CommercialDocumentationMedium impact
Avoidance of antibiotic treatment in adults with acute bronchitis (AAB)
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +2 more·Physician
Effective date
Jan 1, 2019
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield Rhode Island has implemented quality measures to reduce inappropriate antibiotic prescribing for acute bronchitis in adults aged 18-64. Providers must use precise ICD-10 diagnostic codes (especially viral-specific codes) and document relevant comorbidities when antibiotics are prescribed to avoid quality measure penalties.
Action Required
Immediately: Providers must ensure accurate ICD-10 coding for acute bronchitis cases, using viral-specific codes when appropriate and avoiding unspecified codes J20.8 and J20.9 unless necessary. When prescribing antibiotics for bronchitis, providers must document relevant comorbidities (HIV, malignant neoplasm, emphysema, COPD, cystic fibrosis, disorders of immune system) in medical records to justify treatment and ensure proper quality measure reporting.