We have been wondering for several years, why CMS logic looks at the problem list in the encounter where the patient was prescribed antibiotics and doesn’t limit the search to the diagnosis associated with the encounter. Ex. Patient has a Problem of URI and comes for a visit for another condition that requires antibiotics. The encounter fails the measure because an antibiotic, even though prescribed for something else besides URI, is interpreted as being given for the problem in the problem list.

Is there a way that the logic can look at the encounter diagnosis only and not the encounter diagnosis and problems in the problem list?