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V26 Contract Codes Index - click on hyperlink Asthma Atrial Fibrillation Cancer Contraception (Additional Services Domain of Contract) Coronary Heart Disease Chronic Kidney Disease COPD CVD Primary Prevention Dementia Depression Diabetes Epilepsy Heart Failure Hypertension Hypothyroid Learning Disabilities Mental Health Obesity Osteoporosis Palliative Care Peripheral Arterial disease (PAD) Public Health Domain - Blood Pressure Rheumatoid Arthritis Smoking Stroke/TIA Notes 1. Codes are taken from Version 26 of the Dept of Health Dataset and Business Rules (published July 2013) with adjustments for Scottish specific areas. 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. 3. Letters in brackets in item column refer to Field Names in the IT specifications 4. In the final column we have added some comments to help with coding and to indicate changes for v25/ V26 (2013-14) compared with previous versions. 5. For all enties that that were previously in last 15 months, this is now required in the last 12 months. 1 Item Asthma Diagnosis (AST) Asthma-related Drug Prescription Indicator Code ASTHMA Code Breakdown To Index Term H33% Asthma H3120 Chronic asthmatic bronchitis 21262 212G. Asthma resolved Asthma resolved Population requires an Asthma code and an asthma related prescription in the last 12 months. AST001 Prescribed in the last year. AST001 Asthma Resolved AST001 Exception Codes (ASTEXC) all except AST001 9hA.. 9hA1. 9hA2. 9OJ2. Exception reporting: asthma quality indicators Excepted from asthma quality indicators: Patient unsuitable Excepted from asthma quality indicators: Informed dissent Refuses asthma monitoring Spirometry reversibility positive Positive reversibility test to salbutamol Positive reversibility test to ipratropium bromide Positive reversibility test to a combination of salbutamol and ipratropium bromide Positive reversibility test to corticosteroids Airways obstruction reversible Post bronchodilator spirometry Referral for spirometry 9hA% Spirometry Codes (ASTSPIR) AST002 33G1. 33H1. 33I1. 33J1. 33K1. 663J. 745D4 8HRC. Spirometry Exception codes (SPEX) AST003 8I3b. 8I6L. 8I2j. 33720 Spirometry test declined Spirometry not indicated Spirometry contraindicated Unable to perform spirometry AST003 33950 339c. 339d. 339g. 339n. 339A. 339B. 66Yc. 66YX. 66YY. Diurnal variation of peak expiratory flow rate Peak expiratory flow rate pre steroids Peak expiratory flow rate post steroids Serial peak expiratory flow rate Serial peak expiratory flow rate abnormal Peak flow rate before bronchodilation Peak flow rate after bronchodilation Number of consecutive days at less than 80% peak expiratory flow rate Peak expiratory flow rate monitoring Peak expiratory flow rate monitoring using diary PEFR Codes (PEFR) Comments v26 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. 2 Code ASTHMA cont. Code Breakdown 137.. 1371. 1372. 1373. 1374. 1375. 1376. 1377. 1378. 1379. 137A. 137B. 137C. 137D. 137F. 137G. 137H. 137j. 137l. 137m. 137n. 137o. 66YJ. 66YK. 66YQ. 66YR. 8B3j. 9OJA. Asthma annual review Asthma follow-up Asthma monitoring by nurse Asthma monitoring by doctor Asthma medication review Asthma monitoring check done 137..-137D. 137F.-137H. 137J. 137K. Smoking Habit Codes (SMOK) AST004 137M.-137T. 137M. 137N. 137O. 137P. 137Q. 137R. 137S. 137T. 137V. 137X.-137h. Review Codes (REV) AST003 To Index Term Tobacco consumption Never smoked tobacco Trivial smoker - < 1 cig/day Light smoker - 1-9 cigs/day Moderate smoker - 10-19 cigs/d Heavy smoker - 20-39 cigs/day Very heavy smoker - 40+cigs/d Ex-trivial smoker (<1/day) Ex-light smoker (1-9/day) Ex-moderate smoker (10-19/day) Ex-heavy smoker (20-39/day) Ex-very heavy smoker (40+/day) Keeps trying to stop smoking Admitted tobacco cons untrue ? Ex-smoker - amount unknown Trying to give up smoking Pipe smoker Cigar smoker Stopped smoking Rolls own cigarettes Ex pipe smoker Ex cigar smoker Cigarette smoker Smoking started Current smoker Ex smoker Date ceased smoking Smoking reduced Cigarette consumption Cigar consumption Tobacco consumption NOS Pipe tobacco consumption Ready to stop smoking Thinking about stopping smoking Not interested in stopping smoking Smoking restarted Reason for restarting smoking Cigarette pack-years Minutes from waking to first tobacco consumption Ex-cigarette smoker Ex roll-up cigarette smoker Failed attempt to stop smoking Total time smoked Waterpipe tobacco consumption 137X. 137Y. 137Z. 137a. 137b. 137c. 137d. 137e. 137f. 137g. 137h. Comments v26 Required recording for 14 to 19 year olds in the last 12 months. Note - these patients will also require Smoking Cessation support (QOF Indicators SMOK004 and SMOK005). 3 Code ASTHMA cont. Code Breakdown To Index Term AST003 6635. 663P. 663P0 663P1 663P2 663Q. 663e. 663e0 663e1 663f. 663w. 663x. Increasing exercise wheeze Asthma limiting activities Asthma limits activities 1 to 2 times per month Asthma limits activities 1 to 2 times per week Asthma limits activities most days Asthma not limiting activities Asthma restricts exercise Asthma sometimes restricts exercise Asthma severely restricts exercise Asthma never restricts exercise Asthma limits walking up hills or stairs Asthma limits walking on the flat Asthma Sleep codes (RCPSLP) AST003 663N. 663N0 663N1 663N2 663O. 663O0 663r. 66YP. 66Yq. 66Yr. 66Ys. Asthma disturbing sleep Asthma causing night waking Asthma disturbs sleep weekly Asthma disturbs sleep frequently Asthma not disturbing sleep Asthma never disturbs sleep Asthma causes night symptoms 1 to 2 times per month Asthma night-time symptoms Asthma causes night time symptoms 1 to 2 times per week Asthma causes symptoms most nights Asthma never causes night symptoms Asthma Day Symptoms (RCPDSYMP) AST003 663q. 663s. 663t. 663u. 663v. Asthma daytime symptoms Asthma never causes daytime symptoms Asthma causes daytime symptoms 1 to 2 times per month Asthma causes daytime symptoms 1 to 2 times per week Asthma causes daytime symptoms most days Asthma Smoking exception code (SMOKASTEXC) AST004 137k. Refusal to give smoking status Asthma Exercise codes (RCPEXCER) Comments v26 4 Code Atrial Fibrillation (AFIB) AF001 Atrial Fibrillation Code Breakdown G573% (excluding G5731) G573. G5730 G5732 G5733 G5734 G5735 G573z To Index Term 212R. Atrial fibrillation resolved Exceptions (AFIBEXC) all except AF001 9hF0. 9hF1. Excep atr fib qual ind: Pt uns Exc atr fib qual ind: Inf diss Salicylate contra-indications:persistent (XSAL) AF003 14LK. ZV148 U6051 TJ53. H/O: aspirin allergy [V]Personal history of aspirin allergy [X]Salicylates causing adverse effects in therapeutic use Adverse reaction to salicylates Salicylate contra-indications:expiring (TXSAL) AF003 8I24. 8I38. 8I66. 8I70. Aspirin prophylaxis contra-indicated Aspirin prophylaxis refused Aspirin not indicated Aspirin not tolerated Excluded 14LP. Warfarin contraindications: persistent (XWAR) Warfarin contraindications: expiring TXWAR) AF003, AF004 AF003, AF004 U6042 ZV14A H/O: warfarin allergy Adverse reaction to anticoagulants Adverse reaction to warfarin sodium Adverse reaction to nicoumalone Adverse reaction to phenindione Adverse reaction to anticoagulants NOS [X]Anticoagulants causing adverse effects in therapeutic use [V]Personal history of warfarin allergy 8I25. 8I3E. 8I65. 8I71. 8I2R. 8I3d. 8I6N. 8I7A. 8I2o. 8IES. 8I611 8I7R. Warfarin contraindicated Warfarin declined Warfarin not indicated Warfarin not tolerated Anticoagulation contraindicated Anticoagulation declined Anticoagulation not indicated Anticoagulation not tolerated Dabigatran contraindicated Dabigatran declined Dabigatran not indicated Dabigatran not tolerated TJ42% (except TJ420) TJ42. TJ421 TJ422 TJ423 TJ42z Comments v26 Atrial fibrillation and flutter Atrial fibrillation Paroxysmal atrial fibrillation Non-rheumatic atrial fibrillation Permanent atrial fibrillation Persistent atrial fibrillation Atrial fibrillation and flutter NOS Removes from population if dated after most recent AFIB code 5 Code Atrial Fibrillation cont. Code Breakdown To Index Term Clopidrogel contraindications:persistent (XCLO) AF003 14LQ. U6048 ZV14B Clopidrogel contraindications:expiring (TXCLO) AF003 8I2K. 8I3R. 8I6B. 8I72. Clopidogrel contraindicated Clopidogrel declined Clopidogrel not indicated Clopidogrel not tolerated Dipyridamole CI persisting (XDIPY) AF003 14LX. TJC44 H/O: dipyridamole allergy Adverse reaction to dipyridamole [X]Coronary vasodilators causing adverse effects in therapeutic use, not elsewhere classified U60C3 H/O: clopidogrel allergy [X]Clopidogrel causing adverse effects in therapeutic use [V]Personal history of clopidogrel allergy Dipyridamole CI expiring (TXDIPY) AF003 8I2b. 8I3n. 8I6a. 8I7J. Dipyridamole contraindicated Dipyridamole declined Dipyridamole not indicated Dipyridamole not tolerated OTC salicylate codes (OSAL) AF003 67I8. 8B63. 8B3T. Advice about taking aspirin Salicylate prophylaxis Over the counter aspirin therapy Salicylate prescriptions (SAL) AF003 8B6P. Clopidogrel prophylaxis Clopidogrel prescriptions and code (CLO) AF003 Dipyridamole prescriptions (DIPY) AF003 Warfarin Prescriptions and code (WAR) AF003, AF004 8B2K. Anticoagulant prescribed by third party Stroke Risk Assessment using CHAD (CHAD) AF002, AF003, AF004 38DE. Congestive heart failure, hypertension, age, diabetes, stroke 2 risk score Comments v26 Needs to be recorded within the last 6 months Prescription for antiplatelets or anticoagulants needs to be within last 6 months. Requires a value for result added. Requires entry every 12 months unless they have had a previous CHADS2 score of >1. 6 Code B0…-B32z. B34..-B6z0 (excluding B677.) CANCER Code Breakdown B0% B1% B2% B3... B30% B31% B32% B34% B35% B36.. B3y.. B3z.. B4% B5% To Index Term Malignant neoplasm of lip, oral cavity and pharynx Malignant neoplasm of digestive organs and peritoneum Malignant neoplasm of respiratory tract and intrathoracic organs Malignant neoplasm of bone, connective tissue, skin and breast Malignant neoplasm of bone and articular cartilage Malignant neoplasm of connective and other soft tissue Malignant melanoma of skin Malignant neoplasm of female breast Malignant neoplasm of male breast Local recurrence of malignant tumour of breast Malignant neoplasm of bone, connective tissue, skin and breast otherwise specified Malignant neoplasm of bone, connective tissue, skin and breast NOS Malignant neoplasm of genitourinary organ Malignant neoplasm of other and unspecified sites Comments v26 Non-melanotic skin cancers excluded. Morphology codes (starting' BB%') also not included. B6% (excluding Malignant neoplasm of lymphatic and haemopoietic tissue B677.) Cancer Diagnosis (CAN) CAN001 Byu..-Byu41 Byu5.-ByuE0 Byu.. Byu0. Byu1% Byu2% Byu3% Byu4. Byu40 Byu41 Byu5% Byu6. Byu7% Byu8% Byu9% ByuA% ByuB% ByuC% ByuD% ByuE. ByuE0 [X]Additional neoplasm classification terms [X]Malignant neoplasm of lip, oral cavity and pharynx [X]Malignant neoplasm of digestive organs [X]Malignant neoplasm of respiratory and intrathoracic organs [X]Malignant neoplasm of bone and articular cartilage [X]Melanoma and other malignant neoplasms of skin [X]Malignant melanoma of other and unspecified parts of face [X]Malignant melanoma of skin, unspecified [X]Malignant neoplasm of mesothelial and soft tissue [X]Malignant neoplasm of breast [X]Malignant neoplasm of female genital organs [X]Malignant neoplasm of male genital organs [X]Malignant neoplasm of urinary tract [X]Malignant neoplasm of eye, brain and other parts of central nervous system [X]Malignant neoplasm of thyroid and other endocrine glands [X]Malignant neoplasm of ill-defined, secondary and unspecified sites [X]Malignant neoplasms of lymphoid, haematopoietic and related tissue [X]Malignant neoplasms of independent (primary) multiple sites [X]Malignant neoplasms of independent (primary) multiple sites Acquired renal cyst with neoplastic change Drash syndrome 9h8.. 9h81. 9h82. Exception reporting: cancer quality indicators Excepted from cancer quality indicators: Patient unsuitable Excepted from cancer quality indicators: Informed dissent K1323 K01w1 Cancer exception codes (CANEXC) all except CAN001 9h8% Cancer Care Review (MDRV) CAN002 For Cancers newly diagnosed in the last 15 months (previously was 18 months). Review is required within 3 months after diagnosis (previously was 6 months). Cancer care review 8BAV. Code Contraception Code Breakdown Multiple other codes automatically included within existing code searches. To Index Term Comments v26 Women age <=54 Emergency Contraception prescriptions and codes (EHC) CON001, CON003 Combined Oral Contraception prescription and code (COC) 61F1. 61A1. Prescribed post-coital OCP Morning after pills given In last 13 months and after 1.4.09 CON001, CON002 6147. Combined oral contraceptive In last 12 months and after 1.4.09 Progestogen only pill prescription and code (POC) CON001 6148. Progestagen only oral contrac. In last 12 months and after 1.4.09. Contraceptive patch prescription (CP) CON001, CON002 Contraceptive Diaphram prescription and code CON001 6161. CAP fitted IUD Insertion prescription and codes 6151. 7E090 ZV251 IUD fitted Introduction of intrauterine contraceptive device In last 10 yrs and after 1.4.09. [V]Intrauterine contraceptive device insertion Insertion of T shaped 375 millimetres squared copper coated intrauterine contraceptive device CON001 In last 12 months and after 1.4.09 61511 In last 12 months and after 1.4.09 6152. 615B. 615Q. 7E092 7E093 7E095 IUD removed IUD expelled Intrauterine contraceptive device removed by other healthcare provider Removal of intrauterine contraceptive device NEC Removal of displaced intrauterine contraceptive device Removal of Mirena coil 7E094 Introduction of Mirena coil 7E096 Replacement of intrauterine system 61R.. Intrauterine system contraception Contraceptive Implant - prescription and codes CON001 7G2AG 61KC. 7G2AH 7G2AJ 9kr.. Insertion of Implanon Insertion of subcutaneous contraceptive implant by other healthcare provider Reinsertion of subcutaneous contraceptive Insertion of etonogestrel radiopaque contraceptive implant Subdermal etonogestrel implant insertion enhanced services administration In last 3 yrs and after 1.4.09. Contraceptive implant removal CON001 7G2H7 7G2HA 7G2HB 7G2HC 61KF. Removal of subcutaneous contraceptive Removal of Implanon Removal of etonogestrel radiopaque contraceptive implant Removal of subcutaneous contraceptive implant using ultrasound guidance Removal of subcutaneous contraceptive implant by other healthcare provider Dated after latest Implant insertion code or prescription. Contraceptive injectable - prescriptions only CON001 Sexual Health Exception codes (SHEXC) 9hK0. all except CON001 9hK1. IUD / IUS Removal CON001 IUS Insertion prescription and code CON001 Dated after latest IUS or IUD code or prescription In last 5 yrs and after 1.4.09. Injection prescriptions are detected if prescribed in the last 12 months Except.sexual health indic.: pt. unsuitable Except. sexual health indic.: informed dissent 7 CONTRACEPTION cont. Code LARC advice (LARCADV +LARCADV2)) LARC Verbal advice (LARCVERB + LARCVERB2) Term 8CAw. Advice about long acting reversible contraception 679K2 Education for intrauterine system CON002, CON003 CON002, CON003 8CAw1 8CAw2 LARC written advice (LARCWRIT +LARCWRIT2) To Index Code Breakdown CON002, CON003 8CEF. 8CEG. Comments v26 Dated in last 12 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 Verbal advice about long acting reversible contraception Written advice about long acting reversible contraception If these codes used then required to enter one code from each section to meet indicator, showing that both written and verbal advice given. Intrauterine device contraception leaflet given Long acting reversible contraception leaflet given 8 Code G3…-G309. G30B.-G330z (excluding G310.) Coronary Heart Disease Codes (IHD) CHD001 G33z-G3401 G342-G35X. G38..-G3z.. CHD Code Breakdown G3… G30.. G300. G301% G302. G303. G304. G305. G306. G307% G308. G309. G30B. G30X% G30y% G30z. G31.. G311% G312. G31y% G32.. G33.. G330% G33z% G34.. G340% G342. G343. G344. G34y% G34z% G35% G38% G39.. G3y.. G3z.. Ischaemic heart disease Acute myocardial infarction Acute anterolateral infarction Other specified anterior myocardial infarction Acute inferolateral infarction Acute inferoposterior infarction Posterior myocardial infarction NOS Lateral myocardial infarction NOS True posterior myocardial infarction Acute subendocardial infarction Inferior myocardial infarction NOS Acute Q-wave infarct Acute posterolateral myocardial infarction Acute transmural myocardial infarction of unspecified site Other acute myocardial infarction Acute myocardial infarction NOS Other acute and subacute ischaemic heart disease Preinfarction syndrome Coronary thrombosis not resulting in myocardial infarction Other acute and subacute ischaemic heart disease Old myocardial infarction Angina pectoris Angina decubitus Angina pectoris NOS Other chronic ischaemic heart disease Coronary atherosclerosis Atherosclerotic cardiovascular disease Ischaemic cardiomyopathy Silent myocardial ischaemia Other specified chronic ischaemic heart disease Other chronic ischaemic heart disease NOS Subsequent myocardial infarction Postoperative myocardial infarction Coronary microvascular disease Other specified ischaemic heart disease Ischaemic heart disease NOS 9h0.. 9h01. 9h02. Exception reporting: CHD quality indicators Excepted from CHD quality indicators: Patient unsuitable Excepted from CHD quality indicators: Informed dissent Gyu3.% (excluding Gyu31) Exception Codes (CHDEXC) all except CHD001 9h0% To Index Term Comments v26 [X]Ischaemic heart diseases 9 Code CHD cont. Code Breakdown G30.. G300. G301% G302. G303. G304. G305. G306. G307% G308. G309. G30B. G30X% G30y% G30z. G35.. G350. G351. G353. G35X. G38.. G380. G381. G382. G383. G384. G38z. To Index Term Gyu34 Gyu36 Acute myocardial infarction Acute anterolateral infarction Other specified anterior myocardial infarction Acute inferolateral infarction Acute inferoposterior infarction Posterior myocardial infarction NOS Lateral myocardial infarction NOS True posterior myocardial infarction Acute subendocardial infarction Inferior myocardial infarction NOS Acute Q-wave infarct Acute posterolateral myocardial infarction Acute transmural myocardial infarction of unspecified site Other acute myocardial infarction Acute myocardial infarction NOS Subsequent myocardial infarction Subsequent myocardial infarction of anterior wall Subsequent myocardial infarction of inferior wall Subsequent myocardial infarction of other sites Subsequent myocardial infarction of unspecified site Postoperative myocardial infarction Postoperative transmural myocardial infarction of anterior wall Postoperative transmural myocardial infarction of inferior wall Postoperative transmural myocardial infarction of other sites Postoperative transmural myocardial infarction of unspecified site Postoperative subendocardial myocardial infarction Postoperative myocardial infarction, unspecified [X]Acute transmural myocardial infarction of unspecified site [X]Subsequent myocardial infarction of unspecified site CHD006(S) 9hM.. 9hM0. 9hM1. Exception reporting: myocardial infarction quality indicators Excepted from myocardial infarction quality indicators: informed dissent Excepted from myocardial infarction quality indicators: patient unsuitable CHD002(S) 246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j., 246k.) O/E - blood pressure reading BP Recording Exception Codes (BPEX) CHD002(S) 8I3Y. Blood pressure procedure refused Maximal BP therapy (HTMAX) CHD002(S) 8BL0. Patient on maximal tolerated antihypertensive therapy G30% (excluding G30A.) Myocardial infarction codes (MI) CHD006(S) G35% G38% Myocardial Infarction exception codes (MIEXC) BP Recording Codes (BP) Comments v26 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. 10 CHD cont. Code To Index Code Breakdown Term Total Cholesterol Codes (CHOL2) CHD003(S) 44OE. 44P.. 44PH. 44PJ. 44PK. 662a. Exception from serum cholesterol target persisting (CHEXC) CHD003(S) U60CA TJC24 TJC25 [X]Statin causing adverse effect in therapeutic use Adverse reaction to simvastatin Adverse reaction to pravastatin Exception from serum cholesterol target expiring (TCHEXC) CHD003(S) 8BL1. 8I3C. 8I27. 8I63. 8I76. Patient on maximal tolerated lipid lowering therapy Statin declined Statins contraindicated Statin not indicated Statin not tolerated Salicylate contra-indications:persistent (XSAL) CHD005(S), CHD006(S) 14LK. ZV148 U6051 TJ53. H/O: aspirin allergy [V]Personal history of aspirin allergy [X]Salicylates causing adverse effects in therapeutic use Adverse reaction to salicylates Salicylate contra-indications:expiring (TXSAL) CHD005(S), CHD006(S) 8I24. 8I38. 8I66. 8I70. Aspirin prophylaxis contra-indicated Aspirin prophylaxis refused Aspirin not indicated Aspirin not tolerated Warfarin contraindications: persistent (XWAR) CHD005(S), CHD006(S) 14LP. Plasma total cholesterol level Serum cholesterol Total cholesterol measurement Serum total cholesterol level Serum fasting total cholesterol Pre-treatment serum cholesterol level U6042 ZV14A H/O: warfarin allergy Adverse reaction to anticoagulants Adverse reaction to warfarin sodium Adverse reaction to nicoumalone Adverse reaction to phenindione Adverse reaction to anticoagulants NOS [X]Anticoagulants causing adverse effects in therapeutic use [V]Personal history of warfarin allergy Warfarin contraindicated Warfarin declined Warfarin not indicated Warfarin not tolerated Anticoagulation contraindicated Anticoagulation declined Anticoagulation not indicated Anticoagulation not tolerated Dabigatran contraindicated Dabigatran declined Dabigatran not indicated Dabigatran not tolerated TJ42% (except TJ420) TJ42. TJ421 TJ422 TJ423 TJ42z Comments v26 Cholesterol values should also be recorded for the Contract and your software system will have a system to deal with Read coding of Values. Warfarin contraindications: expiring TXWAR) CHD005(S), CHD006(S) 8I25. 8I3E. 8I65. 8I71. 8I2R. 8I3d. 8I6N. 8I7A. 8I2o. 8IES. 8I611 8I7R. Clopidrogel contraindications:persistent (XCLO) CHD005(S), CHD006(S) 14LQ. U6048 ZV14B H/O: clopidogrel allergy [X]Clopidogrel causing adverse effects in therapeutic use [V]Personal history of clopidogrel allergy Clopidrogel contraindications:expiring (TXCLO) CHD005(S), CHD006(S) 8I2K. 8I3R. 8I6B. 8I72. Clopidogrel contraindicated Clopidogrel declined Clopidogrel not indicated Clopidogrel not tolerated OTC salicylate codes (OSAL) CHD005(S) 67I8. 8B63. 8B3T. Advice about taking aspirin Salicylate prophylaxis Over the counter aspirin therapy Salicylate prescriptions (SAL) CHD005(S), CHD006(S) CHD005(S), CHD006(S) CHD005(S), CHD006(S) 8B6P. Clopidogrel prophylaxis Prescribed in In last 12 months 8B2K. Anticoagulant prescribed by third party Prescribed in In last 12 months Clopidogrel prescriptions and code (CLO) Warfarin Prescriptions and Code (WAR) Prescribed in In last 12 months 11 CHD cont. Code 14LL. U60B9 U60BA U60BB ZV14C ZVu6i ZVu6o ZVu6q 8I26. 8I2g. 8I2h. 8I2i. 8I36. 8IAS. 8IAT. 8IAV. 8I62. 8I6i. 8I6j. 8I6k. 8I73. 8I7K. 8I7L. 8I7M. Beta blocker contraindicated Bisoprolol contraindicated Carvedilol contraindicated Nebivolol contraindicated Beta blocker therapy refused Bisoprolol therapy refused Carvedilol therapy refused Nebivolol therapy refused Beta blocker not indicated Bisoprolol not indicated Carvedilol not indicated Nebivolol not indicated Beta blocker not tolerated Bisoprolol not tolerated Carvedilol not tolerated Nebivolol not tolerated 14LM. K0430 ZV14D TJC77 TJC78 TJC79 H/O: angiotensin converting enzyme inhibitor allergy Acute renal failure due to ACE inhibitor [X]Angiotensin-converting-enzyme inhibitors causing adverse effects in therapeutic use [V]Personal history of angiotensin-converting-enzyme inhibitor allergy Adverse reaction to captopril Adverse reaction to enalapril Adverse reaction to ramipril 8I28. 8I3D. 8I64. 8I74. Angiotensin converting enzyme inhibitors contraindicated Angiotensin converting enzyme inhibitor declined Angiotensin converting enzyme inhibitor not indicated Angiotensin converting enzyme inhibitor not tolerated CHD006(S) U60B7 Beta Blocker contraindications:expiring (TXBB) CHD006(S) Beta Blocker prescriptions (BB) CHD006(S) CHD006(S) Ace inhibitor contraindications: expiring (TXACE) CHD006(S) TJC6. TJC61 TJC62 TJC63 TJC64 TJC65 TJC66 TJC67 TJC68 TJC6z Comments v26 Prescribed in last 6 months U60C4 Ace inhibitor contraindications: persistent (XACE) Term H/O: betablocker allergy Adverse reaction to betablockers Adverse reaction to acebutolol Adverse reaction to atenolol Adverse reaction to labetalol Adverse reaction to metoprolol Adverse reaction to nadolol Adverse reaction to oxprenolol Adverse reaction to sotalol Adverse reaction to timolol Adverse reaction to betablockers NOS [X]Beta-adrenoreceptor antagonists causing adverse effects in therapeutic use, not elsewhere classified [X]Adverse reaction to bisoprolol [X]Adverse reaction to carvedilol [X]Adverse reaction to nebivolol [V]Personal history of betablocker allergy [X]Personal history of allergy to bisoprolol [X]Personal history of allergy to carvedilol [X]Personal history of allergy to nebivolol TJC6% Beta Blocker contraindications:persistent (XBB) To Index Code Breakdown 12 CHD cont. Code Code Breakdown To Index Term AII antagonist contraindications: persisting (XAII) CHD006(S) 14LN. U60CB ZV14E H/O: angiotensin II receptor antagonist allergy [X]Angiotensin II receptor antagonists causing adverse effects in therapeutic use [V]Personal history of angiotensin II receptor antagonist allergy AII antagonist contraindications: expiring (TXAII) CHD006(S) 8I2H. 8I3P. 8I6C. 8I75. Angiotensin II receptor antagonists contraindicated Angiotensin II receptor antagonist declined Angiotensin II receptor antagonist not indicated Angiotensin II receptor antagonist not tolerated ACE inhibitor prescriptions (ACE) CHD006(S) A II antagonist prescription codes (AII) CHD006(S) Statin contraindications persisting (XSTAT) CHD006(S) CHD006(S) CHD006(S) U60CA TJC24 TJC25 [X]Statin causing adverse effect in therapeutic use Adverse reaction to simvastatin Adverse reaction to pravastatin Flu vaccine contraindications: persisting (XFLU) CHD004(S) 14LJ. U60K4 ZV14F H/O: influenza vaccine allergy [X]Influenza vaccine causing adverse effects in therapeutic use [V]Personal history of influenza vaccine allergy Flu vaccine contraindications: expiring (TXFLU) CHD004(S) 8I2F0 8I6D0 68NE. 68NE0 9OX51 Seasonal influenza vaccination contraindicated Seasonal influenza vaccination not indicated No consent - influenza imm. No consent for seasonal influenza vaccination Seasonal influenza vaccination declined Flu vaccine prescriptions and codes CHD004(S) 65ED. 65E20 65ED0 Seasonal influenza vaccination Seasonal influenza vaccination given by other healthcare provider Seasonal influenza vaccination given by pharmacist Comments v26 Prescribed in last 6 months Prescribed in last 6 months. Statin prescriptions (STAT) Prescribed in the previous 1st September to 31st March. 13 Code CKD Code Breakdown To Index Term Comments v26 Age>=18 CKD Codes Stage 3 - 5 (CKD) CKD001 1Z12. 1Z1B. 1Z1C. 1Z15. 1Z1D. 1Z1E. 1Z16. 1Z1F. 1Z1G. 1Z13. 1Z1H. 1Z1J. 1Z14. 1Z1K. 1Z1L. K053. K054. K055. Excluded CKD codes CKD001 1Z10. 1Z17. 1Z18. 1Z11. 1Z19. 1Z1A. K051. K052. Chronic kidney disease stage 1 CKD stage 1 with proteinuria CKD stage 1 wthout proteinuria Chronic kidney disease stage 2 CKD stage 2 with proteinuria CKD stage 2 wthout proteinuria Chronic kidney disease stage 1 Chronic kidney disease stage 2 Exception codes (CKDEXC) all except CKD001 9hE0. 9hE1. Ex ch kid dis qu ind: Pat uns Ex ch kid dis qua ind: Inf dis BP Recording Codes (BP) CKD002(S) 246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j., 246k.) O/E - blood pressure reading BP Recording Exception Codes (BPEX) CKD002(S) 8I3Y. Blood pressure procedure refused Maximal BP therapy (HTMAX) CKD002(S) 8BL0. Patient on maximal tolerated antihypertensive therapy G2... G20% Hypertension (HYP) CKD003 G24..-G2z.. (excluding G24z1, G2400, G2410, G27..) G240. G240z G241. G241z G244. G24z. G24z0 G24zz G25.. G26.. G28.. G2y.. G2z.. Gyu2. Gyu20 Chronic kidney disease stage 3 CKD stage 3 with proteinuria CKD stage 3 wthout proteinuria Chronic kidney diseas stage 3A CKD stage 3A with proteinuria CKD stge 3A wthout proteinuria Chronic kidney diseas stage 3B CKD stage 3B with proteinuria CKD stge 3B wthout proteinuria Chronic kidney disease stage 4 CKD stage 4 with proteinuria CKD stage 4 wthout proteinuria Chronic kidney disease stage 5 CKD stage 5 with proteinuria CKD stage 5 wthout proteinuria Chronic kidney disease stage 3 Chronic kidney disease stage 4 Chronic kidney disease stage 5 See bottom of sheet for classification of CKD. These codes exclude the patient if dated later than the most recent CKD Codes 3-5. 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. Requires recording in the previous 12 months Hypertensive disease Essential hypertension Secondary malignant hypertension Secondary malignant hypertension NOS Secondary benign hypertension Secondary benign hypertension NOS Hypertension secondary to endocrine disorders Secondary hypertension NOS Secondary renovascular hypertension NOS Secondary hypertension NOS Stage 1 hypertension (NICE - National Institute for Health and Clinical Excellence 2011) Severe hypertension (NICE - National Institute for Health and Clinical Excellence 2011) Stage 2 hypertension (NICE - National Institute for Health and Clinical Excellence 2011) Other specified hypertensive disease Hypertensive disease NOS [X]Hypertensive diseases [X]Other secondary hypertension 14 Code Hypertension resolved (HYPRES) Proteinuria (CKDPRT) CKD cont. Code Breakdown To Index Term CKD003 21261 212K. Hypertension resolved Hypertension resolved CKD003 1Z1B. 1Z1D. 1Z1F. 1Z1H. 1Z1K. R110. R1100 R1103 R110z Chronic kidney disease stage 3 with proteinuria Chronic kidney disease stage 3A with proteinuria Chronic kidney disease stage 3B with proteinuria Chronic kidney disease stage 4 with proteinuria Chronic kidney disease stage 5 with proteinuria [D]Proteinuria [D]Albuminuria [D]Microalbuminuria [D]Proteinuria NOS 14LM. K0430 ZV14D TJC77 TJC78 TJC79 H/O: angiotensin converting enzyme inhibitor allergy Acute renal failure due to ACE inhibitor [X]Angiotensin-converting-enzyme inhibitors causing adverse effects in therapeutic use [V]Personal history of angiotensin-converting-enzyme inhibitor allergy Adverse reaction to captopril Adverse reaction to enalapril Adverse reaction to ramipril U60C4 Ace inhibitor contraindications: persistent (XACE) CKD003 Ace inhibitor contraindications: expiring (TXACE) CKD003 8I28. 8I3D. 8I64. 8I74. Angiotensin converting enzyme inhibitors contraindicated Angiotensin converting enzyme inhibitor declined Angiotensin converting enzyme inhibitor not indicated Angiotensin converting enzyme inhibitor not tolerated Albumin/Creatinine or Protein/Creatinine Ratio (APCR) CKD004 44lD. 46TC. 46TD. Urine protein/creatinine ratio Urine albumin:creatinine ratio Urine microalbumin:creatinine ratio Urine specimen exceptions (URINEEXC) Comments v26 CKD004 9RX.. Declines to give urine specimen AII antagonist contraindications: persisting (XAII) CKD003 14LN. U60CB ZV14E H/O: angiotensin II receptor antagonist allergy [X]Angiotensin II receptor antagonists causing adverse effects in therapeutic use [V]Personal history of angiotensin II receptor antagonist allergy If coded in the previous 12 months AII antagonist contraindications: expiring (TXAII) CKD003 8I2H. 8I3P. 8I6C. 8I75. Angiotensin II receptor antagonists contraindicated Angiotensin II receptor antagonist declined Angiotensin II receptor antagonist not indicated Angiotensin II receptor antagonist not tolerated ACE inhibitor prescriptions (ACE) CKD003 Prescribed in last 6 months A II antagonist prescription codes (AII) CKD003 Prescribed in last 6 months. 15 To Index Classification of CRD - From US National Kidney Foundation Stage 1 - Kidney Damage with normal or raised GFR Stage 2 - Kidney Damage with mild decrease GFR Stage 3 - Moderate decrease in GFR Stage 4 - Severe decrease in GFR Stage 5 - Kidney Failure Chronic Kidney Disease is defined as either kidney damage or GFR<60mL/min/1.73m2 over a 3 month period GFR >=90 60 - 89 30 - 59 15 - 29 < 15 (or dialysis) 16 Code COPD Code Breakdown H3… H31% (except H3101, H31y0, H3122) H32% COPD Diagnosis COPD) COPD001 H36..-H3z.. (excluding H3y0. and H3y1.) To Index Term Comments v26 Chronic obstructive pulmonary disease Chronic bronchitis H36.. H37.. H38.. H39.. H3y.. H3A.. H3z.. Emphysema Mild chronic obstructive pulmonary disease Moderate chronic obstructive pulmonary disease Severe chronic obstructive pulmonary disease Very severe chronic obstructive pulmonary disease Other specified chronic obstructive airways disease End stage chronic obstructive airways disease Chronic obstructive airways disease NOS Eosinophilic bronchitis 9h5.. 9h51. 9h52. Exception reporting: COPD quality indicators Excepted from COPD quality indicators: Patient unsuitable Excepted from COPD quality indicators: Informed dissent H5832 Diagnosis - Exclusion Codes (COPDEXC) all except COPD001 9h5% Spirometry exception codes (SPEX) COPD002, COPD004(S) 8I2j. 8I3b. 8I6L. 33720 Spirometry contraindicated Spirometry test declined Spirometry not indicated Unable to perform spirometry 745D4 Post bronchodilator spirometry COPD Spirometry Codes (COPDSPIR) COPD002 8HRC. Referral for spirometry Requires re-entry every 12 months For patients diagnosed after 1.4.11. Requires entry within 3 months before to 12 months after diagnosis 17 COPD cont. Code 33971 33972 3398. 3399. 339M. 339O. 339O0 Term 339O1 Forced expired volume in 1 second percentage change FEV1 after change of bronchodilator FEV1/FVC ratio normal FEV1/FVC ratio abnormal FEV1/FVC ratio Forced expired volume in 1 second Forced expired volume in 1 second reversibility FEV1/FVC percent Percent predicted FEV1 Percentage predicted forced expiratory volume in 1 second after bronchodilation FEV1/FVC > 70% of predicted FEV1/FVC < 70% of predicted FEV1 before bronchodilation FEV1 after bronchodilation FEV1 pre steroids FEV1 post steroids FEV1/FVC ratio pre steroids FEV1/FVC ratio post steroids FEV1/FVC ratio before bronchodilator FEV1/FVC ratio after bronchodilator Forced expired volume in one second/vital capacity ratio 339R.-339U. Codes for FEV1 (FEV1) To Index Code Breakdown COPD004(S) 339R. 339S. 339S0 339T. 339U. 339a. 339b. 339e. 339f. 339j.-339m. 339j. 339k. 339l. 339m. MRC Rating (MRC) COPD003 173H. 173I. 173J. 173K. 173L. MRC Breathlessness Scale: grade 1 MRC Breathlessness Scale: grade 2 MRC Breathlessness Scale: grade 3 MRC Breathlessness Scale: grade 4 MRC Breathlessness Scale: grade 5 MRC Score >=3 (MRC1) COPD005 173J. 173K. 173L. MRC Breathlessness Scale: grade 3 MRC Breathlessness Scale: grade 4 MRC Breathlessness Scale: grade 5 COPD Review (COPDRVW) COPD003 66YM. 66YB0 66YB1 Chronic obstructive pulmonary disease annual review Chronic obstructive pulmonary disease 3 monthly review Chronic obstructive pulmonary disease 6 monthly review Oxygen Saturation (OXYSAT) COPD005 44YA0 44YA1 44YA3 Oxygen saturation at periphery Peripheral blood oxygen saturation on room air at rest Peripheral blood oxygen saturation on supplemental oxygen at rest Flu vaccine contraindications: persisting (XFLU) COPD006(S) 14LJ. U60K4 ZV14F H/O: influenza vaccine allergy [X]Influenza vaccine causing adverse effects in therapeutic use [V]Personal history of influenza vaccine allergy 8I2F0 Seasonal influenza vaccination contraindicated Flu vaccine contraindications: expiring (TXFLU) COPD006(S) 8I6D0 68NE. 68NE0 9OX51 Seasonal influenza vaccination not indicated No consent - influenza imm. No consent for seasonal influenza vaccination Seasonal influenza vaccination declined Flu vaccine prescriptions and codes COPD006(S) 65ED. 65E20 65ED0 Seasonal influenza vaccination Seasonal influenza vaccination given by other healthcare provider Seasonal influenza vaccination given by pharmacist Comments v26 Requires value added to code Prescribed in the previous 1st September to 31st March. 18 CVD - Primary Prevention Code To Index Code Breakdown Term Comments v26 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. 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). Familial Hypercholesterolaemia C3200 C3201 C3203 C3204 C3205 C3220 Familial hypercholesterolaemia Hyperbetalipoproteinaemia Low-density-lipoprotein-type (LDL) hyperlipoproteinaemia Fredrickson's hyperlipoproteinaemia, type IIa Familial defective apolipoprotein B-100 Familial combined hyperlipidaemia CVD Risk Assessment Exception codes (CVDEXC) all 9hJ0. 9hJ1. Excepted from cardiovascular disease quality indicators: patient unsuitable Excepted from cardiovascular disease quality indicators: informed dissent CVD Risk Assessment Exception codes (CVDEXC1) CVD-PP001 9hJ0. 9hJ1. 9Oh9. 8IAK. 8IEL. 8IEV. 9NSB. Excepted from cardiovascular disease quality indicators: patient unsuitable Excepted from cardiovascular disease quality indicators: informed dissent Cardiovascular disease risk assessment declined Cardiovascular disease high risk review declined QRISK cardiovascular disease risk assessment declined QRISK2 cardiovascular disease risk assessment declined Unsuitable for QRISK2 cardiovascular disease risk assessment CVD Risk Assessment >20% codes (CVDASS1) CVD-PP001 662m. 662n. JBS cardiovascular disease risk 20 - 30 percent over next ten years JBS cardiovascular disease risk >30 percent over next ten years 38B10 CVD (cardiovascular disease) risk assessment by third party 38DF. QRISK cardiovascular disease 10 year risk 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 CVD Risk Assessment codes (CVDASS2) Codes 8IAK., 90h9. , 8IEK., 8IEV,and 9NSB. will only exclude patient from the risk assessment indicator. They will still require lifestyle advice. CVD-PP001 38D6. Lifestyle Counselling (LSAVD) Excludes from the population if diagnosed before the hypertension diagnosis date. CVD-PP002 67H.. Assessing cardiovascular risk using Scottish Intercollegiate Guidelines Network Arrangements being made in Scotland to include this code in specifications score 67H8. Lifestyle counselling Lifestyle advice regarding hypertension [X]Statin causing adverse effect in therapeutic use Adverse reaction to simvastatin Adverse reaction to pravastatin Statin contraindications persisting (XSTAT) CVD-PP001 U60CA TJC24 TJC25 Exception from serum cholesterol target expiring (TCHEXC) CVD-PP001 8BL1. 8I3C. 8I27. 8I63. 8I76. Patient on maximal tolerated lipid lowering therapy Statin declined Statins contraindicated Statin not indicated Statin not tolerated Statin prescriptions (STAT) CVD-PP001 For Scot-PASQ CVD-PP003 68L.. Exercise status screening Requires entry in the last 12 months for new hypertension since 1.4.09 prescribed in the last 6 months There is no data extraction for CVD-PP003. A new codes has been requested for Scot-PASQ. This is the recommended code to use until this becomes available. 19 Code DEMENTIA Code Breakdown Eu02. Eu020 Eu021 Eu022 Eu023 Eu024 Eu02y Eu02z E00.. E000. E001% E002% E003. E004% E00y. E00z. Eu01. Eu010 Eu011 Eu012 Eu013 Eu01y Eu01z To Index Term Comments v26 F116. [X]Dementia in other diseases classified elsewhere [X]Dementia in Pick's disease [X]Dementia in Creutzfeldt-Jakob disease [X]Dementia in Huntington's disease [X]Dementia in Parkinson's disease [X]Dementia in human immunodef virus [HIV] disease [X]Dementia in other specified diseases classif elsewhere [X] Unspecified dementia Senile and presenile organic psychotic conditions Uncomplicated senile dementia Presenile dementia Senile dementia with depressive or paranoid features Senile dementia with delirium Arteriosclerotic dementia Other senile and presenile organic psychoses Senile or presenile psychoses NOS [X]Vascular dementia [X]Vascular dementia of acute onset [X]Multi-infarct dementia [X]Subcortical vascular dementia [X]Mixed cortical and subcortical vascular dementia [X]Other vascular dementia [X]Vascular dementia, unspecified Drug-induced dementia Other alcoholic dementia Chronic alcoholic brain syndrome [X]Dementia in Alzheimer's disease [X]Dementia in Alzheimer's disease with early onset [X]Dementia in Alzheimer's disease with late onset [X]Dementia in Alzheimer's dis, atypical or mixed type [X]Dementia in Alzheimer's disease, unspecified Dementia in conditions EC [X]Delirium superimposed on dementia Alzheimer's disease Alzheimer's disease with early onset Alzheimer's disease with late onset Pick's disease Senile degeneration of brain Lewy body disease Dementia Exclusions (DEMEXC) all except DEM001 9hD0. 9hD1. Exc demen qual ind: Pat unsuit Exc demen qual ind: Inform dis FBC (FBC) DEM003 423.. 426.. 42A.. 42H.. Haemoglobin estimation Red blood cell (RBC) count Mean corpuscular volume (MCV) Total white cell count Requires entry within time period 6 months before to 6 months after the first diagnosis date DEM003 44h4. 44I8. 44h7. 44IE. 44ID. 44IC. 44h9. 44hD. 4Q721 Blood calcium level Serum calcium Plasma calcium level Serum ionized calcium (pH 7.4) level Serum ionised calcium level Corrected serum calcium level Plasma corrected calcium level Blood ionised calcium level Calcium adjusted level Requires entry within time period 6 months before to 6 months after the first diagnosis date Eu02% E00% Dementia DEM001 (DEM) Eu01% E02y1 E012% Eu00% E012. E0120 Eu00. Eu000 Eu001 Eu002 Eu00z E041. Eu041 F110.-F112. Calcium (CALC) F110. F1100 F1101 F111. F112. 20 Code Glucose GLUC) DEM003 DEMENTIA cont. Code Breakdown To Index Term 44TM. 44f% 44g% 44T1% 44T2% 44T3. 44TA. 44TE. 44TF. 44TG. 44TH. 44TI. 44TJ. 44TK. Blood glucose series Serum glucose level Plasma glucose level Random blood sugar Fasting blood sugar 2 hours post food blood sugar Plasma glucose 30 minute blood glucose level 60 minute blood glucose level 90 minute blood glucose level 120 minute blood glucose level 150 minute blood glucose level Blood glucose level Fasting blood glucose level 44U% (excluding 44Uz.) Blood glucose result 44V.. 44V1. 44V2. 44V3. 44V6. 7P172 R102. R10D. R1057 Glucose tolerance test Glucose tolerance test normal Glucose tol. test impaired Glucose tol. test diabetic Extended glucose tolerance test Glucose tolerance test [D]Glucose tolerance test abnormal [D]Elevated blood glucose level [D]Glucose, blood level abnormal Comments v26 Requires entry within time period 6 months before to 6 months after the first diagnosis date IFCC HbA1c (IFCCHBA) DEM003 42W5. Haemoglobin A1c level - IFCC standard Requires entry within time period 6 months before to 6 months after the first diagnosis date Glucose test exception (GLUCEXC) DEM003 8IEG. Blood glucose test declined requires entry in last 12 months DEM003 44J3. 44J9. 44JA. 44JC. 44JD. 44JF. Serum creatinine Serum urea level Plasma urea level Corrected plasma creatinine level Corrected serum creatinine level Plasma creatinine level Requires entry within time period 6 months before to 6 months after the first diagnosis date Liver function (LIVER) DEM003 44E.. 44E9. 44EC. 44G7. 44G9. 44GA. 44GB. Serum bilirubin level Plasma total bilirubin level Serum total bilirubin level Plasma gamma-glutamyl transferase level Serum gamma-glutamyl transferase level Plasma alanine aminotransferase level Serum alanine aminotransferase level Requires entry within time period 6 months before to 6 months after the first diagnosis date. Thyroid function (DEMTFT) DEM003 442W. 442X. 442A. Serum TSH level Plasma TSH level TSH - thyroid stim. hormone Requires entry within time period 6 months before to 6 months after the first diagnosis date DEM003 42T.. 44Le. Serum vitamin B12 Plasma vitamin B12 level Requires entry within time period 6 months before to 6 months after the first diagnosis date Folic acid (FOL) DEM003 42U4. 42U5. 42UE. Red blood cell folate Serum folate Plasma folate level Requires entry within time period 6 months before to 6 months after the first diagnosis date. Dementia review (DEMR) DEM002 6AB.. Dementia Annual Review Requires entry within the previous 12 months and after the Dementia diagnosis date. Renal function (RENAL) Vit B12 (VITB12) 21 Code Depression Code Breakdown To Index Term Comments v26 Population for prevalence is Depression diagnosed since 1.4.2009 with no subsequent 'depression resolved' code. For DEP001 and DEP002 it is for diagnosis in the previous 1st April to 31st March. Age>=18 E0013 E0021 E112% E113% E118. E11y2 E11z2 E130. E135. E2003 E291. E2B.. E2B1. Eu204 Eu251 Eu32. Eu320 Eu321 Eu322 Eu323 Eu324 Eu325 Eu326 Eu327 Eu328 Eu32y Eu32z Eu33. Eu330 Eu331 Presenile dementia with depression Senile dementia with depression Single major depressive episode Recurrent major depressive episode Seasonal affective disorder Atypical depressive disorder Masked depression Reactive depressive psychosis Agitated depression Anxiety with depression Prolonged depressive reaction Depressive disorder NEC Chronic depression [X]Post-schizophrenic depression [X]Schizoaffective disorder, depressive type [X]Depressive episode [X]Mild depressive episode [X]Moderate depressive episode [X]Severe depressive episode without psychotic symptoms [X]Severe depressive episode with psychotic symptoms [X]Mild depression [X]Major depression, mild [X]Major depression, moderately severe [X]Major depression, severe without psychotic symptoms [X]Major depression, severe with psychotic symptoms [X]Other depressive episodes [X]Depressive episode, unspecified [X]Recurrent depressive disorder [X]Recurrent depressive disorder, current episode mild [X]Recurrent depressive disorder, current episode moderate Eu332 [X]Recurrent depressive disorder, current episode severe without psychotic symptoms Eu333 Eu334 Eu33y Eu33z Eu341 Eu412 [X]Recurrent depressive disorder, current episode severe with psychotic symptoms [X]Recurrent depressive disorder, currently in remission [X]Other recurrent depressive disorders [X]Recurrent depressive disorder, unspecified [X]Dysthymia [X]Mixed anxiety and depressive disorder 212S. Depression resolved 9hC0. 9hC1. Exc depr qual: ind: Pat unsuit Exc depressi qual ind: Inf dis Bio-psychosocial assessment codes (BIOPSYC) DEP001 38G5. Biopsychosocial assessment Exception codes for Bio-psychosocial assessment (BIOPSYCEXC) 8IET. Biopsychosocial assessment declined DEP001 9NSA. Unsuitable for biopsychosocial assessment Depression review codes (DEPRVW) DEP002 9H91. 9H92. Depression medication review Depression interim review Depression (For Dep2) (DEPR) Eu32% (excluding Eu32A, Eu32B, Eu329) Eu33% Depression resolved Depression exceptions (DEPEXC) all except DEP001 Requires entry on the same date as the depression diagnosis date Requires entry between 10 and 35 days after diagnosis date 22 Code DIABETES Code Breakdown To Index Term Comments v26 Age >=17 C10.. C109J C109K C10C. C10D. C10E% Diabetes mellitus Insulin treated Type 2 diabetes mellitus Hyperosmolar non-ketotic state in type 2 diabetes mellitus Diabetes mellitus autosomal dominant Diabetes mellitus autosomal dominant type 2 Type 1 diabetes mellitus C10F% (except C10F8) Type 2 diabetes mellitus C10G% C10H% C10M% C10N% PKyP. Secondary pancreatic diabetes mellitus Diabetes mellitus induced by non-steroid drugs Lipoatrophic diabetes mellitus Secondary diabetes mellitus Diabetes insipidus, diabetes mellitus, optic atrophy and deafness Diagnosis Resolved 21263 212H. Diabetes resolved Diabetes resolved Diabetes Exception reporting codes (DMEXC) all except DM001 9h4% Diabetes diagnosis DM) DM001 9h4.. 9h41. 9h42. Exception reporting: diabetes quality indicators Excepted from diabetes quality indicators: Patient unsuitable Excepted from diabetes quality indicators: Informed dissent Codes for maximum tolerated diabetes treatment (DMMAX) DM007(S), DM008(S), DM009(S) 8BL2. Patient on maximal tolerated therapy for diabetes IFCC HbA1c levels IFCCHBA) DM007(S), DM008(S), DM009(S) 42W5. Haemoglobin A1c level - IFCC standardised 2BB% 3128% 3128. 31280 31281 31282 31283 31284 3128Z 3129. 312E.-312G. Retinal screening codes (RET) DM011 58C1. 68A7. 68A8. 66AD. 8HBD. 8HBG. 8HBH. 9N1v. 9N2U. 9N2V. 9N2e. 9N2f. 9NNC. 312E. 312F. 312G. . O/E - retinal inspection Fundoscopy Fundoscopy normal Fundoscopy abnormal Dilated fundoscopy normal Camera fundoscopy Indirect fundoscopy following mydriatic Fundoscopy NOS Eye fundus photography Direct fundoscopy following mydriatic Camera fundoscopy Indirect fundoscopy following mydriatic Retinal photography Diabetic retinopathy screening Digital retinal screening Fundoscopy - diabetic check Retinopathy follow up Diabetic retinopathy 12 month review Diabetic retinopathy 6 month review Seen in diabetic eye clinic Seen by optician Seen by optometrist Seen by ophthalmologist Seen by retinal screener Under care of retinal screener 23 Code DIABETES cont. Code Breakdown To Index Term 8I6F. 8I3X. Diabetic retinopathy screening not indicated Diabetic retinopathy screening refused 9OLD. Diabetic patient unsuitable for digital retinal photography 9m0A. Declined diabetic retinopathy screening DM012 8I6G. 8I3W. 8IAo. 8IB6. Diabetic foot examination not indicated Diabetic foot examination declined Foot pulse check declined Patient unsuitable for foot pulse check Neuropathy testing exception codes (NPTEXC) DM012 8I6G. 8I3W. 8IAn. 8IB5. Diabetic foot examination not indicated Diabetic foot examination declined Neuropathy assessment declined Patient unsuitable for neuropathy assessment Foot risk classification (FRC) DM012 2G5E. 2G5F. 2G5G. 2G5H. 2G5d. 2G5e. 2G5I. 2G5J. 2G5K. 2G5L. O/E - Right diabetic foot at low risk O/E - Right diabetic foot at moderate risk O/E - Right diabetic foot at high risk O/E - Right diabetic foot - ulcerated O/E - Left diabetic foot at increased risk O/E - Right diabetic foot at increased risk O/E - Left diabetic foot at low risk O/E - Left diabetic foot at moderate risk O/E - Left diabetic foot at high risk O/E - Left diabetic foot - ulcerated Right foot amputation (AMPR) DM012 2G42. 2G44. 2G46. O/E - Amputated right leg O/E - Amputated right above knee O/E - Amputated right below knee Left foot amputation (AMPL) DM012 2G43. 2G45. 2G47. O/E - Amputated left leg O/E - Amputated left above knee O/E - Amputated left below knee BP Recording Codes (BP) DM002(S), DM003(S) 246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j., 246k.) O/E - blood pressure reading BP Recording Exception Codes (BPEX) DM002(S), DM003(S) 8I3Y. Blood pressure procedure refused Maximal BP therapy (HTMAX) DM002(S), DM003(S) 8BL0. Patient on maximal tolerated antihypertensive therapy Retinal exclusion codes (RETEXC) Foot examination exception codes (FEEXC) DM011 Comments v26 . 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. 24 DIABETES cont. Code Proteinuria Diagnosis (PRT) To Index Code Breakdown Term R110. R1100 R110z [D]Proteinuria [D]Albuminuria [D]Proteinuria NOS C10EK Type 1 diabetes mellitus with persistent proteinuria C10FL Type 2 diabetes mellitus with persistent proteinuria K08yA K190X Kyu5G Proteinuric diabetic nephropathy Persistent proteinuria, unspecified [X]Persistent proteinuria, unspecified DM006(S) Comments v26 Care should be taken only to use these codes for persistant proteinuria and not for dipstick test results. Microalbuminural Testing (MALT) DM005 46TC. 46TD. Urine albumin:creatinine ratio Urine microalbumin:creatinine ratio V25 reduced codeset to 2 codes. Urine specimen exceptions (URINEEXC) CKD004 9RX.. Declines to give urine specimen If coded in the previous 12 months R1103 [D]Microalbuminuria Microralbuminuria (MAL) DM006(S) C10EL Type 1 diabetes mellitus with persistent microalbuminuria C10FM Type 2 diabetes mellitus with persistent microalbuminuria 14LM. K0430 ZV14D TJC77 TJC78 TJC79 H/O: angiotensin converting enzyme inhibitor allergy Acute renal failure due to ACE inhibitor [X]Angiotensin-converting-enzyme inhibitors causing adverse effects in therapeutic use [V]Personal history of angiotensin-converting-enzyme inhibitor allergy Adverse reaction to captopril Adverse reaction to enalapril Adverse reaction to ramipril U60C4 Ace inhibitor contraindications: persistent (XACE) DM006(S) Ace inhibitor contraindications: expiring (TXACE) DM006(S) 8I28. 8I3D. 8I64. 8I74. Angiotensin converting enzyme inhibitors contraindicated Angiotensin converting enzyme inhibitor declined Angiotensin converting enzyme inhibitor not indicated Angiotensin converting enzyme inhibitor not tolerated AII antagonist contraindications: persisting (XAII) DM006(S) 14LN. U60CB ZV14E H/O: angiotensin II receptor antagonist allergy [X]Angiotensin II receptor antagonists causing adverse effects in therapeutic use [V]Personal history of angiotensin II receptor antagonist allergy AII antagonist contraindications: expiring (TXAII) DM006(S) 8I2H. 8I3P. 8I6C. 8I75. Angiotensin II receptor antagonists contraindicated Angiotensin II receptor antagonist declined Angiotensin II receptor antagonist not indicated Angiotensin II receptor antagonist not tolerated 25 Code DIABETES cont. Code Breakdown To Index Term Comments v26 ACE inhibitor prescriptions (ACE) DM006(S) Prescribed in last 6 months A II antagonist prescription codes (AII) DM006(S) Prescribed in last 6 months. Total Cholesterol Codes (CHOL2) DM004 44OE. 44P.. 44PH. 44PJ. 662a. Plasma total cholesterol level Serum cholesterol Total cholesterol measurement Serum total cholesterol level Pre-treatment serum cholesterol level Exception from serum cholesterol target persisting (CHEXC) DM004 U60CA TJC24 TJC25 [X]Statin causing adverse effect in therapeutic use Adverse reaction to simvastatin Adverse reaction to pravastatin Exception from serum cholesterol target expiring (TCHEXC) DM004 8BL1. 8I3C. 8I27. 8I63. 8I76. Patient on maximal tolerated lipid lowering therapy Statin declined Statins contraindicated Statin not indicated Statin not tolerated Flu vaccine contraindications: persisting (XFLU) DM010(S) 14LJ. U60K4 ZV14F H/O: influenza vaccine allergy [X]Influenza vaccine causing adverse effects in therapeutic use [V]Personal history of influenza vaccine allergy Flu vaccine contraindications: expiring (TXFLU) DM010(S) 8I2F0 8I6D0 68NE. 68NE0 9OX51 Seasonal influenza vaccination contraindicated Seasonal influenza vaccination not indicated No consent - influenza imm. No consent for seasonal influenza vaccination Seasonal influenza vaccination declined Flu vaccine prescriptions and codes FLU) DM010(S) 65ED. 65E20 65ED0 Seasonal influenza vaccination Seasonal influenza vaccination given by other healthcare provider Seasonal influenza vaccination given by pharmacist C/O erectile dysfrunction (EDC) DM015, DM016 1D1B. C/O erectile dysfunction Not C/O erectile dysfunction (EDNC) DM015 1ABJ. Does not complain of erectile dysfunction Diabetic assessment of erectile dysfunction (DMAED) DM016 66Av. Diabetic assessment of erectile dysfunction 66Au. Diabetic erectile dysfunction review 8Hj0. Referral to diabetes structured education programme 8Hj3. Referral to DAFNE diabetes structured education programme 8Hj4. Referral to DESMOND diabetes structured education programme 8Hj5. Referral to XPERT diabetes structured education programme 8IE9. Referral to diabetes education and self management for ongoing and newly diagnosed structured programme declined 8IEa. Referral to DAFNE diabetes structured education programme declined 9OLM. Diabetes structured education programme declined Referred for diabetes structured education programme (DSEP) Diabetes structured education programme exception codes (DSEPEXC) DM014 DM014 Diabetic dietary review (DRV) DM013 66At. 66At0 66At1 Diabetic dietary review Type I diabetic dietary review Type II diabetic dietary review Diabetic dietary review exception codes (DRVEXC DM013 8IAs. Diabetic dietary review declined Cholesterol values should also be recorded for the Contract and your software system will have a system to deal with Read coding of Values. Prescribed in the previous 1st September to 31st March. Requires entry for new diabetes patients (in last year) within 9 months after their diagnosis date 26 Code EPILEPSY Code Breakdown To Index Term Comments v26 Age >=18 Epilepsy Diagnosis (EPIL) EP001 F25% (excluding F2501, F2504, F2511, F2516, F25G., F25y4, F256%, F258.F25A.,F25H.) F25.. F250. F2500 F2502 F2503 F2505 F250y F250z F251. F2510 F2512 F2513 F2514 F2515 F251y F251z F252. F253. F254% F255% F257. F25B. F25C. F25D. F25E. F25F. F25X. F25y. F25y0 F25y1 F25y2 F25y3 F25y5 F25yz F25z. Epilepsy medication Prescription Epilepsy Generalised nonconvulsive epilepsy Petit mal (minor) epilepsy Epileptic seizures - atonic Epileptic seizures - akinetic Lennox-Gastaut syndrome Other specified generalised nonconvulsive epilepsy Generalised nonconvulsive epilepsy NOS Generalised convulsive epilepsy Grand mal (major) epilepsy Epileptic seizures - clonic Epileptic seizures - myoclonic Epileptic seizures - tonic Tonic-clonic epilepsy Other specified generalised convulsive epilepsy Generalised convulsive epilepsy NOS Petit mal status Grand mal status Partial epilepsy with impairment of consciousness Partial epilepsy without mention of impairment of consciousness Kojevnikov's epilepsy Alcohol-induced epilepsy Drug-induced epilepsy Menstrual epilepsy Stress-induced epilepsy Photosensitive epilepsy Status epilepticus, unspecified Other forms of epilepsy Cursive (running) epilepsy Gelastic epilepsy Localization-related(focal)(partial)idiopathic epilepsy and epileptic syndromes with seizures of localised onset Complex partial status epilepticus Panayiotopoulos syndrome Other forms of epilepsy NOS F1321 SC200 Epilepsy NOS Progressive myoclonic epilepsy Traumatic epilepsy 21260 212J. Epilepsy resolved Epilepsy resolved EP001 Epilepsy resolved Prescribed in the previous 6 months. 9h6.. 9h61. 9h62. Exception reporting: epilepsy quality indicators Excepted from epilepsy quality indicators: Patient unsuitable Excepted from epilepsy quality indicators: Informed dissent Epilepsy Exception codes (EPILEXC) all except EP001 9h6% Maximum anticonvulsant therapy (MAXEP) EP002 8BL3. Patient on maximal tolerated anticonvulsant therapy Seizure Free > 12 months (LSZ) EP002 667F. Seizure free >12 months 27 Code EPILEPSY cont. Code Breakdown To Index Term Comments v26 Females aged under 55 Contraceptive counselling (EPILCC) EP003 6110. Contraceptive advice for patients with epilepsy Preconception advice (EPILCA) EP003 67IJ0 Pre-conception advice for patients with epilepsy Pregnancy advice (EPILPA) EP003 67AF. Pregnancy advice for patients with epilepsy Contraceptive advice exceptions (EPILCCEXC) EP003 8IAg. 8IB2. Contraceptive advice for patients with epilepsy declined Contraceptive advice for patients with epilepsy not indicated Pre-conception advice exceptions (EPICCAEXC) EP003 8IAh. 8IB3. Pre-conception advice for patients with epilepsy declined Pre-conception advice for patients with epilepsy not indicated Pregnancy advice exceptions (EPILPAEXC) EP003 8IAi. 8IB4. Pregnancy advice for patients with epilepsy declined Pregnancy advice for patients with epilepsy not indicated L3985 Delivery by caesarean hysterectomy 7E04% (excluding 7E04D) Abdominal excision of uterus 7E05% 7F1A0 7L0A% ZV6G8 Vaginal excision of uterus Caesarean hysterectomy Clearance of pelvis [V]Acquired absence of uterus 7E10% 7E111 7E113 7E115 7E15% 7E160 7E162 7E1C% 7E1D0 159A. ZV25x ZV252 Bilateral excision of adnexa of uterus Salpingoophorectomy of remaining solitary fallopian tube and ovary Salpingectomy of remaining solitary fallopian tube NEC Oophorectomy of remaining solitary ovary NEC Open bilateral occlusion of fallopian tubes Open ligation of remaining solitary fallopian tube Open clipping of remaining solitary fallopian tube Endoscopic bilateral occlusion of fallopian tubes Endoscopic occlusion of remaining solitary fallopian tube H/O: tubal ligation [V]Other sterilisation [V]Sterilisation Hysterectomy codes (HYST2) Sterilisation codes (STERIL) EP003 EP003 Patients require all three codes entered within the last 12 months to meet the 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. Permanent exclusion from indicator Permanent exclusion from indicator 28 Code G58% Heart Failure (HF) HF001 HEART FAILURE Code Breakdown G58.. G580. G5800 G5801 G5802 G5803 G581. G5810 G582. G583. G584. G58z. G1yz1 662f.-662i. 662f. 662g. 662h. 662i. G58% G58.. G580. G5800 G5801 G5802 G5803 G581. G5810 G582. G583. G584. G58z. Heart Failure due to LVSD G1yz1 662f.-662i. 662f. 662g. 662h. 662i. G5yy9 all except HF001 9hH% Echo Declined (ECEXC) Ace inhibitor contraindications: persistent (XACE) HF002 HF002 HF003(S) and HF004(S) Heart failure Congestive heart failure Acute congestive heart failure Chronic congestive heart failure Decompensated cardiac failure Compensated cardiac failure Left ventricular failure Acute left ventricular failure Acute heart failure Heart failure with normal ejection fraction Right ventricular failure Heart failure NOS Rheumatic left ventricular failure New York Heart Assoc. classification - class I New York Heart Assoc. classification - class II New York Heart Assoc. classification - class III New York Heart Assoc. classification - class IV Exception reporting: heart failure quality indicators Excepted from heart failure quality indicators: Patient unsuitable Excepted from heart failure quality indicators: Informed dissent U-S heart scan Echocardiogram abnormal Echocardiogram shows left ventricular systolic dysfunction Echocardiogram shows left ventricular diastolic dysfunction Echocardiogram equivocal Echocardiogram requested Transoesophageal echocardiography Diagnostic echocardiography Transthoracic echocardiography Transoesophageal echocardiography Stress echocardiography Referral for echocardiography 8HTL. Referral to heart failure clinic 8HTL0 Referral to rapid access heart failure clinic R1320 R1322 5531. 5533. 5538. 79380 79382 7P0H6 [D]Echocardiogram abnormal [D]Ultrasound cardiogram abnormal Angiocardiography awaited Angiocardiography abnormal Angiocardiography equivocal Angiocardiography of both right and left sides of heart Angiocardiography of left side of heart NEC Contrast echocardiography 8A544 Monitoring of cardiac output using echocardiography 8H4R. 8HVJ. 8H44. Ref to cardio spec interest GP Private referral to cardiologist Cardiological referral 8H7o0 Fast track heart failure referral for transthoracic two dimensional echocardiogram 56F1. 5534. Echocardiogram declined Angiocardiography declined 14LM. K0430 H/O: angiotensin converting enzyme inhibitor allergy Acute renal failure due to ACE inhibitor [X]Angiotensin-converting-enzyme inhibitors causing adverse effects in therapeutic use [V]Personal history of angiotensin-converting-enzyme inhibitor allergy Adverse reaction to captopril Adverse reaction to enalapril Adverse reaction to ramipril U60C4 ZV14D TJC77 TJC78 TJC79 cdeset changed for 2013-14. Includes wider list of codes. Left ventricular systolic dysfunction 9hH.. 9hH0. 9hH1. 5853. 58531 585f. 585g. 5C20. 33BD. 79352 7P0H. 7P0H0 7P0H1 7P0H4 8HQ7. Echocardiogram (ECOG) Comments v26 Heart failure Congestive heart failure Acute congestive heart failure Chronic congestive heart failure Decompensated cardiac failure Compensated cardiac failure Left ventricular failure Acute left ventricular failure Acute heart failure Heart failure with normal ejection fraction Right ventricular failure Heart failure NOS Rheumatic left ventricular failure New York Heart Assoc. classification - class I New York Heart Assoc. classification - class II New York Heart Assoc. classification - class III New York Heart Assoc. classification - class IV Echocardiogram shows left ventricular systolic dysfunction 585f. Heart Failure Exceptions (HFEXC) To Index Term 29 Code Heart Failure cont. Code Breakdown To Index Term Ace inhibitor contraindications: expiring (TXACE) HF003(S) and HF004(S) 8I28. 8I3D. 8I64. 8I74. AII antagonist contraindications: persisting (XAII) HF003(S) and HF004(S) 14LN. U60CB ZV14E H/O: angiotensin II receptor antagonist allergy [X]Angiotensin II receptor antagonists causing adverse effects in therapeutic use [V]Personal history of angiotensin II receptor antagonist allergy AII antagonist contraindications: expiring (TXAII) HF003(S) and HF004(S) 8I2H. 8I3P. 8I6C. 8I75. Angiotensin II receptor antagonists contraindicated Angiotensin II receptor antagonist declined Angiotensin II receptor antagonist not indicated Angiotensin II receptor antagonist not tolerated Angiotensin converting enzyme inhibitors contraindicated Angiotensin converting enzyme inhibitor declined Angiotensin converting enzyme inhibitor not indicated Angiotensin converting enzyme inhibitor not tolerated Comments v26 ACE inhibitor prescriptions (ACE) HF003(S) and HF004(S) Prescribed in last 6 months A II antagonist prescription codes (AII) HF003(S) and HF004(S) Prescribed in last 6 months. 14LL. TJC00 TJC02 TJC6% Beta Blocker contraindications:persistent (XLBB) HF004(S) TJC6. TJC61 TJC62 TJC63 TJC64 TJC65 TJC66 TJC67 TJC68 TJC6z U60B7 U60B9 U60BA U60BB ZV14C ZVu6i ZVu6o ZVu6q 8I26. 8I2g.-8I2i 8I2g. 8I2h. 8I2i. 8I36. 8IAS. - 8IAV Beta Blocker contraindications:expiring (TXBB) HF004(S) 8IAS. 8IAT. 8IAV. 8I62. 8I6i. - 8I6k. 8I6i. 8I6j. 8I6k. 8I73. 8I7K.-8!7M. Prescription codes for licensed Beta blocker (LBB) HF004(S) Prescription codes for unlicensed Beta blocker HF004(S) (ULBB) 8I7K. 8I7L. 8I7M. H/O: betablocker allergy Adverse reaction to practolol Adverse reaction to propranolol Adverse reaction to betablockers Adverse reaction to acebutolol Adverse reaction to atenolol Adverse reaction to labetalol Adverse reaction to metoprolol Adverse reaction to nadolol Adverse reaction to oxprenolol Adverse reaction to sotalol Adverse reaction to timolol Adverse reaction to betablockers NOS [X]Beta-adrenoreceptor antagonists causing adverse effects in therapeutic use, not elsewhere classified [X]Adverse reaction to bisoprolol [X]Adverse reaction to carvedilol [X]Adverse reaction to nebivolol [V]Personal history of betablocker allergy [X]Personal history of allergy to bisoprolol [X]Personal history of allergy to carvedilol [X]Personal history of allergy to nebivolol Beta blocker contraindicated Bisoprolol contraindicated Carvedilol contraindicated Nebivolol contraindicated Beta blocker therapy refused Bisoprolol therapy refused Carvedilol therapy refused Nebivolol therapy refused Beta blocker not indicated Bisoprolol not indicated Carvedilol not indicated Nebivolol not indicated Beta blocker not tolerated Bisoprolol not tolerated Carvedilol not tolerated Nebivolol not tolerated BISOPROLOL FUMARATE CARVEDILOL NEBIVOLOL Prescribed in last 6 months 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) 30 Code HYPERTENSION Code Breakdown G2... G20% Hypertension (HYP) HYP001 Gyu2. Gyu20 Hypertensive disease Essential hypertension Secondary malignant hypertension Secondary malignant hypertension NOS Secondary benign hypertension Secondary benign hypertension NOS Hypertension secondary to endocrine disorders Secondary hypertension NOS Secondary renovascular hypertension NOS Secondary hypertension NOS Stage 1 hypertension (NICE - National Institute for Health and Clinical Excellence 2011) Severe hypertension (NICE - National Institute for Health and Clinical Excellence 2011) Stage 2 hypertension (NICE - National Institute for Health and Clinical Excellence 2011) Other specified hypertensive disease Hypertensive disease NOS [X]Hypertensive diseases [X]Other secondary hypertension 21261 212K. Hypertension resolved Hypertension resolved G24..-G2z.. (excluding G24z1, G2400, G2410, G27..) G240. G240z G241. G241z G244. G24z. G24z0 G24zz G25.. G26.. G28.. G2y.. G2z.. Hypertension resolved To Index Term 9h3.. 9h31. 9h32. Comments v26 Exception reporting: hypertension quality indicators Excepted from hypertension quality indicators: Patient unsuitable Excepted from hypertension quality indicators: Informed dissent Hypertension Exception Codes (HYPEXC) all except HYP001 9h3% BP Recording Codes (BP) HYP002(S) 246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j., 246k.) O/E - blood pressure reading BP Recording Exception Codes (BPEX) HYP002(S) 8I3Y. Blood pressure procedure refused Maximal BP therapy (HTMAX) HYP002(S) 8BL0. Patient on maximal tolerated antihypertensive therapy 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. Requuires entry in the previous 9 months 31 Code Hypothyroid (THY) THY001 HYPOTHYROID Code Breakdown C04% C03% To Index Term Comments v26 Acquired hypothyroidism Congenital hypothyroidism Prescribed in the previous 6 months. Hypothyroid Medication prescription Hypothyroid Exception Codes (THYEXC) all except THY001 9h7% Thyroid function test codes (TFT) THY002 442% 9h7.. 9h71. 9h72. Exception reporting: thyroid quality indicators Excepted from thyroid quality indicators: Patient unsuitable Excepted from thyroid quality indicators: Informed dissent Thyroid hormone tests 32 Learning disabilities Code To Index Code Breakdown Term Comments v26 Age>=18 E3% Eu7% Learning disabilities (LD) LD001 Eu7.. Eu70% Eu71% Eu72% Eu73% Eu7y% Eu7z% Eu814 Eu815 Eu816 Eu817 Eu81z 918e. Mental retardation [X]Mental retardation [X]Mild mental retardation [X]Moderate mental retardation [X]Severe mental retardation [X]Profound mental retardation [X]Other mental retardation [X]Unspecified mental retardation [X]Moderate learning disability [X]Severe learning disability [X]Mild learning disability [X]Profound learning disability [X]Developmental disorder of scholastic skills, unspecified On learning disability register Learning disabilities Exception Codes (LDEXC) all except LD001 9hL% 9hL.. 9hL0. 9hL1. Exception reporting: learning disability quality indicators Excepted from learning disability quality indicators: informed dissent Excepted from learning disability quality indicators: patient unsuitable Downs Syndrome (DS) LD002 PJ0% PJ0.. PJ00. PJ01. PJ02. PJ0z. Down's syndrome - trisomy 21 Trisomy 21, meiotic nondisjunction Trisomy 21, mosaicism Trisomy 21, translocation Down's syndrome NOS Hypothyroid (THY) LD002 C04% C03% Acquired hypothyroidism Congenital hypothyroidism 442% Thyroid hormone tests Hypothyroid Medication prescription (THYR) LD002 Thyroid function test codes (TFT) LD002 A previous diagnosis of hypothyroidism + on medication will exclude patient from indicator LD2 unless the hypothyroid diagnosis has been made within the last 12 months. Prescription of levothyroxine requires to be in the previous 6 months Prescribed in the previous 6 months. 33 Code Mental Health Code Breakdown E10% E110% E111% E1124 E1134 E114.-E117z E11y% (excluding E11y2) Eu2.. Eu20% Eu21. Eu22% Eu23% Eu24. Eu25% Eu26% Eu2y. Eu2z. Eu30. Eu300 Eu301 Eu302 Eu30y Eu30z Eu31. Schizophrenic disorders Manic disorder, single episode Recurrent manic episodes Single major depressive episode, severe, with psychosis Recurrent major depressive episodes, severe, with psychosis Bipolar affective disorder, currently manic Bipolar affective disorder, currently depressed Mixed bipolar affective disorder Unspecified bipolar affective disorder Other and unspecified manic-depressive psychoses Unspecified manic-depressive psychoses Atypical manic disorder Other mixed manic-depressive psychoses Other and unspecified manic-depressive psychoses NOS Other and unspecified affective psychoses Unspecified affective psychoses NOS Other affective psychosis NOS Paranoid states Other nonorganic psychoses Reactive depressive psychosis Acute hysterical psychosis Reactive confusion Acute paranoid reaction Psychogenic paranoid psychosis Other reactive psychoses Nonorganic psychosis NOS Schizotypal personality [X]Schizophrenia, schizotypal and delusional disorders [X]Schizophrenia [X]Schizotypal disorder [X]Persistent delusional disorders [X]Acute and transient psychotic disorders [X]Induced delusional disorder [X]Schizoaffective disorders [X]Nonorganic psychosis in remission [X]Other nonorganic psychotic disorders [X]Unspecified nonorganic psychosis [X]Manic episode [X]Hypomania [X]Mania without psychotic symptoms [X]Mania with psychotic symptoms [X]Other manic episodes [X]Manic episode, unspecified [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 E114% E115% E116% E117% E11y. E11y0 E11y1 E11y3 E11yz E11z. E11z0 E11zz E12% E13% (excluding E135.) E13.. E130. E131. E132. E133. E134. E13y% E13z. E2122 Eu2% Psychosis, Schizophrenia + bipolar affective disease codes (MH) MH001 Eu30% Eu31% To Index Term Eu314 Eu315 Comments v26 Patients are in the Mental Health population if they have one of these diagnosis codes or they are on Lithium. [X]Bipolar affective disorder, current episode severe depression without psychotic symptoms [X]Bipolar affective disorder, current episode severe depression with psychotic symptoms Eu316 [X]Bipolar affective disorder, current episode mixed Eu317 Eu318 Eu319 Eu31y Eu31z [X]Bipolar affective disorder, currently in remission [X]Bipolar affective disorder type I X]Bipolar affective disorder type II [X]Other bipolar affective disorders [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 34 Code Lithium Prescription codes (LIT + ELIT)) MH001 Stopped Lithium (excluded) Remission from severe Mental Illness (MHREM+MHREM2) MH002-MH008 Mental Health cont. Code Breakdown all except MH001 Comments v26 d6% LITHIUM SALTS prescribed in the last 6 months 665B. Lithium stopped Excludes patient if entered after the last prescription date E1005 E1015 E1025 E1035 E1055 E1075 E1106 E1116 E1146 E1156 E1166 E1176 Eu223 Eu26. Eu317 Eu329 Schizophrenia in remission Hebephrenic schizophrenia in remission Catatonic schizophrenia in remission Paranoid schizophrenia in remission Latent schizophrenia in remission Schizo-affective schizophrenia in remission Single manic episode in full remission Recurrent manic episodes, in full remission Bipolar affective disorder, currently manic, in full remission Bipolar affective disorder, currently depressed, in full remission Mixed bipolar affective disorder, in full remission Unspecified bipolar affective disorder, in full remission [X]Paranoid state in remission [X]Nonorganic psychosis in remission [X]Bipolar affective disorder, currently in remission [X]Single major depressive episode, severe, with psychosis, psychosis in remission [X]Recurrent major depressive episodes, severe, with psychosis, psychosis in remission Exception 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. New information in guidance document about what constitutes 'remission' Eu32A Mental Health Exception codes (MHEXC) To Index Term 9h9% 9h9.. 9h91. 9h92. Exception reporting: mental health quality indicators Excepted from mental health quality indicators: Patient unsuitable Excepted from mental health quality indicators: Informed dissent 8CG6% 8CG6. 8CG60 8CG61 8CG62 8CY.. Care Programme Approach review Initial Care Programme Approach review Ongoing Care Programme Approach review Discharge Care Programme Approach review Review of mental health care plan Agreeing on mental health care plan Mental Health Care Programme Approach Lithium level test (SLIT) MH010 44W8% 44vE. R1053 Serum lithium level Lithium level therapeutic [D]Lithium, blood level abnormal 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 Lithium level Therapeutic (TLIT) MH010 44W80 44vE. Lithium level therapeutic Lithium level therapeutic This code is not required if Lithium values are within the therapeutic range (0.4 - 1.0). Serum Creatinine (CRE) MH009 44J3% 44JC. 44JD. 44JF. Serum creatinine Corrected plasma creatinine level Corrected serum creatinine level Plasma creatinine level Creatinine test results required in the last 9 months TSH test (TSH) MH009 442A% 442K.-442T. 442W. 442X. 442e. TSH - thyroid stim. hormone 30 minute plasma TSH level Serum TSH level Plasma TSH level Blood spot TSH level MH Care plan (MHP) MH002 8CMG1 8CS7. TSH test results required in the last 9 months There are others in this range for different times of testing 35 Mental Health cont. Code Breakdown 136.. 1361. 1362. 1363. 1364. 1365. 1366. 1367. 136A. 136C. 136C. 136D. 136E. 136F. 136G. 136% (excluding 136H. 1368., 1369., 136M., 136I. 136W, 136Y., 136b., 136J. 136e.) 136K. 136L. 136N. 136O. 136P. 136Q. 136R. 136S. 136T. 136V. 136X. 136Z. 136a. 136c. 136d. Alcohol consumption Teetotaller Trivial drinker - <1u/day Light drinker - 1-2u/day Moderate drinker - 3-6u/day Heavy drinker - 7-9u/day Very heavy drinker - >9u/day Stopped drinking alcohol Ex-trivial drinker (<1u/day) Ex-moderate drinker - (3-6u/d) Ex-moderate drinker - (3-6u/d) Ex-heavy drinker - (7-9u/day) Ex-very heavy drinker-(>9u/d) Spirit drinker Beer drinker Drinks beer and spirits Drinks wine Social drinker Alcohol intake above recommended sensible limits Alcohol intake within recommended sensible limits Light drinker Moderate drinker Heavy drinker Very heavy drinker Binge drinker Hazardous alcohol use Harmful alcohol use Alcohol units per week Alcohol units consumed on heaviest drinking day Alcohol consumption NOS Increasing risk drinking Higher risk drinking Lower risk drinking To Index Code Term Comments v26 Alcohol consumption (ALC) MH007 Alcohol Consumption screening declined (ALCEX) MH007 136e. 8IA7. 8IAF. 8IAt. 9k19. Declines to state current alcohol consumption Alcohol consumption screening test declined Brief intervention for excessive alcohol consumption declined Extended intervention for excessive alcohol consumption declined Alcohol assessment declined - enhanced services administration BMI Codes (BMI) MH006 22K% (excluding 22K9., 22K90, 22KA.) Body Mass Index BP Recording Codes (BP) MH003 246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j., 246k.) 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. BP Recording Exception Codes MH003 8I3Y. Blood pressure procedure refused Requires recording within the previous 12 months MH004 44PF. 44l2. 44lF. 44lG. Total cholesterol:HDL ratio Cholesterol/HDL ratio Serum cholesterol/HDL ratio Plasma cholesterol/HDL ratio 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. C3200 C3201 C3203 C3204 C3205 C3220 Familial hypercholesterolaemia Hyperbetalipoproteinaemia Low-density-lipoprotein-type (LDL) hyperlipoproteinaemia Fredrickson's hyperlipoproteinaemia, type IIa Familial defective apolipoprotein B-100 Familial combined hyperlipidaemia Excludes from requiring Tot Chol/HDL test. Requires entry in the previous 12 months 0 Total Cholesterol:HDL (TCHOLHDL) Familial Hypercholesterolaemia (FHYP) 36 Code Mental Health cont. Code Breakdown 44TM. 44f% 44g% 44T1. - 44T3. 44T1. 44T10 44T11 44T12 44T2. 44T3. 44TA. Glucose (GLC) MH005 44TE. - 44TK. (excluding 44TJO44TJ7) 44TE. 44TF. 44TG. 44TH. 44TI. 44TJ. 44TK. 44U% (except 44Uz.) To Index Term Blood glucose series Serum glucose level Plasma glucose level Random blood sugar Random blood sugar normal Random blood sugar low Random blood sugar raised Fasting blood sugar 2 hours post food blood sugar Plasma glucose 30 minute blood glucose level 60 minute blood glucose level 90 minute blood glucose level 120 minute blood glucose level 150 minute blood glucose level Blood glucose level Fasting blood glucose level 44V6. 7P172 R102. R10D. R1057 IFCC HbA1c levels (IFCCHBA) MH005 42W5. Haemoglobin A1c level - IFCC standardised Glucose test exception code (GLUCEXC) MH005 8IEG. Blood glucose test declined MH008 685H. 685I. 685K. 9O8Y. 7E05% 7E040 7E042 7E043 7E046 7E049 7E04B 7E04G 7L0A% 26L3. No smear - benign hysterectomy No smear-amputation of cervix No smear - no cervix No cervical smear required - no uterus Vaginal excision of uterus Abdominal hysterocolpectomy and excision of periuterine tissue Abdominal hysterocolpectomy NEC Total abdominal hysterectomy NEC Radical hysterectomy Total abdominal hysterectomy and bilateral salpingoophorectomy Laparoscopic total abdominal hysterectomy and bilateral salpingo-oophorectomy Total abdominal hysterectomy with conservation of ovaries Clearance of pelvis Uterine cervix absent Hysterectomy and equivalent codes (HYST) Applies only to patients age 40 and over. Patients with diabetes diagnosed more that 12 months ago are excluded. Blood glucose result 44V.. 44V1. 44V2. 44V3. Glucose tolerance test Glucose tolerance test normal Glucose tol. test impaired Glucose tol. test diabetic Extended glucose tolerance test Glucose tolerance test [D]Glucose tolerance test abnormal [D]Elevated blood glucose level [D]Glucose, blood level abnormal 44V.. - 44V3. Comments v26 Permanent exclusion from indicator MH16 37 Mental Health cont. Code Breakdown 4K22. 4K23. 4K24. 4K25. 4K22. - 2K29. 4K26. 4K27. 4K28. 4K29. 4K2C. 4K2H. 4K2F. 4K2G. 4KA1. 4KA3. 4KA4. 6856. 6859. 685B. 685B. - 685D. 685C. 685D. 685R. 7E2A2 7E2A3 ZV762 7E2A0 4K3E. Cervical smear: negative Cerv.smear: mild dyskaryosis Cerv.smear: severe dyskaryosis Cerv.smear:severe dysk.?inv.ca Cervical smear: ? gland neopl. Cervical smear:atrophic change Cerv.smear: mod.dyskaryosis Cerv.smear: borderline changes Smear NAD - no endocervical cells Cervical smear epithelial cells absent Cervical smear pus cells present Cervical smear red blood cells present Vaginal vault smear negative Vaginal vault smear-atrophic Vaginal vault smear abnormal Ca cervix screen - up to date Ca cervix - screen done Ca cervix screen normal Ca cervix screen abnormal Ca cervix screen + fee claim Liquid based cervical cytology screening Papanicolau smear NEC Vaginal vault smear [V]Screening for malignant neoplasm of cervix Examination of female genital tract under anaesthetic and Papanicolau smear HPV - Human papillomavirus test negative 6853. 685L. 8I6K. 9O8Q. Ca cervix screen - not wanted Cervical smear refused Cervical smear not indicated Cerv.smear disclaimer received To Index Code Cervical Smear (SMEAR) MH008 Cervical cytology exceptions (CYTEXC) MH008 Term Comments v26 In Scotland for females age 20 - 60. Requires entry within the previous 5 yrs. Requires entry within the previous 5 years 38 Code Obesity Code Breakdown To Index Term Comments v26 Age >=16 22K5. 22K7. Obesity Body mass index 30+ - obesity Body mass index 40+ - severely obese 22K.. (If has attached Body Mass Index value of >=30) 22KB. (If has attached Baseline body mass index value of >=30) OB001 Need to be recorded in the last 12 months only if value attached of >=30 and recorded in the last 12 months. 39 Osteoporosis: Secondary prevention of Fragility fractures Code Code Breakdown New Area for 2012-13 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. fragility fracture. Fragility fracture (FF) OST001 N331N N331M N330% (excluding N3308, N3309) Osteoporosis OST001 N331H - N331M Comments v26 2. Those age 75+ require code for Fragility fracture Fragility fracture due to unspecified osteoporosis N330. N3300 N3301 N3302 N3303 N3304 N3305 N3306 N3307 N330A N330B N330C N330D N330z N3312 N3313 N3314 N3315 N3316 N3318 - N331B To Index Term N3318 N3319 N331A N331B N331H N331J N331K N331L N331M N3746 NyuB0 NyuB1 NyuB2 NyuB8 9hP.. 9hP0. 9hP1. Osteoporosis Osteoporosis, unspecified Senile osteoporosis Postmenopausal osteoporosis Idiopathic osteoporosis Dissuse osteoporosis Drug-induced osteoporosis Postoophorectomy osteoporosis Postsurgical malabsorption osteoporosis Osteoporosis in endocrine disorders Vertebral osteoporosis Osteoporosis localized to spine Osteoporosis due to corticosteroids Osteoporosis NOS Postoophorectomy osteoporosis with pathological fracture Osteoporosis of disuse with pathological fracture Postsurgical malabsorption osteoporosis with pathological fracture Drug-induced osteoporosis with pathological fracture Idiopathic osteoporosis with pathological fracture Osteoporosis + pathological fracture lumbar vertebrae Osteoporosis + pathological fracture thoracic vertebrae Osteoporosis + pathological fracture cervical vertebrae Postmenopausal osteoporosis with pathological fracture Collapse of cervical vertebra due to osteoporosis Collapse of lumbar vertebra due to osteoporosis Collapse of thoracic vertebra due to osteoporosis Collapse of vertebra due to osteoporosis NOS Fragility fracture due to unspecified osteoporosis Osteoporotic kyphosis [X]Other osteoporosis with pathological fracture [X]Other osteoporosis [X]Osteoporosis in other disorders classified elsewhere [X]Unspecified osteoporosis with pathological fracture Exception reporting: osteoporosis quality indicators Excepted from osteoporosis quality indicators: patient unsuitable Excepted from osteoporosis quality indicators: informed dissent Osteoporosis exception codes (OSTEOEXC) all except OST001 9hP% DEXA scan (without score) OST001 58EG. 58EM. 58EV. Hip DXA scan result osteoporotic Lumbar DXA scan result osteoporotic Femoral neck DEXA scan result osteoporotic Dexa scan (with T score value < -2.5) OST001 58EE. 58EK. 58ES. Hip DXA scan T score Lumbar spine DXA scan T score Femoral neck DEXA scan T score 40 Code Osteoporosis cont. Code Breakdown To Index Term Comments v26 14LT. ZV14K 14La. 14Lb. 14LW. ZV14H 14Lc. 14LT0 14LT1 14LT2 14LT3 14LT4 H/O: bisphosphonate allergy [V]Personal history of bisphosphonate allergy H/O: raloxifene allergy H/O: teriparatide allergy H/O: strontium ranelate allergy [V]Personal history of strontium ranelate allergy H/O denosumab allergy H/O ibandronic acid allergy H/O zoledronic acid monohydrate allergy H/O disodium etidronate allergy H/O alendronic acid allergy H/O risedronate sodium allergy Bone sparing agents contra-indicated, expiring OST002, OST003 (TXBSACAT) 8I3e. 8I6R. 8I7E. 8I2V. 8I6p. 8I7P. 8IEH. 8I2l. 8I6q. 8I7Q. 8IED. 8I2m. 8I3h. 8I6V. 8I7H. 8I2Y. 8I2p. 8I2V0 8IEW. 8I3e0 8I7S. 8I7E0 8I612 8I6R0 8I2V3 8I3e3 8I6R3 8I7E3 8I2V2 8I3e2 8I6R2 8I7E2 8I2V4 8I3e4 8I6R4 8I7E4 8I3e1 8I6R1 8I7E1 8I2V1 Bisphosphonates declined Bisphosphonates not indicated Bisphosphonates not tolerated Bisphosphonates contraindicated Raloxifene not indicated Raloxifene not tolerated Raloxifene declined Raloxifene contraindicated Teriparatide not indicated Teriparatide not tolerated Teriparatide declined Teriparatide contraindicated Strontium ranelate declined Strontium ranelate not indicated Strontium ranelate not tolerated Strontium ranelate contraindicated Denosumab contraindicated Ibandronic acid contraindicated Denosumab declined Ibandronic acid declined Denosumab not tolerated Ibandronic acid not tolerated Denosumab not indicated Ibandronic acid not indicated Alendronic acid contraindicated Alendronic acid declined Alendronic acid not indicated Alendronic acid not tolerated Disodium etidronate contraindicated Disodium etidronate declined Disodium etidronate not indicated Disodium etidronate not tolerated Risedronate sodium contraindicated Risedronate sodium declined Risedronate sodium not indicated Risedronate sodium not tolerated Zoledronic acid monohydrate declined Zoledronic acid monohydrate not indicated Zoledronic acid monohydrate not tolerated Zoledronic acid monohydrate contraindicated Requires entry within the last 12 months OST002, OST003 fo1% fo4% fo6% fo7% fo8% fv1% fu3% fu5% fu9% 8BP1. 8B6c. 8B6b. DISODIUM ETIDRONATE ALENDRONIC ACID RISEDRONATE SODIUM ZOLEDRONIC ACID IBANDRONIC ACID RALOXIFENE HYDROCHLORIDE TERIPARATIDE STRONTIUM DENOSUMAB Teriparatide therapy Intravenous bisphosphonate prophylaxis Osteoporosis medication prophylaxis Requires entry in last 6 months Bone sparing agents contra-indicated, persisting (XBSACAT) Bone sparing agent prescriptions (BSA) OST002, OST003 prescription codes Code Palliative Care Code Breakdown 1Z01. 2JE.. 8B2a. 8BA2. 8BAP. 8BAS. Specialist palliative care treatment - outpatient 8BAe. 8BJ1. 8CM1. Anticipatory palliative care Palliative treatment On gold standards palliative care framework 8CM10 Gold standards framework supportive care stage 1 - advancing disease 8CM11 8CM1% (excluding 8CM15) 8CM12 Gold standards framework supportive care stage 2 - increasing decline 8CM13 8CM14 8CM4. 8CME. 8CMQ. 8CMW3 8CMb. 8H6A. 8H7L. 8H7g. 8HH7. 8IEE Comments v26 Terminal illness - late stage Last days of life Prescription of palliative care anticipatory medication Terminal care Specialist palliative care Specialist palliative care treatment - daycare 8BAT. PC001 To Index Term Gold standards framework supportive care stage 3 - last days: category C - weeks prognosis Gold standards framework supportive care stage 3 - last days: category D - days prognosis Gold standards framework supportive care stage 3 - last days: category B - months prognosis Liverpool care pathway for the dying Has end of life advanced care plan On Liverpool care pathway for the dying End of life care pathway Integrated care priorities for end of life Refer to terminal care consult Refer for terminal care Referral to palliative care service Referred to community specialist palliative care team 9367. Referral to community palliative care team declined Patient held palliative care record 9EB5. DS 1500 Disability living allowance (terminal care) completed 9G8.. Ambulance service notified of patient on end of life care register 9K9.. 9NNd. 9NNf0 9Ng7. 9NgD. 9c0L0 9c0M. 9c0P. 9c0N. ZV57C Palliative care handover form completed Under care of palliative care specialist nurse Under care of palliative care physician On end of life care register Under care of palliative care service Planned palliative oncology treatment Planned supportive care for terminal illness Current palliative oncology treatment Current supportive care for terminal illness [V]Palliative care Population is patients coded since 1.4.2008. 41 Peripheral Arterial Disease Code To Index Code Breakdown G73.. G734. G73y. Term Comments v26 Gyu74 Other peripheral vascular disease Peripheral arterial disease Other specified peripheral vascular disease Peripheral vascular disease NOS Intermittent claudication Peripheral vascular disease NOS [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 PAD002 246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j., 246k.) 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. BP Recording Exception Codes (BPEX) PAD002 8I3Y. Blood pressure procedure refused Requires recording within the previous 12 months Maximal BP therapy (HTMAX) PAD002 8BL0. Patient on maximal tolerated antihypertensive therapy Total Cholesterol Codes (CHOL2) PAD003 44OE. 44P.. 44PH. 44PJ. 44PK. 662a. Plasma total cholesterol level Serum cholesterol Total cholesterol measurement Serum total cholesterol level Serum fasting total cholesterol Pre-treatment serum cholesterol level Exception from serum cholesterol target persisting (CHEXC) U60CA [X]Statin causing adverse effect in therapeutic use PAD003 TJC24 TJC25 Adverse reaction to simvastatin Adverse reaction to pravastatin Exception from serum cholesterol target expiring (TCHEXC) PAD003 8BL1. 8I3C. 8I27. 8I63. 8I76. Patient on maximal tolerated lipid lowering therapy Statin declined Statins contraindicated Statin not indicated Statin not tolerated Peripheral Arterial Disease (PAD) PAD Exception codes (PAD£XC) BP Recording Codes (BP) PAD001 all except PAD001 G73z% (excluding G73z1) G73z. G73z0 G73zz Cholesterol values should also be recorded for the Contract and your software system will have a system to deal with Read coding of Values. Requires recording within the previous 12 months 42 Peripheral Arterial Disease cont. Code Code Breakdown To Index Term Comments v26 Salicylate prescriptions (SAL) PAD004 Clopidogrel prescriptions and code (CLO) PAD004 8B6P. Clopidogrel prophylaxis Prescribed in In last 12 months Warfarin Prescriptions and Code (WAR) PAD004 8B2K. Anticoagulant prescribed by third party Prescribed in In last 12 months. Warfarin acts as an exclusion for being given aspirin or other anti-platelet medication. Therefore there are no exception codes for warfarin therapy. OTC salicylate codes (OSAL) PAD004 67I8. 8B63. 8B3T. Advice about taking aspirin Salicylate prophylaxis Over the counter aspirin therapy Salicylate contra-indications:persistent (XSAL) PAD004 14LK. ZV148 U6051 TJ53. H/O: aspirin allergy [V]Personal history of aspirin allergy [X]Salicylates causing adverse effects in therapeutic use Adverse reaction to salicylates Salicylate contra-indications:expiring (TXSAL) PAD004 8I24. 8I38. 8I66. 8I70. Aspirin prophylaxis contra-indicated Aspirin prophylaxis refused Aspirin not indicated Aspirin not tolerated Clopidrogel contraindications:persistent (XCLO) PAD004 14LQ. U6048 ZV14B H/O: clopidogrel allergy [X]Clopidogrel causing adverse effects in therapeutic use [V]Personal history of clopidogrel allergy Clopidrogel contraindications:expiring (TXCLO) PAD004 8I2K. 8I3R. 8I6B. 8I72. Clopidogrel contraindicated Clopidogrel declined Clopidogrel not indicated Clopidogrel not tolerated Prescribed in In last 12 months Requires recording within the previous 12 months Requires recording within the previous 12 months 43 Public Health - Blood Pressure Code BP Recording Codes (BP) BP001 246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j., 246k.) Code Breakdown To Index Term O/E - blood pressure reading Comments v26 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. Requires entry for all age 40+ within the previous 5 years 44 Rheumatoid Arthritis Code To Index Code Breakdown Term Comments v26 New for 2013-14 For Patients age 16 and over N040% N041. N047. N04X. N04y0 N04y2 Nyu11 Nyu12 Nyu1G Nyu10 Rheumatoid arthritis Felty's syndrome Other rheumatoid arthropathy with visceral or systemic involvement Rheumatic carditis Rheumatoid lung disease Rheumatoid nodule Rheumatoid arthropathy with visceral or systemic involvement NOS Seropositive errosive rheumatoid arthritis Seropositive rheumatoid arthritis, unspecified Rheumatoid lung Adult-onset Still's disease [X]Other seropositive rheumatoid arthritis [X]Other specified rheumatoid arthritis [X]Seropositive rheumatoid arthritis, unspecified [X]Rheumatoid arthritis with involvement of other organs or systems all except RA001 9hR.. 9hR0. 9hR1. Exception reporting: rheumatoid arthritis quality indicators Excepted from rheumatoid arthritis quality indicators: patient unsuitable Excepted from rheumatoid arthritis quality indicators: informed dissent RA003 38DP. QRISK2 cardiovascular disease 10 year risk score 38D6. Assessing cardiovascular risk using Scottish Intercollegiate Guidelines Network Arrangements being made in Scotland to include this code in specifications. Advice to use website version score and can use Diabetes as a proxy for RA untl updates to ASSIGN tool occur. 8IEV. QRISK2 cardiovascular disease risk assessment declined 9NSB. Unsuitable for QRISK2 cardiovascular disease risk assessment 38DB. World Health Organisation FRAX 10 year hip fracture probability score N042% Rheumatoid Arthritis diagnosis (RARTH) RA001 RA Exception codes (RARTHEXC) CVD Assessment tool adjusted for RA (CVDASSRA) CVD Assessment tool adjusted for RA exception codes (CVDASSRAEXC) 38DB1 RA004 38DC. 38DC0 38DC1 World Health Organisation FRAX 10 year osteoporotic fracture probability score QFracture risk calculator Osteoporosis risk assessment refused 9OdC. Osteoporosis risk assessment defaulted RA002 66HB0 Rheumatoid arthritis annual review RA003 C3200 C3201 C3203 C3204 C3205 C3220 Familial hypercholesterolaemia Hyperbetalipoproteinaemia Low-density-lipoprotein-type (LDL) hyperlipoproteinaemia Fredrickson's hyperlipoproteinaemia, type IIa Familial defective apolipoprotein B-100 Familial combined hyperlipidaemia RA Review (RARTHRVW) For patients age 50-90, required in the last 24 months. Patients with osteoporosis or negative bone scan in the last 24 months, or on osteoporosis prevention therapy in last 6 months, are excluded. World Health Organisation FRAX 10 year osteoporotic fracture probability score with bone mineral density World Health Organisation FRAX 10 year osteoporotic fracture probability score with body mass index 9OdB. RA004 Familial Hypercholesterolaemia World Health Organisation FRAX 10 year hip fracture probability score with bone mineral density World Health Organisation FRAX 10 year hip fracture probability score with body mass index 38GR. Fracture risk assessment tool adjusted for RA exception codes (FRCASSRAEXC) For patients age 30-85 requires entry in last 12 months. Patients with CVD, Stroke or familial hypercholesterolaemia removed from this requirement Requires entry in last 12 months. Application made for new codes to act as exceptions for ASSIGN tool. RA003 38DB0 Fracture risk assessment tool adjusted for RA (FRCASSRA) N042. N0420 N0421 N0422 N042z Requires entry within the last 12 months Excludes from the population if diagnosed before the hypertension diagnosis date. 45 Code SMOKING Code Breakdown To Index Term Comments v26 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 as the population for indicators SMOK002 and SMOK005 137.. 1371. 1372. 1373. 1374. 1375. 1376. 1377. 1378. 1379. 137A. 137B. 137C. 137D. 137F. 137G. 137H. 137j. 137l. 137m. 137n. 137o. Tobacco consumption Never smoked tobacco Trivial smoker - < 1 cig/day Light smoker - 1-9 cigs/day Moderate smoker - 10-19 cigs/d Heavy smoker - 20-39 cigs/day Very heavy smoker - 40+cigs/d Ex-trivial smoker (<1/day) Ex-light smoker (1-9/day) Ex-moderate smoker (10-19/day) Ex-heavy smoker (20-39/day) Ex-very heavy smoker (40+/day) Keeps trying to stop smoking Admitted tobacco cons untrue ? Ex-smoker - amount unknown Trying to give up smoking Pipe smoker Cigar smoker Stopped smoking Rolls own cigarettes Ex pipe smoker Ex cigar smoker Cigarette smoker Smoking started Current smoker Ex smoker Date ceased smoking Smoking reduced Cigarette consumption Cigar consumption Tobacco consumption NOS Pipe tobacco consumption Ready to stop smoking Thinking about stopping smoking Not interested in stopping smoking Smoking restarted Reason for restarting smoking Cigarette pack-years Minutes from waking to first tobacco consumption Ex-cigarette smoker Ex roll-up cigarette smoker Failed attempt to stop smoking Total time smoked Waterpipe tobacco consumption 1371. Never smoked tobacco 137..-137D. 137F.-137H. 137J. 137K. Smoking Habit Codes (SMOK) 137M.-137T. 137M. 137N. 137O. 137P. 137Q. 137R. 137S. 137T. 137V. 137X.-137h. Never Smoked (NSMOK) SMOK001 +SMOK002 1377-137B Ex-Smoker (EXSMOK + EXSMOK2 + LEXSMOK)) SMOK001 +SMOK002 137X. 137Y. 137Z. 137a. 137b. 137c. 137d. 137e. 137f. 137g. 137h. 1377. 1378. 1379. 137A. 137B. 137F. 137K. 137N. - 137O. 137S. - 137T. 137j. 137l. 137N. 137O. 137S. 137T. Ex-trivial smoker (<1/day) Ex-light smoker (1-9/day) Ex-moderate smoker (10-19/day) Ex-heavy smoker (20-39/day) Ex-very heavy smoker (40+/day) Ex-smoker - amount unknown Stopped smoking Ex pipe smoker Ex cigar smoker Ex smoker Date ceased smoking Ex-cigarette smoker Ex roll-up cigarette smoker Requires entry in last 12months if aged 15 to 25. If aged over 25 requires entry once ever dated after patients 25th birthday and after their diagnosis date if in a disease group Complex. Requires entry in last 12 months OR, if entered more than a 12 months ago, requires 3 ex-smoker entries dated over a 3 year period with no 'smoker' code subsequently entered. 46 Code SMOKING cont. Code Breakdown 1372. 1373. 1374. 1375. 1376. 137C. 137D. 137G. 137H. all 9hG0. 9hG1. 137k. Except smok qual ind: Pt uns Except smok qual ind: Inf diss Refusal to give smoking status Note - overall exception codes for the individual disease areas will not exclude patients from the Smoking criteria and these codes will also need entry. SMOK004 + SMOK005 8CAL. 8HTK. 8HkQ. 8H7i. 8IAj. 8IEK. 8T08. 8IEo. 9N2k. 13p50 9Ndf. 9Ndg. Smoking cessation advice Referral to stop-smoking clinic Referral to NHS stop smoking service Referral to smoking cessation advisor Smoking cessation advice declined Smoking cessation programme declined Referral to smoking cessation service Referral to smoking cessation service declined Seen by smoking cessation advisor Practice based smoking cessation programme start date Consent given for follow-up by smoking cessation team Declined consent for follow-up by smoking cessation team only one codeid required frm either Support and refer, or pharmacotherapy from either group is now required. Support required in last 24 months but in last 12 months if has one of the specified chronic diseases. Smoking cessation therapy Nicotine replacement therapy using nicotine patches Nicotine replacement therapy using nicotine gum Nicotine replacement therapy using nicotine inhalator Nicotine replacement therapy using nicotine lozenges Other specified smoking cessation therapy Smoking cessation therapy NOS Nicotine replacement therapy provided free Nicotine replacement therapy Over the counter nicotine replacement therapy Smoking cessation drug therapy declined only one codeid required frm either Support and refer, or pharmacotherapy from either group is now required. 137C.-137D. 137G.-137H. 137J. 137M. SMOK001 +SMOK002 +SMOK004 137P.-137R. Support and Refer Stop Smoking Service/ Adviser (REFERSSSA) 745H% Pharmacotherapy (prescriptions + codes) 137P. 137Q. 137R. 137V. 137X.-137f. Smoking Exception reporting codes Comments v26 137h. 137m. 137o. 1372.-1376. Current Smoker Code (CSMOK) To Index Term Trivial smoker - < 1 cig/day Light smoker - 1-9 cigs/day Moderate smoker - 10-19 cigs/d Heavy smoker - 20-39 cigs/day Very heavy smoker - 40+cigs/d Keeps trying to stop smoking Admitted tobacco cons untrue ? Trying to give up smoking Pipe smoker Cigar smoker Rolls own cigarettes Cigarette smoker Smoking started Current smoker Smoking reduced Cigarette consumption Cigar consumption Tobacco consumption NOS Pipe tobacco consumption Ready to stop smoking Thinking about stopping smoking Not interested in stopping smoking Smoking restarted Reason for restarting smoking Minutes from waking to first tobacco consumption Failed attempt to stop smoking Waterpipe tobacco consumption SMOK004 + SMOK005 8B3f. 8B2B. 8B3Y. 8IEM. 137X. 137Y. 137Z. 137a. 137b. 137c. 137d. 137e. 137f. 745H. 745H0 745H1 745H2 745H3 745Hy 745Hz Requires entry within last 12 months. 47 Code STROKE / TIA Code Breakdown G61% (Except G617.) G63y0 G63y1 G64% STIA001 Cerebral infarct due to thrombosis of precerebral arteries Cerebral infarction due to embolism of precerebral arteries Cerebral arterial occlusion Stroke and cerebrovascular accident unspecified G6760 G6W.. G6X.. Gyu62 Gyu63-Gyu66 Gyu63 Gyu64 Gyu65 Gyu66 Gyu6F TIA Codes (TIA) STIA001 G656.-G65zz G65.. G650. G651. G6510 G652. G653. G654. G656. G657. G65y. G65z. G65z0 G65z1 G65zz Transient cerebral ischaemia Basilar artery syndrome Vertebral artery syndrome Vertebro-basilar artery syndrome Subclavian steal syndrome Carotid artery syndrome hemispheric Multiple and bilateral precerebral artery syndromes Vertebrobasilar insufficiency Carotid territory transient ischaemic attack Other transient cerebral ischaemia Transient cerebral ischaemia NOS Impending cerebral ischaemia Intermittent cerebral ischaemia Transient cerebral ischaemia NOS [X]Other transient cerebral ischaemic attacks and related syndromes [V]Personal history of transient ischaemic attack 9h2.. 9h21. 9h22. Exception reporting: stroke quality indicators Excepted from stroke quality indicators: Patient unsuitable Excepted from stroke quality indicators: Informed dissent Fyu55 ZV12D Stroke Exception Codes (STREXC) all except STIA001 9h2% Cerebral infarction due to cerebral venous thrombosis, nonpyogenic Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries [X]Other intracerebral haemorrhage [X]Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries [X]Other cerebral infarction [X]Occlusion and stenosis of other precerebral arteries [X]Occlusion and stenosis of other cerebral arteries [X]Intracerebral haemorrhage in hemisphere, unspecified If known, Strokes should be coded as Ischaemic or Haemorrhagic rather than unspecified. [X]Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries Gyu6G G65..-G654 Comments v26 Intracerebral haemorrhage G66% (excluding G669.) Stroke Disease Codes (STRT) To Index Term 48 Code STROKE / TIA cont. Code Breakdown G63y0 - G63y1 Non-haemorrhagic Stroke (OSTR) G63y0 G63y1 G64% G665. G666. G6760 G6W.. STIA005, STIA007 G6X.. Gyu63 - Gyu66 Gyu63 Gyu64 Gyu65 Gyu66 To Index Term [X]Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries Gyu6G 567.. 5671. 5672. 5673. 569.. 5691. 5692. 5693. 5675. 567C. 5694. 569F. 569K0 5C00. 5C12. 8HQ3. 8HQ4. 8HBJ. 8HTQ. Computerised axial tomography CAT scan requested CAT scan normal CAT scan abnormal Nuclear magnetic resonance Nuclear magn.reson.requested Nuclear magn reson normal Nuclear magn.reson. abnormal CAT scan - brain CAT scan brain - abnormal Magnetic resonance imaging of brain abnormal Magnetic resonance imaging of brain normal Magnetic resonance imaging of brain CT scan brain - normal Computerised tomography brain scan abnormal Refer for NMR scanning Refer for CAT scanning Stroke / transient ischaemic attack referral Referral to stroke clinic STIA002(S) 5695. 56F0. Magnetic resonance imaging scan declined CT scan brain declined STIA003(S) 246%(Except 2460., 2468., 246H., 246I., 246K., 246L., 246M., 246h., 246i., 246j., 246k.) O/E - blood pressure reading BP Recording Exception Codes (BPEX) STIA003(S) 8I3Y. Blood pressure procedure refused Maximal BP therapy (HTMAX) STIA003(S) 8BL0. Patient on maximal tolerated antihypertensive therapy 567..-5673. 569..-5693. MRI / CT Scan codes (SCAN) STIA002(S) MRI / CT Declined (SCEXC) BP Recording Codes (BP) 44OE. 44PH. 44PJ. 44PK. Plasma total cholesterol level Serum cholesterol Serum cholesterol normal Serum cholesterol borderline Serum cholesterol raised Serum cholesterol very high Total cholesterol measurement Serum total cholesterol level Serum fasting total cholesterol 44OE. 44P.. 44PH. 44PJ. Plasma total cholesterol level Serum cholesterol Total cholesterol measurement Serum total cholesterol level 44P.. - 44P4. Total Cholesterol Codes (CHOL) Cholesterol code with a value (CHOL2) STIA004 STIA005 Comments v26 Cerebral infarct due to thrombosis of precerebral arteries Cerebral infarction due to embolism of precerebral arteries Cerebral arterial occlusion Pure motor lacunar syndrome Pure sensory lacunar syndrome Cerebral infarction due to cerebral venous thrombosis, nonpyogenic Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries [X]Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries [X]Other cerebral infarction [X]Occlusion and stenosis of other precerebral arteries [X]Occlusion and stenosis of other cerebral arteries 44P.. 44P1. 44P2. 44P3. 44P4. 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. Cholesterol values should also be recorded for the Contract and your software system will have a system to deal with Read coding of Values. For patients with a non-haemorrhagic stroke or TIA (target Chol<=5) 49 44PK. 662a. Serum fasting total cholesterol Pre-treatment serum cholesterol level 50 Code STROKE / TIA cont. Code Breakdown To Index Term U60CA TJC24 TJC25 [X]Statin causing adverse effect in therapeutic use Adverse reaction to simvastatin Adverse reaction to pravastatin 8BL1. Patient on maximal tolerated lipid lowering therapy 8I3C. 8I27. 8I63. 8I76. Statin declined Statins contraindicated Statin not indicated Statin not tolerated STIA007(S) 14LK. ZV148 U6051 TJ53. H/O: aspirin allergy [V]Personal history of aspirin allergy [X]Salicylates causing adverse effects in therapeutic use Adverse reaction to salicylates Salicylate contra-indications:expiring (TXSAL) STIA007(S) 8I24. 8I38. 8I66. 8I70. Aspirin prophylaxis contra-indicated Aspirin prophylaxis refused Aspirin not indicated Aspirin not tolerated Warfarin contraindications: persistent (XWAR) STIA007(S) Exception from serum cholesterol target persisting (CHEXC) STIA005 Exception from serum cholesterol target expiring (TCHEXC) STIA005 Salicylate contra-indications:persistent (XSAL) 14LP. U6042 ZV14A H/O: warfarin allergy Adverse reaction to anticoagulants Adverse reaction to warfarin sodium Adverse reaction to nicoumalone Adverse reaction to phenindione Adverse reaction to anticoagulants NOS [X]Anticoagulants causing adverse effects in therapeutic use [V]Personal history of warfarin allergy Warfarin contraindicated Warfarin declined Warfarin not indicated Warfarin not tolerated Anticoagulation contraindicated Anticoagulation declined Anticoagulation not indicated Anticoagulation not tolerated Dabigatran contraindicated Dabigatran declined Dabigatran not indicated Dabigatran not tolerated TJ42% (except TJ420) TJ42. TJ421 TJ422 TJ423 TJ42z Warfarin contraindications: expiring TXWAR) STIA007(S) 8I25. 8I3E. 8I65. 8I71. 8I2R. 8I3d. 8I6N. 8I7A. 8I2o. 8IES. 8I611 8I7R. Clopidrogel contraindications:persistent (XCLO) STIA007(S) 14LQ. U6048 ZV14B H/O: clopidogrel allergy [X]Clopidogrel causing adverse effects in therapeutic use [V]Personal history of clopidogrel allergy Clopidrogel contraindications:expiring (TXCLO) STIA007(S) 8I2K. 8I3R. 8I6B. 8I72. Clopidogrel contraindicated Clopidogrel declined Clopidogrel not indicated Clopidogrel not tolerated Dipyridamole CI persisting (XDIPY) STIA007(S) 14LX. TJC44 H/O: dipyridamole allergy Adverse reaction to dipyridamole [X]Coronary vasodilators causing adverse effects in therapeutic use, not elsewhere classified U60C3 Dipyridamole CI expiring (TXDIPY) STIA007(S) 8I2b. 8I3n. 8I6a. 8I7J. Dipyridamole contraindicated Dipyridamole declined Dipyridamole not indicated Dipyridamole not tolerated OTC salicylate codes (OSAL) STIA007(S) 67I8. 8B63. 8B3T. Advice about taking aspirin Salicylate prophylaxis Over the counter aspirin therapy Comments v26 If exception coding, patients require an exception code for Dypyridamole, Aspirin, Warfarin and Clopidogrel to be excluded. 51 Code Salicylate prescriptions (SAL) STROKE / TIA cont. Code Breakdown To Index Term Comments v26 STIA007(S) Clopidogrel prescriptions and code (CLO) STIA007(S) Dipyridamole prescriptions (DIPY) STIA007(S) 8B6P. Clopidogrel prophylaxis Warfarin Prescriptions and Code (WAR) STIA007(S) 8B2K. Anticoagulant prescribed by third party Flu vaccine contraindications: persisting (XFLU) STIA006(S) 14LJ. U60K4 ZV14F H/O: influenza vaccine allergy [X]Influenza vaccine causing adverse effects in therapeutic use [V]Personal history of influenza vaccine allergy Flu vaccine contraindications: expiring (TXFLU) STIA006(S) 8I2F0 8I6D0 68NE. 68NE0 9OX51 Seasonal influenza vaccination contraindicated Seasonal influenza vaccination not indicated No consent - influenza imm. No consent for seasonal influenza vaccination Seasonal influenza vaccination declined STIA006(S) 65ED. 65E20 65ED0 Seasonal influenza vaccination Flu vaccine prescriptions and codes (FLU) For patients with a non-haemorrhagic stroke or TIA .Prescribed in last 12 months Seasonal influenza vaccination given by other healthcare provider Seasonal influenza vaccination given by pharmacist Prescribed in the previous 1st September to 31st March. 52