Meet the Measure

The “Do’s” of Acute Bronchitis

The Blue Cross Blue Shield Massachusetts (BCBSMA) AQC measure for treating Acute Bronchitis in adults can be a challenging measure for providers.  Based on HEDIS guidelines, the measure states that patients aged 18-64 who are diagnosed with acute bronchitis (without a competing diagnosis) should not be treated with an antibiotic.  Many patients have preset opinions that they need an antibiotic whenever they have a respiratory illness.  Addressing these opinions and expectations can be difficult. Listed below are some suggestions for successfully treating and coding for acute bronchitis.

  • DO code for Acute Bronchitis, J20.3-20.9, as appropriate
  • DO have a conversation about the why, to reduce patient expectation for an antibiotic:
    • CDC Synonyms for Acute Bronchitis: “Chest” cold, Acute Cough Illness
    • Majority of cases are viral (>90%), not bacterial, so antibiotics don’t work and cases are self-limited
  • DO address the elephant in the room:
    • It’s not pneumonia (…and this is why it isn’t)
  • DO use OTC script pad (acetaminophen, dextromethorphan, guaifenesin, Nasalcrom etc.)
  • DO offer a contingency plan if symptoms worsen

For more information on this measure including a list of competing diagnosis codes and OTC treatment options please contact NEPHO Pharmacist Carol Freedman, RPh at 978-236-1774 or Carol.Freedman@Lahey.org