the prescription pad through the CDC website.

Measure up: HEDIS® guidelines for URI/Pharyngitis
URI measures the percentage of episodes for members 3 months of age and older with a URI diagnosis that did not result in an antibiotic dispensing event.
Appropriate Testing for Pharyngitis (CWP) evaluates members 3 years of age and older where the member was diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode.
Records and Billing Codes
URI: In the patient’s medical records, document results of all strep tests or refusal for testing. If antibiotics are prescribed for another condition, take care to associate the antibiotic with the appropriate diagnosis.
Description |
CPT/HCPCS/ICD-10 |
Pharyngitis |
ICD10CM: J02.0, J02.8, J02.9, J03.00, J03.01, J03.80, J03.81, J03.90, J03.91 |
URI |
ICD10CM: J00, J06.0, J06.9 |
Online assessments |
CPT: 98970, 98971, 98972, 99421, 99422, 99423, 99457 |
Telephone visits |
CPT: 98966, 98967, 98968, 99441, 99422, 99423 |
CWI: In the patient’s medical records, document results of all strep tests or refusal for testing. If antibiotics are prescribed for another condition, take care to associate the antibiotic with the appropriate diagnosis.
Description |
CPT/HCPCS/ICD-10 |
Pharyngitis |
ICD10CM: J02.0, J02.8, J02.9, J03.00, J03.01, J03.80, J03.81, J03.90, J03.91 |
Group A streptococcal tests |
CPT: 87070, 87071, 87081, 87430, 87650-87652, 87880 |
Online assessments |
CPT: 98970, 98971, 98972, 99421, 99422, 99423, 99457 |
Telephone visits |
CPT: 98966, 98967, 98968, 99441, 99422, 99423 |
PUBLICATIONS: September 2021 Anthem Provider News - Virginia
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