v23 contract codes with scimp suggested codes · salbutamol and ipratropium bromide 33k1. positive...

Notes

4. In the final column we have added some comments to help with coding and to indicate code changes between v21 and v22.

Sexual Health

COPD

Dementia

1. All codes are taken from Version 22 of the Dept of Health Dataset and Business Rules (published March 2012). Major changes are highlighted in red.

DepressionDiabetes

CVD Primary Prevention

Hypertension

Stroke/TIASmoking

V23 Contract Codes with SCIMP suggested codes

Learning DisabilitiesMental HealthObesity

AsthmaIndex - click on hyperlink

Chronic Kidney Disease

Hypothyroid

EpilepsyHeart Failure

2. In some cases common nomenclature has been used. Codes that end with '%' indicated that this code plus any below it in the heirachy are suitable. Codes connected by a hyphen indicate that any codes between and including the 2 connected codes are suitable.

Palliative CareRecords

3. Included are SCIMP suggested codes for use. However in some circumstances it may be more appropriate to use an alternative code that meets the Contract requirements.

CancerAtrial Fibrillation

Coronary Heart Disease

OsteoporosisPeripheral Arterial disease (PAD)

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To Index

Code Code Breakdown Term

SCIMP Suggested

CodesTerm Comments v22

H33% Asthma H33zz Asthma NOS Population requires an Asthma code and an asthma related prescription in the last 12 months. V22 - new code added H3120

H3120 Chronic asthmatic bronchitis

Asthma-related Drug Prescription Prescribed in the last year. V23 added omalizumab (xolair) inj.

21262 Asthma resolved 21262 Asthma resolved212G. Asthma resolved

9hA.. Exception reporting: asthma quality indicators 9hA1. Excepted from asthma quality indicators: Patient unsuitable

9hA1. Excepted from asthma quality indicators: Patient unsuitable 9hA2. Excepted from asthma quality indicators: Informed

dissent

9hA2. Excepted from asthma quality indicators: Informed dissent

9OJ2. Refuses asthma monitoring

33G1. Spirometry reversibility positive 33G1. Spirometry reversibility positive33H1. Positive reversibility test to salbutamol 33H1. Positive reversibility test to salbutamol33I1. Positive reversibility test to ipratropium bromide

33J1. Positive reversibility test to a combination of salbutamol and ipratropium bromide

33K1. Positive reversibility test to corticosteroids663J. Airways obstruction reversible745D4 Post bronchodilator spirometry8HRC. Referral for spirometry

Spirometry Exception codes 8I3b. Spirometry test declined8I6L. Spirometry not indicated8I2j. Spirometry contraindicated33720 Unable to perform spirometry

33950 Diurnal variation of peak expiratory flow rate 339g. Serial peak expiratory flow rate339c. Peak expiratory flow rate pre steroids339d. Peak expiratory flow rate post steroids339g. Serial peak expiratory flow rate339n. Serial peak expiratory flow rate abnormal339A. Peak flow rate before bronchodilation339B. Peak flow rate after bronchodilation

66Yc. Number of consecutive days at less than 80% peak expiratory flow rate

66YX. Peak expiratory flow rate monitoring66YY. Peak expiratory flow rate monitoring using diary

Added V22 for Asthma 8 indicator. Require entry within the last 15 months.

Patients can be coded with both Asthma and COPD if appropriate. Note that there are differences between the the Asthma and COPD Spirometry Codes, the Asthma spirometry code choice only includes those showing positive reversibility.

PEFR Codes

Diagnosis - Included Codes

ASTHMA

Asthma Resolved

Exception Codes

Spirometry Codes

9hA%

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SCIMP Suggested


137.. Tobacco consumption 1371. Never smoked tobacco1371. Never smoked tobacco 137S. Ex smoker1372. Trivial smoker - < 1 cig/day 137R. Current smoker1373. Light smoker - 1-9 cigs/day1374. Moderate smoker - 10-19 cigs/d1375. Heavy smoker - 20-39 cigs/day1376. Very heavy smoker - 40+cigs/d1377. Ex-trivial smoker (<1/day)1378. Ex-light smoker (1-9/day)1379. Ex-moderate smoker (10-19/day)137A. Ex-heavy smoker (20-39/day)137B. Ex-very heavy smoker (40+/day)137C. Keeps trying to stop smoking137D. Admitted tobacco cons untrue ?137F. Ex-smoker - amount unknown137G. Trying to give up smoking137H. Pipe smoker

137J. Cigar smoker137K. Stopped smoking

137M. Rolls own cigarettes137N. Ex pipe smoker137O. Ex cigar smoker137P. Cigarette smoker137Q. Smoking started137R. Current smoker137S. Ex smoker137T. Date ceased smoking

137V. Smoking reduced137X. Cigarette consumption137Y. Cigar consumption137Z. Tobacco consumption NOS137a. Pipe tobacco consumption137b. Ready to stop smoking137c. Thinking about stopping smoking137d. Not interested in stopping smoking137e. Smoking restarted137f. Reason for restarting smoking137g. Cigarette pack-years137h. Minutes from waking to first tobacco consumption

137j. Ex-cigarette smoker137l. Ex roll-up cigarette smoker137m. Failed attempt to stop smoking

66YJ. Asthma annual review 66YJ. Asthma annual review66YK. Asthma follow-up66YQ. Asthma monitoring by nurse66YR. Asthma monitoring by doctor8B3j. Asthma medication review9OJA. Asthma monitoring check done

Required recording for 14 to 19 year olds in the last 15 months. In this age group non-smokers require entry within the previous 15 months. Otherwise asthma patients are included in the Smoking reports. Note - these patients will also require Smoking Cessation advice (QOF Smoking Indicator 2).

137X.-137h.

137M.-137T.

ASTHMA cont.

Review Codes

Smoking Habit Codes

137..-137D.

137F.-137H.

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SCIMP Suggested


6635. Increasing exercise wheeze663P. Asthma limiting activities663P0 Asthma limits activities 1 to 2 times per month663P1 Asthma limits activities 1 to 2 times per week663P2 Asthma limits activities most days663Q. Asthma not limiting activities663e. Asthma restricts exercise663e0 Asthma sometimes restricts exercise663e1 Asthma severely restricts exercise663f. Asthma never restricts exercise663w. Asthma limits walking up hills or stairs663x. Asthma limits walking on the flat

663N. Asthma disturbing sleep663N0 Asthma causing night waking663N1 Asthma disturbs sleep weekly663N2 Asthma disturbs sleep frequently663O. Asthma not disturbing sleep663O0 Asthma never disturbs sleep

663r. Asthma causes night symptoms 1 to 2 times per month

66YP. Asthma night-time symptoms

66Yq. Asthma causes night time symptoms 1 to 2 times per week

66Yr. Asthma causes symptoms most nights66Ys. Asthma never causes night symptoms

663q. Asthma daytime symptoms663s. Asthma never causes daytime symptoms

663t. Asthma causes daytime symptoms 1 to 2 times per month

663u. Asthma causes daytime symptoms 1 to 2 times per week

663v. Asthma causes daytime symptoms most days

Asthma Smoking exception code 137k. Refusal to give smoking status Added V22 as exception for Asthma10. Requires entry within the last 15 months.

Added V22 for new indicator Asthma9. Codes for Exercise, Sleep and Day symptoms require entry on the same date. V23 added codes 663P0, 663P1 and 663P2.

Added V22 for new indicator Asthma9. Codes for Exercise, Sleep and Day symptoms require entry on the same date. V23 added codes 66Yq. And 66Yr.

Added V22 for new indicator Asthma9. Codes for Exercise, Sleep and Day symptoms require entry on the same date

Asthma Exercise codes

Asthma Sleep codes

Asthma Day Symptoms

ASTHMA cont.

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SCIMP Suggested


G573. Atrial fibrillation and flutter G5730 Atrial fibrillationG5730 Atrial fibrillationG5732 Paroxysmal atrial fibrillationG5733 Non-rheumatic atrial fibrillationG5734 Permanent atrial fibrillationG5735 Persistent atrial fibrillationG573z Atrial fibrillation and flutter NOS

Excluded 212R. Atrial fibrillation resolved 212R. Atrial fibrillation resolved

9hF0. Excep atr fib qual ind: Pt uns 9hF0. Excep atr fib qual ind: Pt uns9hF1. Exc atr fib qual ind: Inf diss 9hF1. Exc atr fib qual ind: Inf diss

14LK. H/O: aspirin allergy 14LK. H/O: aspirin allergyZV148 [V]Personal history of aspirin allergy TJ53. Adverse reaction to salicylates

U6051 [X]Salicylates causing adverse effects in therapeutic use

TJ53. Adverse reaction to salicylates

8I24. Aspirin prophylaxis contra-indicated 8I24. Aspirin prophylaxis contra-indicated8I38. Aspirin prophylaxis refused 8I38. Aspirin prophylaxis refused8I66. Aspirin not indicated 8I66. Aspirin not indicated8I70. Aspirin not tolerated 8I70. Aspirin not tolerated

14LP. H/O: warfarin allergy 14LP. H/O: warfarin allergyTJ42. Adverse reaction to anticoagulants TJ421 Adverse reaction to warfarin sodiumTJ421 Adverse reaction to warfarin sodiumTJ422 Adverse reaction to nicoumaloneTJ423 Adverse reaction to phenindioneTJ42z Adverse reaction to anticoagulants NOS

U6042 [X]Anticoagulants causing adverse effects in therapeutic use

ZV14A [V]Personal history of warfarin allergy

8I25. Warfarin contraindicated 8I25. Warfarin contraindicated8I3E. Warfarin declined 8I3E. Warfarin declined8I65. Warfarin not indicated 8I65. Warfarin not indicated8I71. Warfarin not tolerated 8I71. Warfarin not tolerated8I2R. Anticoagulation contraindicated8I3d. Anticoagulation declined8I6N. Anticoagulation not indicated8I7A. Anticoagulation not tolerated

Exceptions

Salicylate contra-indications:persistent

Salicylate contra-indications:expiring

Atrial Fibrillation

Warfarin contraindications: persistent

Atrial Fibrillation

Warfarin contraindications: expiring

TJ42% (except TJ420)

G573% (excluding G5731)

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SCIMP Suggested


14LQ. H/O: clopidogrel allergy 14LQ. H/O: clopidogrel allergy

U6048 [X]Clopidogrel causing adverse effects in therapeutic use U6048 [X]Clopidogrel causing adverse effects in

therapeutic useZV14B [V]Personal history of clopidogrel allergy

8I2K. Clopidogrel contraindicated 8I2K. Clopidogrel contraindicated8I3R. Clopidogrel declined 8I3R. Clopidogrel declined8I6B. Clopidogrel not indicated 8I6B. Clopidogrel not indicated8I72. Clopidogrel not tolerated 8I72. Clopidogrel not tolerated

14LX. H/O: dipyridamole allergy 14LX. H/O: dipyridamole allergyTJC44 Adverse reaction to dipyridamole TJC44 Adverse reaction to dipyridamole

U60C3 [X]Coronary vasodilators causing adverse effects in therapeutic use, not elsewhere classified

8I2b. Dipyridamole contraindicated 8I2b. Dipyridamole contraindicated8I3n. Dipyridamole declined 8I3n. Dipyridamole declined8I6a. Dipyridamole not indicated 8I6a. Dipyridamole not indicated8I7J. Dipyridamole not tolerated 8I7J. Dipyridamole not tolerated

67I8. Advice about taking aspirin 8B3T. Over the counter aspirin therapy Needs to be recorded within the last 6 months8B63. Salicylate prophylaxis8B3T. Over the counter aspirin therapy

Salicylate prescriptionsClopidogrel prescriptions and code 8B6P. Clopidogrel prophylaxisDipyridamole prescriptions

Warfarin Prescriptions and code 8B2K. Anticoagulant prescribed by third party

Stroke Risk Assessment using CHAD 38DE. Congestive heart failure, hypertension, age, diabetes, stroke 2 risk score

New code in V22 for AF5. Synonym = CHADS" risk score. Requires a value for result added. Requires entry every 15 months unless they have had a previous CHADS2 score of >1.

Prescription for antiplatelets or anticoagulants needs to be within last 6 months.

OTC salicylate codes

Clopidrogel contraindications:persistent

Clopidrogel contraindications:expiring

Dipyridamole CI persisting

Dipyridamole CI expiring

Atrial Fibrillation cont.

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SCIMP Suggested


B0% Malignant neoplasm of lip, oral cavity and pharynx Non-melanotic skin cancers excluded. Morphology codes (starting' BB%') also not included.

B1% Malignant neoplasm of digestive organs and peritoneum

B2% Malignant neoplasm of respiratory tract and intrathoracic organs

B3... Malignant neoplasm of bone, connective tissue, skin and breast

B30% Malignant neoplasm of bone and articular cartilage

B31% Malignant neoplasm of connective and other soft tissue

B32% Malignant melanoma of skinB34% Malignant neoplasm of female breastB35% Malignant neoplasm of male breast

B3y.. Malignant neoplasm of bone, connective tissue, skin and breast otherwise specified

B3z.. Malignant neoplasm of bone, connective tissue, skin and breast NOS

B4% Malignant neoplasm of genitourinary organ

B5% Malignant neoplasm of other and unspecified sites

B6% Malignant neoplasm of lymphatic and haemopoietic tissue

Byu.. [X]Additional neoplasm classification terms

Byu0. [X]Malignant neoplasm of lip, oral cavity and pharynx

Byu1% [X]Malignant neoplasm of digestive organs

Byu2% [X]Malignant neoplasm of respiratory and intrathoracic organs

Byu3% [X]Malignant neoplasm of bone and articular cartilage

Byu4. [X]Melanoma and other malignant neoplasms of skin

Byu40 [X]Malignant melanoma of other and unspecified parts of face

Byu41 [X]Malignant melanoma of skin, unspecified

Byu5% [X]Malignant neoplasm of mesothelial and soft tissue

Byu6. [X]Malignant neoplasm of breastByu7% [X]Malignant neoplasm of female genital organsByu8% [X]Malignant neoplasm of male genital organsByu9% [X]Malignant neoplasm of urinary tract

ByuA% [X]Malignant neoplasm of eye, brain and other parts of central nervous system

ByuB% [X]Malignant neoplasm of thyroid and other endocrine glands

ByuC% [X]Malignant neoplasm of ill-defined, secondary and unspecified sites

ByuD% [X]Malignant neoplasms of lymphoid, haematopoietic and related tissue

ByuE. [X]Malignant neoplasms of independent (primary) multiple sites

ByuE0 [X]Malignant neoplasms of independent (primary) multiple sites

9h8.. Exception reporting: cancer quality indicators 9h81. Excepted from cancer quality indicators: Patient unsuitable

9h81. Excepted from cancer quality indicators: Patient unsuitable 9h82. Excepted from cancer quality indicators: Informed

dissent

9h82. Excepted from cancer quality indicators: Informed dissent

Cancer Care Review 8BAV. Cancer care review 8BAV. Cancer care review For Cancers newly diagnosed in the last 18 months.

Cancer Diagnosis

CANCER

B0…-B32z.

B34..-B6z0

Byu..-Byu41

Byu5.-ByuE0

Cancer exception codes 9h8%

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SCIMP Suggested


G3… Ischaemic heart disease G3z.. Ischaemic heart disease NOSG30.. Acute myocardial infarction G340. Coronary atherosclerosisG300. Acute anterolateral infarctionG301% Other specified anterior myocardial infarctionG302. Acute inferolateral infarctionG303. Acute inferoposterior infarctionG304. Posterior myocardial infarction NOSG305. Lateral myocardial infarction NOSG306. True posterior myocardial infarctionG307% Acute subendocardial infarctionG308. Inferior myocardial infarction NOSG309. Acute Q-wave infarctG30B. Acute posterolateral myocardial infarction

G30X% Acute transmural myocardial infarction of unspecified site

G30y% Other acute myocardial infarctionG30z. Acute myocardial infarction NOS

G31.. Other acute and subacute ischaemic heart disease

G311% Preinfarction syndrome

G312. Coronary thrombosis not resulting in myocardial infarction

G31y% Other acute and subacute ischaemic heart disease

G32.. Old myocardial infarctionG33.. Angina pectorisG330% Angina decubitusG33z% Angina pectoris NOSG34.. Other chronic ischaemic heart diseaseG340% Coronary atherosclerosisG342. Atherosclerotic cardiovascular diseaseG343. Ischaemic cardiomyopathyG344. Silent myocardial ischaemiaG34y% Other specified chronic ischaemic heart diseaseG34z% Other chronic ischaemic heart disease NOSG35% Subsequent myocardial infarction

G36% Certain current complications following acute myocardial infarction

G38% Postoperative myocardial infarctionG39.. Coronary microvascular diseaseG3y.. Other specified ischaemic heart diseaseG3z.. Ischaemic heart disease NOS

Gyu3.% (excluding Gyu31) [X]Ischaemic heart diseases

9h0.. Exception reporting: CHD quality indicators 9h01. Excepted from CHD quality indicators: Patient unsuitable

9h01. Excepted from CHD quality indicators: Patient unsuitable 9h02. Excepted from CHD quality indicators: Informed

dissent

9h02. Excepted from CHD quality indicators: Informed dissent

V23 Code G310. (post myocardial infarction syndrome), Gyu31 [X](Other current complications following acute myocardial infarction)and G36% removed from codeset. V23 added G39 to dataset

G342-G35X.

G38..-G3z..

G3…-G309.

G30B.-G330z (excluding G310.)

Exception Codes 9h0%

CHD

G33z-G3401

Coronary Heart Disease Codes

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SCIMP Suggested


G30.. Acute myocardial infarction G301z Anterior myocardial infarction NOSG300. Acute anterolateral infarctionG301% Other specified anterior myocardial infarctionG302. Acute inferolateral infarctionG303. Acute inferoposterior infarctionG304. Posterior myocardial infarction NOSG305. Lateral myocardial infarction NOSG306. True posterior myocardial infarctionG307% Acute subendocardial infarctionG308. Inferior myocardial infarction NOSG309. Acute Q-wave infarctG30B. Acute posterolateral myocardial infarction

G30X% Acute transmural myocardial infarction of unspecified site

G30y% Other acute myocardial infarctionG30z. Acute myocardial infarction NOSG35.. Subsequent myocardial infarction G304. Posterior myocardial infarction NOSG350. Subsequent myocardial infarction of anterior wall G305. Lateral myocardial infarction NOSG351. Subsequent myocardial infarction of inferior wall G308. Inferior myocardial infarction NOSG353. Subsequent myocardial infarction of other sites G307. Acute subendocardial infarction

G35X. Subsequent myocardial infarction of unspecified site G30z. Acute myocardial infarction NOS

G38.. Postoperative myocardial infarction

G380. Postoperative transmural myocardial infarction of anterior wall

G381. Postoperative transmural myocardial infarction of inferior wall

G382. Postoperative transmural myocardial infarction of other sites

G383. Postoperative transmural myocardial infarction of unspecified site

G384. Postoperative subendocardial myocardial infarction

G38z. Postoperative myocardial infarction, unspecified

Gyu34 [X]Acute transmural myocardial infarction of unspecified site

Gyu36 [X]Subsequent myocardial infarction of unspecified site

9hM.. Exception reporting: myocardial infarction quality indicators

9hM0. Excepted from myocardial infarction quality indicators: informed dissent

9hM1. Excepted from myocardial infarction quality indicators: patient unsuitable

BP Recording Codes

246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j.)

O/E - blood pressure reading

Blood Pressure values should also be recorded for the Contract and your software system will have a system to deal with Read coding of Values. V23 excluded additional codes for BP. These were new in April 2012 Read code release.

BP Recording Exception Codes 8I3Y. Blood pressure procedure refused 8I3Y. Blood pressure procedure refused

Maximal BP therapy 8BL0. Patient on maximal tolerated antihypertensive therapy 8BL0. Patient on maximal tolerated antihypertensive therapy

Myocardial infarction codes G35%

CHD cont.

G30% (excluding G30A.)

G38%

Myocardial Infarction exception codes

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SCIMP Suggested


44OE. Plasma total cholesterol levelSerum cholesterol

44P1. Serum cholesterol normal44P2. Serum cholesterol borderline44P3. Serum cholesterol raised44P4. Serum cholesterol very high

44PH. Total cholesterol measurement44PJ. Serum total cholesterol level44PK. Serum fasting total cholesterol

U60CA [X]Statin causing adverse effect in therapeutic use U60CA [X]Statin causing adverse effect in therapeutic use

TJC24 Adverse reaction to simvastatinTJC25 Adverse reaction to pravastatin

8BL1. Patient on maximal tolerated lipid lowering therapy 8I3C. Statin declined

8I3C. Statin declined 8I27. Statins contraindicated8I27. Statins contraindicated 8I63. Statin not indicated8I63. Statin not indicated8I76. Statin not tolerated













67I8. Advice about taking aspirin 8B3T. Over the counter aspirin therapy8B63. Salicylate prophylaxis8B3T. Over the counter aspirin therapy

Salicylate prescriptions Prescribed in In last 15 monthsClopidogrel prescriptions and code 8B6P. Clopidogrel prophylaxis Prescribed in In last 15 months

Warfarin Prescriptions and Code 8B2K. Anticoagulant prescribed by third party Prescribed in In last 15 months


Cholesterol values should also be recorded for the Contract and your software system will have a system to deal with Read coding of Values. V22 codes removed. V23 code 44PK added.

44P..



Exception from serum cholesterol target -persisting

CHD cont.

Total Cholesterol Codes

Exception from serum cholesterol target -expiring






10

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SCIMP Suggested


14LL. H/O: betablocker allergy 14LL. H/O: betablocker allergyTJC6. Adverse reaction to betablockers TJC6. Adverse reaction to betablockersTJC61 Adverse reaction to acebutololTJC62 Adverse reaction to atenololTJC63 Adverse reaction to labetalolTJC64 Adverse reaction to metoprololTJC65 Adverse reaction to nadololTJC66 Adverse reaction to oxprenololTJC67 Adverse reaction to sotalolTJC68 Adverse reaction to timololTJC6z Adverse reaction to betablockers NOS

U60B7 [X]Beta-adrenoreceptor antagonists causing adverse effects in therapeutic use, not elsewhere classified

U60B9 [X]Adverse reaction to bisoprololU60BA [X]Adverse reaction to carvedilolU60BB [X]Adverse reaction to nebivololZV14C [V]Personal history of betablocker allergyZVu6i [X]Personal history of allergy to bisoprololZVu6o [X]Personal history of allergy to carvedilolZVu6q [X]Personal history of allergy to nebivolol

8I26. Beta blocker contraindicated 8I26. Beta blocker contraindicated8I2g. Bisoprolol contraindicated 8I36. Beta blocker therapy refused8I2h. Carvedilol contraindicated 8I62. Beta blocker not indicated8I2i. Nebivolol contraindicated 8I73. Beta blocker not tolerated8I36. Beta blocker therapy refused8IAS. Bisoprolol therapy refused8IAT. Carvedilol therapy refused8IAV. Nebivolol therapy refused8I62. Beta blocker not indicated8I6i. Bisoprolol not indicated8I6j. Carvedilol not indicated8I6k. Nebivolol not indicated8I73. Beta blocker not tolerated8I7K. Bisoprolol not tolerated8I7L. Carvedilol not tolerated8I7M. Nebivolol not tolerated

Beta Blocker prescriptions Prescribed in last 6 months

14LM. H/O: angiotensin converting enzyme inhibitor allergy TJC78 Adverse reaction to enalapril

U60C4 [X]Angiotensin-converting-enzyme inhibitors causing adverse effects in therapeutic use

ZV14D [V]Personal history of angiotensin-converting-enzyme inhibitor allergy

TJC77 Adverse reaction to captoprilTJC78 Adverse reaction to enalaprilTJC79 Adverse reaction to ramipril

8I28. Angiotensin converting enzyme inhibitors contraindicated 8I28. Angiotensin converting enzyme inhibitors

contraindicated

8I3D. Angiotensin converting enzyme inhibitor declined 8I3D. Angiotensin converting enzyme inhibitor declined

8I64. Angiotensin converting enzyme inhibitor not indicated 8I64. Angiotensin converting enzyme inhibitor not indicated

8I74. Angiotensin converting enzyme inhibitor not tolerated 8I74. Angiotensin converting enzyme inhibitor not tolerated

Ace inhibitor contraindications: persistent

Ace inhibitor contraindications: expiring

CHD cont.

Beta Blocker contraindications:expiring

TJC6%

Beta Blocker contraindications:persistent

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SCIMP Suggested


14LN. H/O: angiotensin II receptor antagonist allergy 14LN. H/O: angiotensin II receptor antagonist allergy

U60CB [X]Angiotensin II receptor antagonists causing adverseeffects in therapeutic use

ZV14E [V]Personal history of angiotensin II receptor antagonist allergy

8I2H. Angiotensin II receptor antagonists contraindicated 8I2H. Angiotensin II receptor antagonists contraindicated

8I3P. Angiotensin II receptor antagonist declined 8I3P. Angiotensin II receptor antagonist declined8I6C. Angiotensin II receptor antagonist not indicated 8I6C. Angiotensin II receptor antagonist not indicated8I75. Angiotensin II receptor antagonist not tolerated 8I75. Angiotensin II receptor antagonist not tolerated

ACE inhibitor prescriptions Prescribed in last 6 months

A II antagonist prescription codes Prescribed in last 6 months. V23 added further medications for Olmesartan contained in compound medications

Statin prescriptions and code 8B3z. Over the counter statin therapy V22 OTC statin code no longer valid



14LJ. H/O: influenza vaccine allergy 14LJ. H/O: influenza vaccine allergy

U60K4 [X]Influenza vaccine causing adverse effects in therapeutic use

ZV14F [V]Personal history of influenza vaccine allergy

8I2F. Influenza vaccination contraindicated 8I2F1. Seasonal Influenza vaccination contraindicated8I2F0 Seasonal influenza vaccination contraindicated 8I6D1. Seasonal Influenza vaccination not indicated8I6D. Influenza vaccination not indicated 68NE. No consent - influenza imm.8I6D0 Seasonal influenza vaccination not indicated 9OX51 Seasonal influenza vaccination declined68NE. No consent - influenza imm.9OX5. Influenza vaccination declined9OX51 Seasonal influenza vaccination declined

65E.. Influenza vaccination 65ED. Seasonal Influenza vaccination65E0. First pandemic influenza vaccination65E1. Second pandemic influenza vaccination

65E2. Influenza vaccination given by other healthcare provider

65E3. First pandemic influenza vaccination given by other healthcare provider

65E4. Second pandemic influenza vaccination given by other healthcare provider

ZV048 [V]Influenza vaccination65ED. Seasonal influenza vaccination

65E20 Seasonal influenza vaccination given by other healthcare provider

Flu vaccine contraindications: expiring Code change in V22 with 9OX5., 8I2F., 8I6D. no longer valid and 9OX51, 8I2F1 and 8I6D1 added.

Flu vaccine prescriptions and codesPrescribed in the previous 1st September to 31st March. V22 Codes used in 2011-12 season no longer valid and new one available specifying seasonal Flu vaccination.

CHD cont.

AII antagonist contraindications: expiring

65E..-65E4.

AII antagonist contraindications: persisting

Statin contraindications persisting

Flu vaccine contraindications: persisting

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SCIMP Suggested


Age>=18

1Z12. Chronic kidney disease stage 3 1Z12. Chronic kidney disease stage 31Z1B. CKD stage 3 with proteinuria 1Z13. Chronic kidney disease stage 41Z1C. CKD stage 3 wthout proteinuria 1Z14. Chronic kidney disease stage 51Z15. Chronic kidney diseas stage 3A1Z1D. CKD stage 3A with proteinuria1Z1E. CKD stge 3A wthout proteinuria1Z16. Chronic kidney diseas stage 3B1Z1F. CKD stage 3B with proteinuria1Z1G. CKD stge 3B wthout proteinuria1Z13. Chronic kidney disease stage 41Z1H. CKD stage 4 with proteinuria1Z1J. CKD stage 4 wthout proteinuria1Z14. Chronic kidney disease stage 51Z1K. CKD stage 5 with proteinuria1Z1L. CKD stage 5 wthout proteinuriaK053. Chronic kidney disease stage 3K054. Chronic kidney disease stage 4K055. Chronic kidney disease stage 5

1Z10. Chronic kidney disease stage 1 1Z10. Chronic kidney disease stage 11Z17. CKD stage 1 with proteinuria 1Z11. Chronic kidney disease stage 21Z18. CKD stage 1 wthout proteinuria1Z11. Chronic kidney disease stage 21Z19. CKD stage 2 with proteinuria1Z1A. CKD stage 2 wthout proteinuriaK051. Chronic kidney disease stage 1K052. Chronic kidney disease stage 2

9hE0. Ex ch kid dis qu ind: Pat uns 9hE0. Ex ch kid dis qu ind: Pat uns9hE1. Ex ch kid dis qua ind: Inf dis 9hE1. Ex ch kid dis qua ind: Inf dis

BP Recording Codes

246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j.)





G2... Hypertensive disease G2… Hypertensive diseaseG20% Essential hypertension G20.. Essential hypertension

G240. Secondary malignant hypertension G200. Malignant essential hypertensionG240z Secondary malignant hypertension NOSG241. Secondary benign hypertension G24.. Secondary hypertensionG241z Secondary benign hypertension NOSG244. Hypertension secondary to endocrine disorders G201. Benign essential hypertensionG24z. Secondary hypertension NOS G202. Systolic hypertensionG24z0 Secondary renovascular hypertension NOSG24zz Secondary hypertension NOSG2y.. Other specified hypertensive diseaseG2z.. Hypertensive disease NOS

Gyu2. [X]Hypertensive diseasesGyu20 [X]Other secondary hypertension

Gyu21 [X]Hypertension secondary to other renal disorders

21261 Hypertension resolved 21261 Hypertension resolved212K. Hypertension resolved

1Z1B. Chronic kidney disease stage 3 with proteinuria R110. [D]Proteinuria1Z1D. Chronic kidney disease stage 3A with proteinuria R1100 [D]Albuminuria1Z1F. Chronic kidney disease stage 3B with proteinuria R1103 [D]Microalbuminuria1Z1H. Chronic kidney disease stage 4 with proteinuria1Z1K. Chronic kidney disease stage 5 with proteinuriaR110. [D]ProteinuriaR1100 [D]AlbuminuriaR1103 [D]MicroalbuminuriaR110z [D]Proteinuria NOS

These codes exclude the patient if dated later than the most recent CKD Codes 3-5. V23 added codes K051. and K052. to codeset

V22 code G24z1 removed. V23 codes G2400 and G2410 removed

See bottom of sheet for classification of CKD. V23 added codes K053., K054., K055. to codeset

Hypertension resolved

Proteinuria

Excluded CKD codes

Hypertension

CKD

Exception codes

CKD Codes Stage 3 - 5

G24..-G2z.. (excluding G24z1, G2400, G2410)

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SCIMP Suggested







contraindicated




44lD. Urine protein/creatinine ratio 46TC. Urine albumin:creatinine ratio46TC. Urine albumin:creatinine ratio









CKD cont.


Albumin/Creatinine or Protein/Creatinine Ratio



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To Index

GFR>=90

60 - 8930 - 5915 - 29

< 15 (or dialysis)Stage 4 - Severe decrease in GFRStage 5 - Kidney FailureChronic Kidney Disease is defined as either kidney damage or GFR<60mL/min/1.73m2 over a 3 month period

Classification of CRD - From US National Kidney Foundation

Stage 3 - Moderate decrease in GFRStage 2 - Kidney Damage with mild decrease GFRStage 1 - Kidney Damage with normal or raised GFR

15

To Index


SCIMP Suggested


H3… Chronic obstructive pulmonary disease H31.. Chronic bronchitisH31% (except H3101, H31y0, H3122)

Chronic bronchitis H32.. Emphysema

H32% Emphysema H3z.. Chronic obstructive airways disease NOSH36.. Mild chronic obstructive pulmonary diseaseH37.. Moderate chronic obstructive pulmonary diseaseH38.. Severe chronic obstructive pulmonary disease

H39.. Very severe chronic obstructive pulmonary disease

H3y.. Other specified chronic obstructive airways disease

H3y0. Chronic obstructive pulmonary disease with acute lower respiratory infection

H3y1. Chronic obstructive pulmonary disease with acute exacerbation, unspecified

H3A.. End stage chronic obstructive airways diseaseH3z.. Chronic obstructive airways disease NOS

9h5.. Exception reporting: COPD quality indicators 9h51. Excepted from COPD quality indicators: Patient unsuitable

9h51. Excepted from COPD quality indicators: Patient unsuitable 9h52. Excepted from COPD quality indicators: Informed

dissent

9h52. Excepted from COPD quality indicators: Informed dissent

8I2j. Spirometry contraindicated 8I2M. Spirometry reversibility testing contraindicated8I3b. Spirometry test declined 8I3b. Spirometry test declined8I6L. Spirometry not indicated 8I6L. Spirometry not indicated33720 Unable to perform spirometry

745D4 Post bronchodilator spirometry

8HRC. Referral for spirometry

V23 removed codes H3y0. and H3y1. and added the new code H3A..

Spirometry exception codes

Patients can be coded with both Asthma and COPD if appropriate.

COPD Diagnosis

H36..-H3z.. (excluding H3y0. and H3y1.)

COPD Spirometry Codes

COPD

Diagnosis - Exclusion Codes 9h5%

16

To Index


SCIMP Suggested

CodesTerm

Codes for FEV1 33971 Forced expired volume in 1 second percentage change 339O. Forced expired volume in 1 second

3398. FEV1/FVC ratio normal3399. FEV1/FVC ratio abnormal339M. FEV1/FVC ratio339O. Forced expired volume in 1 second339O0 Forced expired volume in 1 second reversibility

339R. FEV1/FVC percent339S. Percent predicted FEV1

339S0 Percentage predicted forced expiratory volume in 1 second after bronchodilation

339T. FEV1/FVC > 70% of predicted339U. FEV1/FVC < 70% of predicted

339a. FEV1 before bronchodilation339b. FEV1 after bronchodilation339e. FEV1 pre steroids339f. FEV1 post steroids

339j. FEV1/FVC ratio pre steroids339k. FEV1/FVC ratio post steroids339l. FEV1/FVC ratio before bronchodilator339m. FEV1/FVC ratio after bronchodilator

339O1 Forced expired volume in one second/vital capacity ratio

173H. MRC Breathlessness Scale: grade 1173I. MRC Breathlessness Scale: grade 2173J. MRC Breathlessness Scale: grade 3173K. MRC Breathlessness Scale: grade 4173L. MRC Breathlessness Scale: grade 5

66YM. Chronic obstructive pulmonary disease annual review

66YB0 Chronic obstructive pulmonary disease 3 monthly review

66YB1 Chronic obstructive pulmonary disease 6 monthly review











Code change in V22 with 9OX5., 8I2F., 8I6D. no longer valid and 9OX51, 8I2F1 and 8I6D1 added.

339j.-339m.

339R.-339U.

COPD cont.

Flu vaccine contraindications: expiring

COPD Review

MRC Rating

Prescribed in the previous 1st September to 31st March. V22 Codes used in 2011-12 season no longer valid and new one available specifying seasonal Flu vaccination.

Flu vaccine prescriptions and codes

65E..-65E4.


17

To Index


SCIMP Suggested


G73.. Other peripheral vascular disease G73z. Peripheral vascular disease NOSG73z. Peripheral vascular disease NOSG73z0 Intermittent claudicationG73zz Peripheral vascular disease NOS

Gyu74 [X]Other specified peripheral vascular diseases

C3200 Familial hypercholesterolaemia C3200 Familial hypercholesterolaemiaC3201 HyperbetalipoproteinaemiaC3204 Fredrickson's hyperlipoproteinaemia, type IIaC3205 Familial defective apolipoprotein B-100

9hJ0. Excepted from cardiovascular disease quality indicators: patient unsuitable

9hJ1. Excepted from cardiovascular disease quality indicators: informed dissent

9Oh9. Cardiovascular disease risk assessment declined8IAK. Cardiovascular disease high risk review declined

8IEL. QRISK cardiovascular disease risk assessment declined

662k. JBS cardiovascular disease risk <10 percent over nextten years 38DR. Framingham 1991 cardiovascular disease 10 year

risk score

662l. JBS cardiovascular disease risk 10 - 20 percent over next ten years 38D6. Assessing cardiovascular risk using SIGN score

662m. JBS cardiovascular disease risk 20 - 30 percent over next ten years

662n. JBS cardiovascular disease risk >30 percent over nextten years

38B10 CVD (cardiovascular disease) risk assessment by third party

38DF. QRISK cardiovascular disease 10 year risk score38D6. Assessing cardiovascular risk using SIGN score

38DR. Framingham 1991 cardiovascular disease 10 year risk score

38DP. QRISK2 cardiovascular disease 10 year risk score

38G6. Joint British Societies cardiovascular disease risk score

38G8. Dundee CVS risk score

67H.. Lifestyle counselling67H8. Lifestyle advice regarding hypertension

CVD Risk Assessment codes

CVD Risk Assessment Exception codesCodes 8IAK., 90h9. and 8IEK. will only exclude patient from the risk assessment indicator. They will still require lifestyle advice. V23 added code 8IEK.

Requires entry within 3 months of hypertension diagnosis. V23 added codes 38G6. and 38G8.

Requires entry in the last 15 months for new hypertension since 1.4.09

Familial Hypercholesterolaemia

662k.-662n.

Lifestyle Counselling

Applies to Patients newly diagnosed with Hypertension since 1.4.09. Patients with co-existing CHD, Stroke, TIA, Diabetes, PVD, Familial Hypercholesterolaemia or CKD are excluded from population

Codes for Hypertension, CHD, Stroke, TIA, Diabetes and CKD as detailed in relevant sections within this spreadsheet.

CVD - Primary Prevention

G73z% (excluding G73z1)

Patients age under 30 or 75 or over, newly diagnosed with hypertension are excluded from requiring risk assessment (PP1) but do still require lifestyle advice (PP2).

PVD

18

To Index


SCIMP Suggested


Eu02. [X]Dementia in other diseases classified elsewhere Eu00. [X]Dementia in Alzheimer's disease

Eu020 [X]Dementia in Pick's disease Eu01. [X]Vascular dementiaEu021 [X]Dementia in Creutzfeldt-Jakob disease Eu02z [X] Unspecified dementiaEu022 [X]Dementia in Huntington's disease F110. Alzheimer's diseaseEu023 [X]Dementia in Parkinson's disease

Eu024 [X]Dementia in human immunodef virus [HIV] disease

Eu02y [X]Dementia in other specified diseases classif elsewhere

Eu02z [X] Unspecified dementiaE00.. Senile and presenile organic psychotic conditionsE000. Uncomplicated senile dementiaE001% Presenile dementia

E002% Senile dementia with depressive or paranoid features

E003. Senile dementia with deliriumE004% Arteriosclerotic dementiaE00y. Other senile and presenile organic psychosesE00z. Senile or presenile psychoses NOSEu01. [X]Vascular dementiaEu010 [X]Vascular dementia of acute onsetEu011 [X]Multi-infarct dementiaEu012 [X]Subcortical vascular dementia

Eu013 [X]Mixed cortical and subcortical vascular dementia

Eu01y [X]Other vascular dementiaEu01z [X]Vascular dementia, unspecified

E02y1 Drug-induced dementiaE012. Other alcoholic dementiaE0120 Chronic alcoholic brain syndromeEu00. [X]Dementia in Alzheimer's disease

Eu000 [X]Dementia in Alzheimer's disease with early onset

Eu001 [X]Dementia in Alzheimer's disease with late onset

Eu002 [X]Dementia in Alzheimer's dis, atypical or mixed type

Eu00z [X]Dementia in Alzheimer's disease, unspecifiedE041. Dementia in conditions ECEu041 [X]Delirium superimposed on dementia

F110. Alzheimer's diseaseF1100 Alzheimer's disease with early onsetF1101 Alzheimer's disease with late onsetF111. Pick's diseaseF112. Senile degeneration of brain

F116. Lewy body disease

9hD0. Exc demen qual ind: Pat unsuit 9hD0. Exc demen qual ind: Pat unsuit9hD1. Exc demen qual ind: Inform dis 9hD1. Exc demen qual ind: Inform dis

423.. Haemoglobin estimation426.. Red blood cell (RBC) count42A.. Mean corpuscular volume (MCV)42H.. Total white cell count

44h4. Blood calcium level44I8. Serum calcium44h7. Plasma calcium level44IE. Serum ionized calcium (pH 7.4) level44ID. Serum ionised calcium level44IC. Corrected serum calcium level44h9. Plasma corrected calcium level44hD. Blood ionised calcium level

Dementia

Eu02%

E00%

E012%

Requires entry within time period 6 months before to 6 months after the first diagnosis date

DEMENTIA

Eu00%

F110.-F112.

Dementia Exclusions

Eu01%

Calcium Requires entry within time period 6 months before to 6 months after the first diagnosis date

FBC

19

To Index


SCIMP Suggested


44TM. Blood glucose series44f% Serum glucose level44g% Plasma glucose level44T1. Random blood sugar44T2. Fasting blood sugar44T3. 2 hours post food blood sugar44TA. Plasma glucose44TE. 30 minute blood glucose level44TF. 60 minute blood glucose level44TG. 90 minute blood glucose level44TH. 120 minute blood glucose level44TI. 150 minute blood glucose level44TJ. Blood glucose level44TK. Fasting blood glucose level44U% (excluding 44Uz.) Blood glucose result

44V.. Glucose tolerance test44V1. Glucose tolerance test normal44V2. Glucose tol. test impaired44V3. Glucose tol. test diabetic44V6. Extended glucose tolerance testR102. [D]Glucose tolerance test abnormalR10D. [D]Elevated blood glucose levelR1057 [D]Glucose, blood level abnormal

IFCC HbA1c 42W5. Haemoglobin A1c level - IFCC standard V22 New field

Glucose test exception 8IEG. Blood glucose test declined V22 New field

44J3. Serum creatinine44J9. Serum urea level44JA. Plasma urea level44JC. Corrected plasma creatinine level44JD. Corrected serum creatinine level44JF. Plasma creatinine level

44E.. Serum bilirubin level44E9. Plasma total bilirubin level44EC. Serum total bilirubin level44F3. Total alkaline phosphatase44CU. Plasma alkaline phosphatase level44FA. Plasma alkaline phosphatase liver isoenzyme level44FD. Serum alkaline phosphatase liver isoenzyme level44FH. Alkaline phosphatase liver isoenzyme level44G4. Gamma - G.T. level44G7. Plasma gamma-glutamyl transferase level44G9. Serum gamma-glutamyl transferase level44GA. Plasma alanine aminotransferase level44GB. Serum alanine aminotransferase level

442W. Serum TSH level442X. Plasma TSH level442A. TSH - thyroid stim. hormone

42T.. Serum vitamin B1244Le. Plasma vitamin B12 level

42U4. Red blood cell folate42U5. Serum folate42UE. Plasma folate level

Dementia review 6AB Dementia Annual Review 6AB.. Dementia Annual Review Requires entry within the previous 15 months and after the Dementia diagnosis date.

Liver function





DEMENTIA cont.

Requires entry within time period 6 months before to 6 months after the first diagnosis date. Codes removed in V22 (SCIMP checking this with UK terminology group)

Glucose

Renal function

Requires entry within time period 6 months before to 6 months after the first diagnosis date.

Vit B12

Folic acid

Thyroid function

20

To Index


SCIMP Suggested


Age>=18 (for Dep2 only)

E0013 Presenile dementia with depressionE0021 Senile dementia with depressionE112% Single major depressive episode Eu32. [X]Depressive episodeE113% Recurrent major depressive episode Eu33. [X]Recurrent depressive disorderE118. Seasonal affective disorderE11y2 Atypical depressive disorderE11z2 Masked depressionE130. Reactive depressive psychosisE135. Agitated depressionE2003 Anxiety with depressionE291. Prolonged depressive reactionE2B.. Depressive disorder NECE2B1. Chronic depressionEu204 [X]Post-schizophrenic depressionEu251 [X]Schizoaffective disorder, depressive type

Eu32. [X]Depressive episodeEu320 [X]Mild depressive episodeEu321 [X]Moderate depressive episode

Eu322 [X]Severe depressive episode without psychotic symptoms

Eu323 [X]Severe depressive episode with psychotic symptoms

Eu324 [X]Mild depressionEu325 [X]Major depression, mildEu326 [X]Major depression, moderately severe

Eu327 [X]Major depression, severe without psychotic symptoms

Eu328 [X]Major depression, severe with psychotic symptoms

Eu32y [X]Other depressive episodesEu32z [X]Depressive episode, unspecifiedEu33. [X]Recurrent depressive disorder

Eu330 [X]Recurrent depressive disorder, current episode mild

Eu331 [X]Recurrent depressive disorder, current episode moderate

Eu332 [X]Recurrent depressive disorder, current episode severe without psychotic symptoms

Eu333 [X]Recurrent depressive disorder, current episode severe with psychotic symptoms

Eu334 [X]Recurrent depressive disorder, currently in remission

Eu33y [X]Other recurrent depressive disordersEu33z [X]Recurrent depressive disorder, unspecified

Eu341 [X]DysthymiaEu412 [X]Mixed anxiety and depressive disorder

Depression resolved 212S. Depression resolved 212S. Depression resolved

9hC0. Exc depr qual: ind: Pat unsuit 9hC0. Exc depr qual: ind: Pat unsuit9hC1. Exc depressi qual ind: Inf dis 9hC1. Exc depressi qual ind: Inf dis

68910 Assessment using Whooley depression screen6896. Depression screen using quest 6896. Depression screen using quest

388f. Pt health quest (PHQ-9) score388g. BDI second edition score388P. HAD scale: depression score

Depression

For Dep1 - Population = ALL patients with Diabetes or CHD (ie. they may not have a current diagnosis of depression)

Depression (For Dep2)Eu32% (excluding Eu32A, Eu32B, Eu329)

Depression Assessment tool codes

Depression question codes

Depression exceptions

Eu33%

First entry required within the timeframe of depression diagnosis + 1 month. 2nd assessment code required within 2 to 12 weeks after the first assessment code.

21

To Index


SCIMP Suggested


Age >=17

C10.. Diabetes mellitus C10E. Type 1 diabetes mellitusC109J Insulin treated Type 2 diabetes mellitus C10F. Type 2 diabetes mellitus

C109K Hyperosmolar non-ketotic state in type 2 diabetes mellitus

C10C. Diabetes mellitus autosomal dominantC10D. Diabetes mellitus autosomal dominant type 2C10E% Type 1 diabetes mellitus

C10F% (except C10F8) Type 2 diabetes mellitus

C10G% Secondary pancreatic diabetes mellitusC10H% Diabetes mellitus induced by non-steroid drugsC10M% Lipoatrophic diabetes mellitusC10N% Secondary diabetes mellitus

21263 Diabetes resolved 21263 Diabetes resolved212H. Diabetes resolved

9h4.. Exception reporting: diabetes quality indicators 9h41. Excepted from diabetes quality indicators: Patient unsuitable

9h41. Excepted from diabetes quality indicators: Patient unsuitable 9h42. Excepted from diabetes quality indicators: Informed

dissent

9h42. Excepted from diabetes quality indicators: Informed dissent

9h43. Excepted from diabetes quality indicators: service unavailable

BMI Codes 22K% (excluding 22K9.) Body Mass Index

Codes for maximum tolerated diabetes treatment 8BL2. Patient on maximal tolerated therapy for diabetes 8BL2. Patient on maximal tolerated therapy for diabetes

IFCC HbA1c levels 42W5. Haemoglobin A1c level - IFCC standardised V22. IFCC results only ones now accepted for HbA1c

2BB% O/E - retinal inspection 31280 Fundoscopy normal3128. Fundoscopy 31281 Fundoscopy abnormal31280 Fundoscopy normal 66AD. Fundoscopy - diabetic check31281 Fundoscopy abnormal 68A7. Diabetic retinopathy screening31282 Dilated fundoscopy normal 68A8. Digital retinal screening31283 Camera fundoscopy31284 Indirect fundoscopy following mydriatic3128Z Fundoscopy NOS

3129. Eye fundus photography312E. Direct fundoscopy following mydriatic312F. Camera fundoscopy312G. Indirect fundoscopy following mydriatic

58C1. Retinal photography68A7. Diabetic retinopathy screening68A8. Digital retinal screening66AD. Fundoscopy - diabetic check8HBD. Retinopathy follow up8HBG. Diabetic retinopathy 12 month review8HBH. Diabetic retinopathy 6 month review9N1v. Seen in diabetic eye clinic9N2U. Seen by optician9N2V. Seen by optometrist9N2e. Seen by ophthalmologist9N2f. Seen by retinal screener9NNC. Under care of retinal screener

V22 code 9h43. no longer recognised as an exception code

V22, range of codes expanded

Retinal screening codes

312E.-312G.

Diabetes Exception reporting codes

3128%

9h4%

Diabetes diagnosis

Diagnosis Resolved

DIABETES

22

To Index


SCIMP Suggested


8I6F. Diabetic retinopathy screening not indicated 8I6F. Diabetic retinopathy screening not indicated8I3X. Diabetic retinopathy screening refused 8I3X. Diabetic retinopathy screening refused

9OLD. Diabetic patient unsuitable for digital retinal photography

9m0A. Declined diabetic retinopathy screening

8I6G. Diabetic foot examination not indicated 8I6G. Diabetic foot examination not indicated8I3W. Diabetic foot examination declined 8I3W. Diabetic foot examination declined8IAo. Foot pulse check declined8IB6. Patient unsuitable for foot pulse check

311A. Monofilament foot sensation test 29BB. 10g monofilament sensation R foot normal29B7.-29BV. 29B7. 10g monofilament sensation present 29B9. 10g monofilament sensation R foot abnormal and other codes in range for monofilament test result.

29B1. O/E - tactile sensation normal 29BC. 10g monofilament sensation L foot normal29B2. O/E - anaesthesia present 29BA. 10g monofilament sensation L foot abnormal V23 codes 29B1. - 29B3. removed 29B20 O/E - anaesthesia in legs 29H4. O/E - Vibration sense of right foot abnormal29B21 O/E - anaesthesia of extremities 29H5. O/E - Vibration sense of right foot normal29B3. O/E - hypoaesthesia present 29H6. O/E - Vibration sense of left foot abnormal

29H1.-29HB. O/E - vibration sense normal 29H7. O/E - Vibration sense of left foot normal and other codes in range for side and result of vibration test.

66Ac. Diabetic peripheral neuropathy screening66Aq. Diabetic foot screen9NND. Under care of diabetic foot screener8H7r. Refer to diabetic foot screener

8I6G. Diabetic foot examination not indicated8I3W. Diabetic foot examination declined8IAn. Neuropathy assessment declined8IB5. Patient unsuitable for neuropathy assessment

2G5E. O/E - Right diabetic foot at low risk2G5F. O/E - Right diabetic foot at moderate risk2G5G. O/E - Right diabetic foot at high risk2G5H. O/E - Right diabetic foot - ulcerated2G5I. O/E - Left diabetic foot at low risk2G5J. O/E - Left diabetic foot at moderate risk2G5K. O/E - Left diabetic foot at high risk2G5L. O/E - Left diabetic foot - ulcerated

2G42. O/E - Amputated right leg2G44. O/E - Amputated right above knee2G46. O/E - Amputated right below knee

2G43. O/E - Amputated left leg2G45. O/E - Amputated left above knee2G47. O/E - Amputated left below knee

BP Recording Codes

246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j.)





Neuropathy testing codes

Left foot amputation

Foot risk classification

DIABETES cont.

Retinal exclusion codes

Neuropathy testing exception codes These codes can be used for both DM10 and DM29

29B1.-29B3.

Right foot amputation

Foot examination exception codes These codes can be used for DM29 but codes 8IAo. And 8IB6. will not exclude from DM10

23

To Index


SCIMP Suggested


R110. [D]Proteinuria R1100 [D]AlbuminuriaR1100 [D]AlbuminuriaR110z [D]Proteinuria NOS

C10EK Type 1 diabetes mellitus with persistent proteinuria

C10FL Type 2 diabetes mellitus with persistent proteinuria

K190X Persistent proteinuria, unspecifiedKyu5G [X]Persistent proteinuria, unspecified

44lD. Urine protein/creatinine ratio 46W.. Urine microalbumin467A. 24 hour urine protein output 46W0. Urine microalbumin positive467E. Urine protein level 46W1. Urine microalbumin negative467H. Random urine protein level 46TC. Urine albumin:creatinine ratio

46W.. Urine microalbumin 46N5. 24 hour urine protein excretion test46W0. Urine microalbumin positive46W1. Urine microalbumin negative46W2. Microalbumin excretion rate

46TC. Urine albumin:creatinine ratio46N5. 24 hour urine protein excretion test46N6. 24 hour urine albumin output46N7. Urine protein/creatinine index46N8. Urine microalbumin profile

46N3. Urine total protein46N4. Urine albumin

44J3% Serum creatinine44JC. Corrected plasma creatinine level44JD. Corrected serum creatinine level44JF. Plasma creatinine level

451E. GFR calculated abbreviated MDRD451F. Glomerular filtration rate

451G. GFR calculated abbreviated MDRD adj for African Americ orign

R1103 [D]Microalbuminuria R1103 [D]Microalbuminuria

C10EL Type 1 diabetes mellitus with persistent microalbuminuria

C10FM Type 2 diabetes mellitus with persistent microalbuminuria






contraindicated









Proteinuria Diagnosis Care should be taken only to use these codes for persistant proteinuria and not for dipstick test results


46W%

An alternative to Creatinine.

46N5.-46N8.

Microalbuminural Testing

Microralbuminuria

DIABETES cont.

Serum Creatinine


Estimated Glomerular Filtration rate



24

To Index


SCIMP Suggested





















Total Cholesterol CodesCholesterol values should also be recorded for the Contract and your software system will have a system to deal with Read coding of Values. V22 codes removed. V23 code 44PK added.


Code change in V22 with 9OX5., 8I2F., 8I6D. no longer valid and 9OX51, 8I2F1 and 8I6D1 added.


DIABETES cont.


44P..

Flu vaccine contraindications: expiring


65E..-65E4.


25

To Index


SCIMP Suggested


Age >=18

F25.. Epilepsy F25.. EpilepsyF250. Generalised nonconvulsive epilepsyF2500 Petit mal (minor) epilepsyF2502 Epileptic seizures - atonicF2503 Epileptic seizures - akineticF2505 Lennox-Gastaut syndrome

F250y Other specified generalised nonconvulsive epilepsy

F250z Generalised nonconvulsive epilepsy NOSF251. Generalised convulsive epilepsyF2510 Grand mal (major) epilepsyF2512 Epileptic seizures - clonicF2513 Epileptic seizures - myoclonicF2514 Epileptic seizures - tonicF2515 Tonic-clonic epilepsyF251y Other specified generalised convulsive epilepsyF251z Generalised convulsive epilepsy NOSF252. Petit mal statusF253. Grand mal status

F254% Partial epilepsy with impairment of consciousness

F255% Partial epilepsy without mention of impairment of consciousness

F257. Kojevnikov's epilepsyF25B. Alcohol-induced epilepsyF25C. Drug-induced epilepsyF25D. Menstrual epilepsyF25E. Stress-induced epilepsyF25F. Photosensitive epilepsyF25X. Status epilepticus, unspecifiedF25y. Other forms of epilepsyF25y0 Cursive (running) epilepsyF25y1 Gelastic epilepsy

F25y2Localization-related(focal)(partial)idiopathic epilepsy and epileptic syndromes with seizures of localised onset

F25y3 Complex partial status epilepticusF25y5 Panayiotopoulos syndromeF25yz Other forms of epilepsy NOS

F25z. Epilepsy NOSF1321 Progressive myoclonic epilepsySC200 Traumatic epilepsy

Epilepsy medication Prescription Prescribed in the previous 6 months.

21260 Epilepsy resolved 21260 Epilepsy resolved212J. Epilepsy resolved

9h6.. Exception reporting: epilepsy quality indicators 9h61. Excepted from epilepsy quality indicators: Patient unsuitable

9h61. Excepted from epilepsy quality indicators: Patient unsuitable 9h62. Excepted from epilepsy quality indicators: Informed

dissent

9h62. Excepted from epilepsy quality indicators: Informed dissent

6675. Fit frequency 667F. Seizure free >12 months667F. Seizure free >12 months 667Q. 1 to 12 seizures a year

667P. No seizures on treatment 667R. 2 to 4 seizures a month667Q. 1 to 12 seizures a year 667S. 1 to 7 seizures a week667R. 2 to 4 seizures a month 667T. Daily seizures667S. 1 to 7 seizures a week 667V. Many seizures a day667T. Daily seizures667V. Many seizures a day

Maximum anticonvulsant therapy 8BL3. Patient on maximal tolerated anticonvulsant therapy 8BL3. Patient on maximal tolerated anticonvulsant therapy

Seizure Free > 12 months 667F. Seizure free >12 months 667F. Seizure free >12 months

Epilepsy Diagnosis

F25% (excluding F2501, F2504, F2511, F2516, F25y4, F256%, F258.-F25A.)

667P.-667V.

9h6%

Seizure Frequency

Epilepsy resolved

Epilepsy Exception codes

EPILEPSY

26

To Index


SCIMP Suggested


Females aged under 55

Contraceptive counselling 6110. Contraceptive advice for patients with epilepsy

Preconception advice 67IJ0 Pre-conception advice for patients with epilepsy

Pregnancy advice 67AF. Pregnancy advice for patients with epilepsy

8IAg. Contraceptive advice for patients with epilepsy declined

8IB2. Contraceptive advice for patients with epilepsy not indicated

8IAh. Pre-conception advice for patients with epilepsy declined

8IB3. Pre-conception advice for patients with epilepsy not indicated

8IAi. Pregnancy advice for patients with epilepsy declined

8IB4. Pregnancy advice for patients with epilepsy not indicated

7E04% (excluding 7E04D) Abdominal excision of uterus

7E05% Vaginal excision of uterus7F1A0 Caesarean hysterectomy7L0A% Clearance of pelvisZV6G8 [V]Acquired absence of uterus

7E10% Bilateral excision of adnexa of uterus

7E111 Salpingoophorectomy of remaining solitary fallopian tube and ovary

7E113 Salpingectomy of remaining solitary fallopian tube NEC

7E115 Oophorectomy of remaining solitary ovary NEC7E15% Open bilateral occlusion of fallopian tubes7E160 Open ligation of remaining solitary fallopian tube7E162 Open clipping of remaining solitary fallopian tube7E1C. Endoscopic bilateral occlusion of fallopian tubes

7E1C3 Endoscopic bilateral placement of intrafallopian implants

7E1D0 Endoscopic occlusion of remaining solitary fallopian tube

159A. H/O: tubal ligationZV25x [V]Other sterilisationZV252 [V]Sterilisation

EPILEPSY cont.

Sterilisation codes

Pre-conception advice exceptions

Pregnancy advice exceptions

Contraceptive advice exceptions

Permanent exclusion from indicator Epilepsy 9

Patients require all three codes entered within the last 15 month to meet the new Epilespy9 indicator. It is not necessary for these all to be on the same day

To exception code from any one of these items the patient must have either an exception code or a code to meet the indicator for each of the 3 types of advice.

Hysterectomy codes

27

To Index


SCIMP Suggested


G58.. Heart failure G58.. Heart failureG580. Congestive heart failure G581. Left ventricular failureG5800 Acute congestive heart failureG5801 Chronic congestive heart failureG5802 Decompensated cardiac failureG5803 Compensated cardiac failureG581. Left ventricular failureG5810 Acute left ventricular failureG582. Acute heart failureG583. Heart failure with normal ejection fractionG584. Right ventricular failureG58z. Heart failure NOS

G1yz1 Rheumatic left ventricular failure662f. New York Heart Assoc. classification - class I662g. New York Heart Assoc. classification - class II662h. New York Heart Assoc. classification - class III662i. New York Heart Assoc. classification - class IV

G581. Left ventricular failure G581. Left ventricular failureG5810 Acute left ventricular failure

585f. Echocardiogram shows left ventricular systolic dysfunction

585g. Echocardiogram shows left ventricular diastolic dysfunction

G5yy9 Left ventricular systolic dysfunctionG5yyA Left ventricular diastolic dysfunction

662f. New York Heart Assoc. classification - class I662g. New York Heart Assoc. classification - class II662h. New York Heart Assoc. classification - class III662i. New York Heart Assoc. classification - class IV

9hH.. Exception reporting: heart failure quality indicators 9hH0. Excepted from heart failure quality indicators: Patient unsuitable

9hH0. Excepted from heart failure quality indicators: Patient unsuitable 9hH1. Excepted from heart failure quality indicators:

Informed dissent

9hH1. Excepted from heart failure quality indicators: Informed dissent

5853. U-S heart scan 5853. U-S heart scan58531 Echocardiogram abnormal 58531 Echocardiogram abnormal

585f. Echocardiogram shows left ventricular systolic dysfunction 33BD. Echocardiogram requested

585g. Echocardiogram shows left ventricular diastolic dysfunction 8HQ7. Referral for echocardiography

5C20. Echocardiogram equivocal 5531. Angiocardiography awaited33BD. Echocardiogram requested 5533. Angiocardiography abnormal8HQ7. Referral for echocardiography 8H44. Cardiological referralR1320 [D]Echocardiogram abnormalR1322 [D]Ultrasound cardiogram abnormal5531. Angiocardiography awaited5533. Angiocardiography abnormal5538. Angiocardiography equivocal

79380 Angiocardiography of both right and left sides of heart

79382 Angiocardiography of left side of heart NEC8H4R. Ref to cardio spec interest GP8HVJ. Private referral to cardiologist8H44. Cardiological referral

8H7o0 Fast track heart failure referral for transthoracic two dimensional echocardiogram

56F1. Echocardiogram declined 56F1. Echocardiogram declined5534. Angiocardiography declined 5534. Angiocardiography declined





Heart Failure

G58%

662f.-662i.

Heart Failure

Heart Failure Exceptions 9hH%

Heart Failure is no longer secondary to CHD (as for 2005-06). This population applies to Indicators HF1 and HF2. V23 added new code G584.

Echo Declined


662f.-662i.

This population applies to indicator HF3 and HF4. Patients need both a 'Heart Failure' code and a 'LVD' code to qualify. V22. Codes removed

Echocardiogram V22. New code added

LVD

G581%

28

To Index


SCIMP Suggested



contraindicated











14LL. H/O: betablocker allergy 14LL. H/O: betablocker allergyTJC6. Adverse reaction to betablockers TJC6. Adverse reaction to betablockersTJC61 Adverse reaction to acebutololTJC62 Adverse reaction to atenololTJC63 Adverse reaction to labetalolTJC64 Adverse reaction to metoprololTJC65 Adverse reaction to nadololTJC66 Adverse reaction to oxprenololTJC67 Adverse reaction to sotalolTJC68 Adverse reaction to timololTJC6z Adverse reaction to betablockers NOS

U60B7 [X]Beta-adrenoreceptor antagonists causing adverse effects in therapeutic use, not elsewhere classified

U60B9 [X]Adverse reaction to bisoprololU60BA [X]Adverse reaction to carvedilolU60BB [X]Adverse reaction to nebivololZV14C [V]Personal history of betablocker allergyZVu6i [X]Personal history of allergy to bisoprololZVu6o [X]Personal history of allergy to carvedilolZVu6q [X]Personal history of allergy to nebivolol

8I26. Beta blocker contraindicated 8I26. Beta blocker contraindicated8I2g. Bisoprolol contraindicated 8I36. Beta blocker therapy refused8I2h. Carvedilol contraindicated 8I62. Beta blocker not indicated8I2i. Nebivolol contraindicated 8I73. Beta blocker not tolerated

8I36. Beta blocker therapy refused8IAS. Bisoprolol therapy refused8IAT. Carvedilol therapy refused8IAV. Nebivolol therapy refused

8I62. Beta blocker not indicated8I6i. Bisoprolol not indicated8I6j. Carvedilol not indicated8I6k. Nebivolol not indicated

8I73. Beta blocker not tolerated8I7K. Bisoprolol not tolerated8I7L. Carvedilol not tolerated8I7M. Nebivolol not tolerated

BISOPROLOL FUMARATECARVEDILOLNEBIVOLOL

Prescription codes for unlicensed Beta blocker

All other Beta-Adrenoceptor Blockers apart for licensed ones above

Patient can remain on an unlicensed B-blocker if they were on this in the 6 months prior to Heart Failure diagnosis (ie. it may not be clinically appropriate to change to a licensed brand)

Beta Blocker contraindications:persistent


Heart Failure cont.



8IAS. - 8IAV

8I6i. - 8I6k.

Beta Blocker contraindications:expiring

TJC6%

Prescription codes for licensed Beta blocker

8I7K.-8!7M.

8I2g.-8I2i

Prescribed in last 6 months

29

To Index


SCIMP Suggested


G2... Hypertensive disease G2… Hypertensive diseaseG20% Essential hypertension G20.. Essential hypertension

G240. Secondary malignant hypertension G200. Malignant essential hypertensionG240z Secondary malignant hypertension NOSG241. Secondary benign hypertension G24.. Secondary hypertensionG241z Secondary benign hypertension NOSG244. Hypertension secondary to endocrine disorders G201. Benign essential hypertensionG24z. Secondary hypertension NOS G202. Systolic hypertensionG24z0 Secondary renovascular hypertension NOSG24zz Secondary hypertension NOSG2y.. Other specified hypertensive diseaseG2z.. Hypertensive disease NOS

Gyu2. [X]Hypertensive diseasesGyu20 [X]Other secondary hypertension

Gyu21 [X]Hypertension secondary to other renal disorders

21261 Hypertension resolved 21261 Hypertension resolved212K. Hypertension resolved

9h3.. Exception reporting: hypertension quality indicators 9h31. Excepted from hypertension quality indicators: Patient unsuitable

9h31. Excepted from hypertension quality indicators: Patient unsuitable 9h32. Excepted from hypertension quality indicators:

Informed dissent

9h32. Excepted from hypertension quality indicators: Informed dissent

BP Recording Codes

246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j.)





Hypertension V22 code G24z1 removed. V23 codes G2400 and G2410 removed

G24..-G2z.. (excluding G24z1, G2400, G2410)

9h3%Hypertension Exception Codes

Hypertension resolved

HYPERTENSION

30

To Index


SCIMP Suggested


C04% Acquired hypothyroidism C03z. Acquired hypothyroidismC03% Congenital hypothyroidism C04.. Congenital hypothyroidism

Hypothyroid Medication prescription Prescribed in the previous 6 months

9h7.. Exception reporting: thyroid quality indicators 9h71. Excepted from thyroid quality indicators: Patient unsuitable

9h71. Excepted from thyroid quality indicators: Patient unsuitable 9h72. Excepted from thyroid quality indicators: Informed

dissent

9h72. Excepted from thyroid quality indicators: Informed dissent

Thyroid function test codes 442% Thyroid hormone tests

Hypothyroid

Hypothyroid Exception Codes 9h7%

HYPOTHYROID

31

To Index


SCIMP Suggested


Age>=18

E3% Mental retardation 918e. On learning disability registerEu7.. [X]Mental retardation Eu814 [X]Moderate learning disabilityEu70% [X]Mild mental retardation Eu815 [X]Severe learning disabilityEu71% [X]Moderate mental retardationEu72% [X]Severe mental retardationEu73% [X]Profound mental retardationEu7y% [X]Other mental retardationEu7z% [X]Unspecified mental retardation

Eu814 [X]Moderate learning disabilityEu815 [X]Severe learning disabilityEu816 [X]Mild learning disabilityEu817 [X]Profound learning disability

Eu81z [X]Developmental disorder of scholastic skills, unspecified

918e. On learning disability register

9hL.. Exception reporting: learning disability quality indicators

9hL0. Excepted from learning disability quality indicators: informed dissent

9hL1. Excepted from learning disability quality indicators: patient unsuitable

PJ0.. Down's syndrome - trisomy 21PJ00. Trisomy 21, meiotic nondisjunctionPJ01. Trisomy 21, mosaicismPJ02. Trisomy 21, translocationPJ0z. Down's syndrome NOS

C04% Acquired hypothyroidism C03z. Acquired hypothyroidismC03% Congenital hypothyroidism C04.. Congenital hypothyroidism

Hypothyroid Medication prescription

Thyroid function test codes 442% Thyroid hormone tests Required in the last 15 months

Eu7%

Learning disabilities Exception Codes

PJ0%

Learning disabilities

Learning disabilities

A previous diagnosis of hypothyroidism + on medication will exclude patient from indicator LD2 unless the hypothyroid diagnosis has been made within the last 15 months. Prescription of levothyroxine requires to be in the previous 6 months

Hypothyroid

9hL%

Downs Syndrome

32

To Index


SCIMP Suggested


E10% Schizophrenic disorders E104. Acute schizophrenic episodeE110% Manic disorder, single episode E10z. Schizophrenia NOSE111% Recurrent manic episodes E12z. Paranoid psychosis NOS

E1124 Single major depressive episode, severe, with psychosis E130. Reactive depressive psychosis

E1134 Recurrent major depressive episodes, severe, with psychosis Eu220 [X]Delusional disorder

E114% Bipolar affective disorder, currently manic Eu300 [X]HypomaniaE115% Bipolar affective disorder, currently depressed Eu31. [X]Bipolar affective disorderE116% Mixed bipolar affective disorderE117% Unspecified bipolar affective disorder

E11y. Other and unspecified manic-depressive psychoses

E11y0 Unspecified manic-depressive psychosesE11y1 Atypical manic disorderE11y3 Other mixed manic-depressive psychoses

E11yz Other and unspecified manic-depressive psychoses NOS

E11z. Other and unspecified affective psychosesE11z0 Unspecified affective psychoses NOSE11zz Other affective psychosis NOSE12% Paranoid states

E13.. Other nonorganic psychosesE130. Reactive depressive psychosisE131. Acute hysterical psychosisE132. Reactive confusionE133. Acute paranoid reactionE134. Psychogenic paranoid psychosisE13y% Other reactive psychosesE13z. Nonorganic psychosis NOS

E2122 Schizotypal personality

Eu2.. [X]Schizophrenia, schizotypal and delusional disorders

Eu20% [X]SchizophreniaEu21. [X]Schizotypal disorderEu22% [X]Persistent delusional disordersEu23% [X]Acute and transient psychotic disordersEu24. [X]Induced delusional disorderEu25% [X]Schizoaffective disordersEu26% [X]Nonorganic psychosis in remissionEu2y. [X]Other nonorganic psychotic disordersEu2z. [X]Unspecified nonorganic psychosisEu30. [X]Manic episodeEu300 [X]HypomaniaEu301 [X]Mania without psychotic symptomsEu302 [X]Mania with psychotic symptomsEu30y [X]Other manic episodesEu30z [X]Manic episode, unspecifiedEu31. [X]Bipolar affective disorder

Eu310 [X]Bipolar affective disorder, current episode hypomanic

Eu311 [X]Bipolar affective disorder, current episode manic without psychotic symptoms

Eu312 [X]Bipolar affective disorder, current episode manic with psychotic symptoms

Eu313 [X]Bipolar affective disorder, current episode mild or moderate depression

Eu314 [X]Bipolar affective disorder, current episode severe depression without psychotic symptoms

Eu315 [X]Bipolar affective disorder, current episode severe depression with psychotic symptoms

Eu316 [X]Bipolar affective disorder, current episode mixed

Eu317 [X]Bipolar affective disorder, currently in remissionEu318 [X]Bipolar affective disorder type IEu319 X]Bipolar affective disorder type IIEu31y [X]Other bipolar affective disordersEu31z [X]Bipolar affective disorder, unspecified

Eu323 [X]Severe depressive episode with psychotic symptoms

Eu328 [X]Major depression, severe with psychotic symptoms

Eu329 [X]Single major depressive episode, severe, with psychosis, psychosis in remission

Eu32A [X]Recurrent major depressive episodes, severe, with psychosis, psychosis in remission

Eu333 [X]Recurrent depressive disorder, current episode severe with psychotic symptoms

Eu31%

E13% (excluding E135.)

Psychosis, Schizophrenia + bipolar affective disease codes

E11y% (excluding E11y2)

Mental Health

E114.-E117z

Patients are in the Mental Health population if they have one of these diagnosis codes or they are on Lithium.

Eu30%

Eu2%

33

To Index


SCIMP Suggested


Lithium Prescription codes d6% LITHIUM SALTS 665B. Lithium stopped prescribed in the last 6 monthsStopped Lithium (excluded) 665B. Lithium stopped Excludes patient if entered after the last prescription date

E1005 Schizophrenia in remissionE1015 Hebephrenic schizophrenia in remissionE1025 Catatonic schizophrenia in remissionE1035 Paranoid schizophrenia in remissionE1055 Latent schizophrenia in remissionE1075 Schizo-affective schizophrenia in remissionE1106 Single manic episode in full remissionE1116 Recurrent manic episodes, in full remission

E1146 Bipolar affective disorder, currently manic, in full remission

E1156 Bipolar affective disorder, currently depressed, in full remission

E1166 Mixed bipolar affective disorder, in full remission

E1176 Unspecified bipolar affective disorder, in full remission

Eu223 [X]Paranoid state in remissionEu26. [X]Nonorganic psychosis in remissionEu317 [X]Bipolar affective disorder, currently in remission

Eu329 [X]Single major depressive episode, severe, with psychosis, psychosis in remission

Eu32A [X]Recurrent major depressive episodes, severe, with psychosis, psychosis in remission

9h9.. Exception reporting: mental health quality indicators 9h91. Excepted from mental health quality indicators: Patient unsuitable

9h91. Excepted from mental health quality indicators: Patient unsuitable 9h92. Excepted from mental health quality indicators:

Informed dissent

9h92. Excepted from mental health quality indicators: Informed dissent

8CM2. Psychiatry care plan 8CM2. Psychiatry care plan8CR7. Mental health personal health plan

44W8% Serum lithium level44vE. Lithium level therapeuticR1053 [D]Lithium, blood level abnormal

44W80 Lithium level therapeutic 44W80 Lithium level therapeutic44vE. Lithium level therapeutic

44J3% Serum creatinine Creatinine test results required in the last 9 months44JC. Corrected plasma creatinine level44JD. Corrected serum creatinine level44JF. Plasma creatinine level

442A% TSH - thyroid stim. hormone TSH test results required in the last 9 months442K.-442T. 30 minute plasma TSH level There are others in this range for different times of testing442W. Serum TSH level442X. Plasma TSH level442e. Blood spot TSH level

Mental Health Exception codes

Mental Health cont.

Remission from severe Mental IllnessException codes patients permanently from the indicators but not from the MH overall population. If a later dated MH code is added this will over-ride the remission code

Lithium level values should also be recorded for the Contract and your software system will have a system to deal with Read coding of Values. Requires entry within previous 4 months

9h9%

TSH test

Lithium level test

MH Care plan

Serum Creatinine

Lithium level Therapeutic This code is not required if Lithium values are within the therapeutic range (0.4 - 1.0).

34

To Index


SCIMP Suggested


136.. Alcohol consumption 1361. Teetotaller

1361. Teetotaller 136L. Alcohol intake within recommended sensible limits

1362. Trivial drinker - <1u/day 136K. Alcohol intake above recommended sensible limits

1363. Light drinker - 1-2u/day1364. Moderate drinker - 3-6u/day1365. Heavy drinker - 7-9u/day1366. Very heavy drinker - >9u/day1367. Stopped drinking alcohol136A. Ex-trivial drinker (<1u/day)136C. Ex-moderate drinker - (3-6u/d)136C. Ex-moderate drinker - (3-6u/d)136D. Ex-heavy drinker - (7-9u/day)136E. Ex-very heavy drinker-(>9u/d)136F. Spirit drinker136G. Beer drinker136H. Drinks beer and spirits136I. Drinks wine136J. Social drinker

136K. Alcohol intake above recommended sensible limits

136L. Alcohol intake within recommended sensible limits

136N. Light drinker136O. Moderate drinker136P. Heavy drinker136Q. Very heavy drinker136R. Binge drinker136S. Hazardous alcohol use136T. Harmful alcohol use136V. Alcohol units per week136X. Alcohol units consumed on heaviest drinking day136Z. Alcohol consumption NOS136a. Increasing risk drinking136c. Higher risk drinking136d. Lower risk drinking

8IA7. Alcohol consumption screening test declined

8IAt. Extended intervention for excessive alcohol consumption declined

22K.. Body Mass Index22K1. Body Mass Index normal K/M222K2. Body Mass Index high K/M222K3. Body Mass Index low K/M222K4. Body mass index index 25-29 - overweight22K5. Body mass index 30+ - obesity22K6. Body mass index less than 2022K7. Body mass index 40+ - severely obese22K8. Body mass index 20-24 - normal

BP Recording Codes

246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j.)



BP Recording Exception Codes 8I3Y. Blood pressure procedure refused Requires recording within the previous 15 months

44PF. Total cholesterol:HDL ratio44l2. Cholesterol/HDL ratio44lF. Serum cholesterol/HDL ratio44lG. Plasma cholesterol/HDL ratio

C3200 Familial hypercholesterolaemia C3200 Familial hypercholesterolaemiaC3201 HyperbetalipoproteinaemiaC3204 Fredrickson's hyperlipoproteinaemia, type IIaC3205 Familial defective apolipoprotein B-100

Mental Health cont.

Applies only to patients age 40 and over. Patients with pre-existing, hypertension, diabetes, CHD, PVD, Stroke or TIA, familial hypercholesterolaemia, or CKD are excluded from requiring Tot Chol/HDL test.

Requires entry in the previous 15 monthsAlcohol Consumption screening declined

22K% (excluding 22K9.)

Excludes from requiring Tot Chol/HDL test.

BMI

Total Cholesterol:HDL

Alcohol consumption

Familial Hypercholesterolaemia

136% (excluding 1368., 1369., 136M., 136W, 136Y., 136b.)

35

To Index


SCIMP Suggested


44TM. Blood glucose series44f% Serum glucose level44g% Plasma glucose level

44T1. Random blood sugar44T10 Random blood sugar normal44T11 Random blood sugar low44T12 Random blood sugar raised44T2. Fasting blood sugar44T3. 2 hours post food blood sugar

44TA. Plasma glucose44TE. 30 minute blood glucose level44TF. 60 minute blood glucose level44TG. 90 minute blood glucose level44TH. 120 minute blood glucose level44TI. 150 minute blood glucose level44TJ. Blood glucose level44TK. Fasting blood glucose level

44U% (except 44Uz.) Blood glucose result

44V.. Glucose tolerance test44V1. Glucose tolerance test normal44V2. Glucose tol. test impaired44V3. Glucose tol. test diabetic

44V6. Extended glucose tolerance testR102. [D]Glucose tolerance test abnormalR10D. [D]Elevated blood glucose levelR1057 [D]Glucose, blood level abnormal

IFCC HbA1c levels 42W5. Haemoglobin A1c level - IFCC standardised V22.Added as an alternative to Glucose test

Glucose test exception code 8IEG. Blood glucose test declined V22 added

685H. No smear - benign hysterectomy685I. No smear-amputation of cervix685K. No smear - no cervix9O8Y. No cervical smear required - no uterus7E05% Vaginal excision of uterus

7E040 Abdominal hysterocolpectomy and excision of periuterine tissue

7E042 Abdominal hysterocolpectomy NEC7E043 Total abdominal hysterectomy NEC7E046 Radical hysterectomy

7E049 Total abdominal hysterectomy and bilateral salpingoophorectomy

7E04B Laparoscopic total abdominal hysterectomy and bilateral salpingo-oophorectomy

7E04G Total abdominal hysterectomy with conservation of ovaries

7L0A% Clearance of pelvis26L3. Uterine cervix absent

4K22. Cervical smear: negative4K23. Cerv.smear: mild dyskaryosis4K24. Cerv.smear: severe dyskaryosis4K25. Cerv.smear:severe dysk.?inv.ca4K26. Cervical smear: ? gland neopl.4K27. Cervical smear:atrophic change4K28. Cerv.smear: mod.dyskaryosis4K29. Cerv.smear: borderline changes

4K2C. Smear NAD - no endocervical cells4K2H. Cervical smear epithelial cells absent4K2F. Cervical smear pus cells present4K2G. Cervical smear red blood cells present4KA1. Vaginal vault smear negative4KA3. Vaginal vault smear-atrophic4KA4. Vaginal vault smear abnormal6856. Ca cervix screen - up to date6859. Ca cervix - screen done

685B. Ca cervix screen normal685C. Ca cervix screen abnormal685D. Ca cervix screen + fee claim

685R. Liquid based cervical cytology screening7E2A2 Papanicolau smear NEC7E2A3 Vaginal vault smearZV762 [V]Screening for malignant neoplasm of cervix

7E2A0 Examination of female genital tract under anaesthetic and Papanicolau smear

Applies only to patients age 40 and over. Patients with diabetes diagnosed more that 12 months ago are excluded. V23 excluded the new Read codes 44TJ0 -44TJ7 inclusive

Permanent exclusion from indicator MH16

Glucose44TE. - 44TK. (excluding 44TJO-44TJ7)

4K22. - 2K29.

In Scotland for females age 20 - 60. Requires entry within the previous 5 yrs. V23 added new codes 4K2H., 4K2F., 4K2G.

44V.. - 44V3.

Hysterectomy and equivalent codes

Cervical Smear

685B. - 685D.

Mental Health cont.

44T1. - 44T3.

36

To Index


SCIMP Suggested


6853. Ca cervix screen - not wanted685L. Cervical smear refused8I6K. Cervical smear not indicated9O8Q. Cerv.smear disclaimer received

Cervical cytology exceptions Requires entry within the previous 5 years

Mental Health cont.

37

To Index


SCIMP Suggested


Age >=16

22K5. Body mass index 30+ - obesity22K7. Body mass index 40+ - severely obese

22K.. (If has attached value of >=30) Body Mass Index only if value attached of >=30 and recorded in the last 15 months

Need to be recorded in the last 15 months

Obesity

Obesity

38

To Index


SCIMP Suggested


New Area for 2012-13

N331N Fragility fracture N331N Fragility fractureN331M Fragility fracture due to unspecified osteoporosis

N330. Osteoporosis N330. OsteoporosisN3300 Osteoporosis, unspecifiedN3301 Senile osteoporosisN3302 Postmenopausal osteoporosisN3303 Idiopathic osteoporosisN3304 Dissuse osteoporosisN3306 Postoophorectomy osteoporosisN330B Vertebral osteoporosisN330C Osteoporosis localized to spine

N3312 Postoophorectomy osteoporosis with pathological fracture

N3313 Osteoporosis of disuse with pathological fractureN3316 Idiopathic osteoporosis with pathological fracture

N3318 Osteoporosis + pathological fracture lumbar vertebrae

N3319 Osteoporosis + pathological fracture thoracic vertebrae

N331A Osteoporosis + pathological fracture cervical vertebrae

N331B Postmenopausal osteoporosis with pathological fracture

N331H Collapse of cervical vertebra due to osteoporosisN331J Collapse of lumbar vertebra due to osteoporosisN331K Collapse of thoracic vertebra due to osteoporosisN331L Collapse of vertebra due to osteoporosis NOSN331M Fragility fracture due to unspecified osteoporosis

NyuB0 [X]Other osteoporosis with pathological fractureNyuB1 [X]Other osteoporosis

NyuB8 [X]Unspecified osteoporosis with pathological fracture

9hP.. Exception reporting: osteoporosis quality indicators

9hP0. Excepted from osteoporosis quality indicators: patient unsuitable

9hP1. Excepted from osteoporosis quality indicators: informed dissent

58E4. Forearm DXA scan result osteoporotic58EA. Heel DXA scan result osteoporotic58EG. Hip DXA scan result osteoporotic58EM. Lumbar DXA scan result osteoporotic58EV. Femoral neck DEXA scan result osteoporotic

58E2. Forearm DXA scan T score58E8. Heel DXA scan T score58EE. Hip DXA scan T score58EK. Lumbar spine DXA scan T score58ES. Femoral neck DEXA scan T score

N330% (excluding N3305, N3307, N3308, N3309, N330A, N330D)

N3318 - N331B

N331H - N331M

There are two populations for osteoporosis 1. age 50-74, require codes for fragility fracture after 1.4.12 and diagnosis of osteoporosis and DEXA scan code. 2. Those age 75+ require code for fragility fracture.

Osteoporosis: Secondary prevention of Fragility fractures

Fragility fracture

DEXA scan (without score)

Dexa scan (with T score value < -2.5)

9hP%Osteoporosis exception codes

Osteoporosis

39

To Index


SCIMP Suggested


14LT. H/O: bisphosphonate allergy To exception codes from bone sparing agents there needs to be an entry from each of the 4 categories of medication.

ZV14K [V]Personal history of bisphosphonate allergy

8I3e. Bisphosphonates declined8I6R. Bisphosphonates not indicated8I7E. Bisphosphonates not tolerated8I2V. Bisphosphonates contraindicated

Bone sparing agents Category2 contra-indicated, persisting 14La. H/O: raloxifene allergy

8I6p. Raloxifene not indicated8I7P. Raloxifene not tolerated8IEH. Raloxifene declined8I2l. Raloxifene contraindicated

Bone sparing agents Category3 contra-indicated, persisting 14Lb. H/O: teriparatide allergy

8I6q. Teriparatide not indicated8I7Q. Teriparatide not tolerated8IED. Teriparatide declined8I2m. Teriparatide contraindicated

14LW. H/O: strontium ranelate allergyZV14H [V]Personal history of strontium ranelate allergy

8I3h. Strontium ranelate declined8I6V. Strontium ranelate not indicated8I7H. Strontium ranelate not tolerated8I2Y. Strontium ranelate contraindicated

fn2% CALCITONIN(SALMON)fo1% DISODIUM ETIDRONATEfo4% ALENDRONIC ACIDfo6% RISEDRONATE SODIUMfo8% IBANDRONIC ACIDfv1% RALOXIFENE HYDROCHLORIDEfu3% TERIPARATIDEfu9% DENOSUMABfu5% STRONTIUM

Bone sparing agent prescriptions Requires prescription in the last 6 months. V23 added codes to prescriptions

Bone sparing agents Category4 contra-indicated, persisting

Bone sparing agents Category4 contra-indicated, expiring

requires entry within the last 15 months



requires entry within the last 15 monthsBone sparing agents Category3 contra-indicated, expiring

Bone sparing agents Category1 contra-indicated, persisting

Bone sparing agents Category2 contra-indicated, expiring

Bone sparing agents Category 1 contra-indicated, expiring

Osteoporosis cont.

40

To Index


SCIMP Suggested


New Area for 2012-13G73.. Other peripheral vascular disease G73z. Peripheral vascular disease NOS

G73z. Peripheral vascular disease NOSG73z0 Intermittent claudicationG73zz Peripheral vascular disease NOS

Gyu74 [X]Other specified peripheral vascular diseases

9hS.. Exception reporting: peripheral arterial disease quality indicators

9hS0. Excepted from peripheral arterial disease quality indicators: patient unsuitable

9hS1. Excepted from peripheral arterial disease quality indicators: informed dissent

BP Recording Codes

246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j.)



BP Recording Exception Codes 8I3Y. Blood pressure procedure refused Requires recording within the previous 15 months


44OE. Plasma total cholesterol level44P.. Serum cholesterol44PH. Total cholesterol measurement44PJ. Serum total cholesterol level44PK. Serum fasting total cholesterol





Total Cholesterol CodesCholesterol values should also be recorded for the Contract and your software system will have a system to deal with Read coding of Values. V23 added code 44PK.


Peripheral Arterial Disease

PAD G73z% (excluding G73z1)

PAD Exception codes

Requires recording within the previous 15 monthsException from serum cholesterol target -expiring

41

To Index


SCIMP Suggested


Salicylate prescriptions Prescribed in In last 15 monthsClopidogrel prescriptions and code 8B6P. Clopidogrel prophylaxis Prescribed in In last 15 months

Warfarin Prescriptions and Code 8B2K. Anticoagulant prescribed by third party Prescribed in In last 15 months. Warfarin acts as an exclusion for being given aspirin or other anti-platelet medication. Therefore there are no exception















Requires recording within the previous 15 months

Requires recording within the previous 15 months

Peripheral Arterial Disease cont.

42

To Index


SCIMP Suggested


1Z01. Terminal illness - late stage ZV57C [V]Palliative care2JE.. Last days of life 8CM1. On gold standards palliative care framework8BA2. Terminal care 8HH7. Referred to community specialist palliative care

team8BAP. Specialist palliative care8BAS. Specialist palliative care treatment - daycare8BAT. Specialist palliative care treatment - outpatient8BAe. Anticipatory palliative care8BJ1. Palliative treatment

8CM1. On gold standards palliative care framework

8CM10 Gold standards framework supportive care stage 1 - advancing disease

8CM11 Gold standards framework supportive care stage 2 - increasing decline

8CM12 Gold standards framework supportive care stage 3 - last days: category C - weeks prognosis

8CM13 Gold standards framework supportive care stage 3 - last days: category D - days prognosis

8CM14 Gold standards framework supportive care stage 3 - last days: category B - months prognosis

8CM4. Liverpool care pathway for the dying8CME. Has end of life advanced care plan8CMQ. On Liverpool care pathway for the dying8H6A. Refer to terminal care consult8H7L. Refer for terminal care8H7g. Referral to palliative care service

8HH7. Referred to community specialist palliative care team

8IEE Referral to community palliative care team declined

9EB5. DS 1500 Disability living allowance (terminal care) completed

9Ng7. On end of life care register9NgD. Under care of palliative care serviceZV57C [V]Palliative care

V23 added codes 8CMQ. And 9NgD.

Palliative Care

8CM1%

43

To Index


SCIMP Suggested


BP Recording Codes

246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j.)



9348. Computer summary updated 9348. Computer summary updated9344. Notes summary on computer 9344. Notes summary on computer9311. Lloyd George+problem summary9313. Lloyd George culled+summarised

Clinical Summaries Recording Codes

Records (BP, Summaries)

44

To Index


SCIMP Suggested


Women age >54

61F1. Prescribed post-coital OCP61A1. Morning after pills given

Combined Oral Contraception prescription and code 6147. Combined oral contraceptive In last 15 months and after 1.4.09

Progestogen only pill prescription and code 6148. Progestagen only oral contrac. In last 15 months and after 1.4.09

Contraceptive patch prescription In last 15 months and after 1.4.09

Contraceptive Diaphram prescription and code 6161. CAP fitted In last 15 months and after 1.4.09

6151. IUD fitted7E090 Introduction of intrauterine contraceptive deviceZV251 [V]Intrauterine contraceptive device insertion

61511 Insertion of T shaped 375 millimetres squared copper coated intrauterine contraceptive device

6152. IUD removed615B. IUD expelled

615Q. Intrauterine contraceptive device removed by other healthcare provider

7E092 Removal of intrauterine contraceptive device NEC

7E093 Removal of displaced intrauterine contraceptive device

7E095 Removal of Mirena coil

7E094 Introduction of Mirena coil

61R.. Intrauterine system contraception

7G2AG Insertion of Implanon

61KC. Insertion of subcutaneous contraceptive implant by other healthcare provider

7G2AH Reinsertion of subcutaneous contraceptive

7G2AJInsertion of etonogestrel radiopaque contraceptive implant

9kr.. Subdermal etonogestrel implant insertion enhanced services administration

7G2H7 Removal of subcutaneous contraceptive7G2HA Removal of Implanon

7G2HBRemoval of etonogestrel radiopaque contraceptive implant

61KF. Removal of subcutaneous contraceptive implant by other healthcare provider

Contraceptive injectable - prescriptions only Injection prescriptions are detected if prescribed in the last 12 months

9hK0. Except.sexual health indic.: pt. unsuitable9hK1. Except. sexual health indic.: informed dissent

8CAw. Advice about long acting reversible contraception

679K2 Education for intrauterine system

LARC Verbal advice 8CAw1 Verbal advice about long acting reversible contraception

8CAw2 Written advice about long acting reversible contraception

8CEF. Intrauterine device contraception leaflet given

If these codes used then required to enter one code from each section to meet indicator, showing that both written and verbal advice given.

Dated after latest IUS or IUD code or prescriptionIUD / IUS Removal

IUD Insertion prescription and codes

LARC written advice

In last 10 yrs and after 1.4.09

Contraceptive implant removal Dated after latest Implant insertion code or prescription.

LARC advice

Dated in last 15 months for pts on oral or patch contraceptives. Dated within 1 month of most recent Emergency contraception code or prescription. Advice requires both written AND verbal advice. If one of these codes used then assume both given

IUS Insertion prescription and code In last 5 yrs and after 1.4.09.

Contraceptive Implant - prescription and codes In last 3 yrs and after 1.4.09.

Sexual Health Exception codes

In last 13 months and after 1.4.09

SEXUAL HEALTH

Emergency Contraception prescriptions and codes

45

8CEG. Long acting reversible contraception leaflet given

46

To Index


SCIMP Suggested


137.. Tobacco consumption 1371. Never smoked tobacco1371. Never smoked tobacco 137S. Ex smoker1372. Trivial smoker - < 1 cig/day 137R. Current smoker1373. Light smoker - 1-9 cigs/day1374. Moderate smoker - 10-19 cigs/d1375. Heavy smoker - 20-39 cigs/day1376. Very heavy smoker - 40+cigs/d1377. Ex-trivial smoker (<1/day)1378. Ex-light smoker (1-9/day)1379. Ex-moderate smoker (10-19/day)137A. Ex-heavy smoker (20-39/day)137B. Ex-very heavy smoker (40+/day)137C. Keeps trying to stop smoking137D. Admitted tobacco cons untrue ?137F. Ex-smoker - amount unknown137G. Trying to give up smoking137H. Pipe smoker

137J. Cigar smoker137K. Stopped smoking

137M. Rolls own cigarettes137N. Ex pipe smoker137O. Ex cigar smoker137P. Cigarette smoker137Q. Smoking started137R. Current smoker137S. Ex smoker137T. Date ceased smoking

137V. Smoking reduced137X. Cigarette consumption137Y. Cigar consumption137Z. Tobacco consumption NOS137a. Pipe tobacco consumption137b. Ready to stop smoking137c. Thinking about stopping smoking137d. Not interested in stopping smoking137e. Smoking restarted137f. Reason for restarting smoking137g. Cigarette pack-years137h. Minutes from waking to first tobacco consumption

137j. Ex-cigarette smoker137l. Ex roll-up cigarette smoker137m. Failed attempt to stop smoking

Never Smoked 1371. Never smoked tobacco 1371. Never smoked tobacco Requires entry in 15months if aged 15 to 25. If aged over 25 requires entry once ever dated after patients 25th birthday and after their diagnosis date

1377. Ex-trivial smoker (<1/day) 137S. Ex smoker1378. Ex-light smoker (1-9/day)1379. Ex-moderate smoker (10-19/day)137A. Ex-heavy smoker (20-39/day)137B. Ex-very heavy smoker (40+/day)

137F. Ex-smoker - amount unknown137K. Stopped smoking

137N. Ex pipe smoker137O. Ex cigar smoker137S. Ex smoker137T. Date ceased smoking

137j. Ex-cigarette smoker137l. Ex roll-up cigarette smoker

Complex. Requires entry in last 15 months (but note for records is required in last year) OR, if entered more than a 15 months ago, requires 3 ex-smoker entries dated over a 3 year period with no 'smoker' code subsequently entered.

137S. - 137T.

Smoking Habit Codes

1377-137B

Ex-Smoker

137X.-137h.

137..-137D.

137M.-137T

137F.-137H.

137N. - 137O.

Patients with any one of CHD,Stroke or TIA, PAD, Hypertension, Diabetes (Age>=17), COPD, Asthma (with medication in the last year and age >=20), CKD (age >=18) or on the Mental health Register (Schizophrenia, Psychosis or Bipolar disorder) count for this indicator

SMOKING

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To Index


SCIMP Suggested


1372. Trivial smoker - < 1 cig/day 137R. Current smoker1373. Light smoker - 1-9 cigs/day1374. Moderate smoker - 10-19 cigs/d1375. Heavy smoker - 20-39 cigs/day1376. Very heavy smoker - 40+cigs/d137C. Keeps trying to stop smoking137D. Admitted tobacco cons untrue ?137G. Trying to give up smoking137H. Pipe smoker

137J. Cigar smoker137M. Rolls own cigarettes

137P. Cigarette smoker137Q. Smoking started137R. Current smoker

137V. Smoking reduced137X. Cigarette consumption137Y. Cigar consumption137Z. Tobacco consumption NOS137a. Pipe tobacco consumption137b. Ready to stop smoking137c. Thinking about stopping smoking137d. Not interested in stopping smoking137e. Smoking restarted137f. Reason for restarting smoking

137h. Minutes from waking to first tobacco consumption137m. Failed attempt to stop smoking

9hG0. Except smok qual ind: Pt uns 9hG0. Except smok qual ind: Pt uns9hG1. Except smok qual ind: Inf diss 9hG1. Except smok qual ind: Inf diss

9Ndg. Declined consent for follow-up by smoking cessation team

8CAL. Smoking cessation advice8HTK. Referral to stop-smoking clinic8HkQ. Referral to NHS stop smoking service8H7i. Referral to smoking cessation advisor8IAj. Smoking cessation advice declined8IEK. Smoking cessation programme declined9N2k. Seen by smoking cessation advisor

13p50 Practice based smoking cessation programme start date

9Ndf. Consent given for follow-up by smoking cessation team

9Ndg. Declined consent for follow-up by smoking cessation team

745H. Smoking cessation therapy

745H0 Nicotine replacement therapy using nicotine patches

745H1 Nicotine replacement therapy using nicotine gum

745H2 Nicotine replacement therapy using nicotine inhalator

745H3 Nicotine replacement therapy using nicotine lozenges

745Hy Other specified smoking cessation therapy745Hz Smoking cessation therapy NOS

8B3f. Nicotine replacement therapy provided free8B2B. Nicotine replacement therapy8B3Y. Over the counter nicotine replacement therapy8IEM. Smoking cessation drug therapy declined

137X.-137f.

V22 New field. V22 required both a code for support / referral AND for pharmacotherapy (code or prescription). V23 has altered this so that only one code from either group is now required.

V22 New field. V22 required both a code for support / referral AND for pharmacotherapy (code or prescription). V23 has altered this so that only one code from either group is now required.

Note - overall exception codes for the individual disease areas will not exclude patients from the Smoking criteria and these codes will also need entry.

Requires entry within last 15 months.Current Smoker Code

1372.-1376.

137C.-137D.

137G.-137H.

137P.-137R.

Smoking Exception reporting codes

Support and Refer Stop Smoking Service/ Adviser

745H%

Pharmacotherapy (prescriptions + codes)

SMOKING cont.

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To Index


SCIMP Suggested


G61% (Except G617.) Intracerebral haemorrhage G61.. Intracerebral haemorrhage

G63y0 Cerebral infarct due to thrombosis of precerebral arteries G64z. Cerebral infarction NOS

G63y1 Cerebral infarction due to embolism of precerebral arteries G66.. Stroke and cerebrovascular accident unspecified

G64% Cerebral arterial occlusion

G66% (excluding G669.) Stroke and cerebrovascular accident unspecified

G6760 Cerebral infarction due to cerebral venous thrombosis, nonpyogenic

G6W.. Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries

G6X.. Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries

Gyu62 [X]Other intracerebral haemorrhage

Gyu63 [X]Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries

Gyu64 [X]Other cerebral infarction

Gyu65 [X]Occlusion and stenosis of other precerebral arteries

Gyu66 [X]Occlusion and stenosis of other cerebral arteries

Gyu6F [X]Intracerebral haemorrhage in hemisphere, unspecified

Gyu6G [X]Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries

ZV125 [V]Personal history of circulatory system disease

G65.. Transient cerebral ischaemia G650. Basilar artery syndromeG650. Basilar artery syndrome G65zz Transient cerebral ischaemia NOSG651. Vertebral artery syndromeG6510 Vertebro-basilar artery syndromeG652. Subclavian steal syndromeG653. Carotid artery syndrome hemispheric

G654. Multiple and bilateral precerebral artery syndromes

G656. Vertebrobasilar insufficiencyG65y. Other transient cerebral ischaemiaG65z. Transient cerebral ischaemia NOSG65z0 Impending cerebral ischaemiaG65z1 Intermittent cerebral ischaemiaG65zz Transient cerebral ischaemia NOS

F4236 Amaurosis fugax

Fyu55

[X]Other transient cerebral ischaemic attacks and related syndromes

ZV12D [V]Personal history of transient ischaemic attack

9h2.. Exception reporting: stroke quality indicators 9h21. Excepted from stroke quality indicators: Patient unsuitable

9h21. Excepted from stroke quality indicators: Patient unsuitable 9h22. Excepted from stroke quality indicators: Informed

dissent

9h22. Excepted from stroke quality indicators: Informed dissent

G63y0 Cerebral infarct due to thrombosis of precerebral arteries G64z. Cerebral infarction NOS

G63y1 Cerebral infarction due to embolism of precerebral arteries

G64% Cerebral arterial occlusionG665. Pure motor lacunar syndromeG666. Pure sensory lacunar syndrome

G6760 Cerebral infarction due to cerebral venous thrombosis, nonpyogenic

G6W.. Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries

G6X.. Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries

Gyu63 [X]Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries

Gyu64 [X]Other cerebral infarction

Gyu65 [X]Occlusion and stenosis of other precerebral arteries

If known, Strokes should be coded as Ischaemic or Haemorrhagic rather than unspecified. V23 code Gyu62 and ZV125 removed

V22 code F4236 removed. V23 code Fyu55 added

Non-haemorrhagic Stroke

G65..-G654

G656.-G65zz

STROKE / TIA

Stroke Disease Codes

TIA Codes

Gyu63-Gyu66

9h2%Stroke Exception Codes

49

Gyu66 [X]Occlusion and stenosis of other cerebral arteries

Gyu6G [X]Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries

50

To Index


SCIMP Suggested


567.. Computerised axial tomography 569.. Nuclear magnetic resonance5671. CAT scan requested 5675. CAT scan - brain5672. CAT scan normal 567C. CAT scan brain - abnormal5673. CAT scan abnormal 5694. Magnetic resonance imaging of brain abnormal569.. Nuclear magnetic resonance 8HQ3. Refer for NMR scanning5691. Nuclear magn.reson.requested 8HQ4. Refer for CAT scanning5692. Nuclear magn reson normal5693. Nuclear magn.reson. abnormal

5675. CAT scan - brain567C. CAT scan brain - abnormal5694. Magnetic resonance imaging of brain abnormal569F. Magnetic resonance imaging of brain normal569K0 Magnetic resonance imaging of brain5C00. CT scan brain - normal5C12. Computerised tomography brain scan abnormal8HQ3. Refer for NMR scanning8HQ4. Refer for CAT scanning8HBJ. Stroke / transient ischaemic attack referral8HTQ. Referral to stroke clinic

5695. Magnetic resonance imaging scan declined 5695. Magnetic resonance imaging scan declined56F0. CT scan brain declined 56F0. CT scan brain declined

BP Recording Codes

246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j.)








44OE. Plasma total cholesterol level44P.. Serum cholesterol44PH. Total cholesterol measurement44PJ. Serum total cholesterol level44PK. Serum fasting total cholesterol









Cholesterol values should also be recorded for the Contract and your software system will have a system to deal with Read coding of Values. V22 codes removed. V23 code 44PK added.

Requires entry within 3 months before to 1 month after a new Stroke or TIA after 1.4.08.


MRI / CT Scan codes

567..-5673.

569..-5693.

STROKE / TIA cont.

MRI / CT Declined

44P..




Cholesterol code with a value

Total Cholesterol Codes

V22 field added for Stroke8. V23 code 44PK added.

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To Index


SCIMP Suggested










14LX. H/O: dipyridamole allergy 14LX. H/O: dipyridamole allergyTJC44 Adverse reaction to dipyridamole TJC44 Adverse reaction to dipyridamole

U60C3 [X]Coronary vasodilators causing adverse effects in therapeutic use, not elsewhere classified

8I2b. Dipyridamole contraindicated 8I2b. Dipyridamole contraindicated8I3n. Dipyridamole declined 8I3n. Dipyridamole declined8I6a. Dipyridamole not indicated 8I6a. Dipyridamole not indicated8I7J. Dipyridamole not tolerated 8I7J. Dipyridamole not tolerated


Salicylate prescriptions Prescribed in last 15 monthsClopidogrel prescriptions and code 8B6P. Clopidogrel prophylaxis Prescribed in last 15 monthsDipyridamole prescriptions Prescribed in last 15 months

Warfarin Prescriptions and Code 8B2K. Anticoagulant prescribed by third party Prescribed in last 15 months

Dipyridamole CI persisting


Dipyridamole CI expiring





If exception coding, patients require an exception code for Dypyridamole, Aspirin, Warfarin and Clopidogrel to be excluded.


STROKE / TIA cont.

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SCIMP Suggested













STROKE / TIA cont.



65E..-65E4.

Flu vaccine contraindications: expiring Code change in V22 with 9OX5., 8I2F., 8I6D. no longer valid and 9OX51, 8I2F1 and 8I6D1 added.

53

v23 contract codes with scimp suggested codes · salbutamol and ipratropium bromide 33k1. positive...

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