QOF Recognised Codes (2018 / 2019)

Table of Contents



Asthma

Indicators

Indicator ID Description
AST001 The contractor establishes and maintains a register of patients with asthma, excluding patients with asthma who have been prescribed no asthma-related drugs in the preceding 12 months.
AST002 The percentage of patients aged 8 or over with asthma (diagnosed on or after 1 April 2006), on the register, with measures of variability or reversibility recorded between 3 months before or any time after diagnosis.
AST003 The percentage of patients with asthma, on the register, who have had an asthma review in the preceding 12 months that includes an assessment of asthma control using the 3 RCP questions. (The review and the 3 RCP questions should be completed on the same day)
AST004 The percentage of patients with asthma aged 14 or over and who have not attained the age of 20, on the register, in whom there is a record of smoking status in the preceding 12 months.

QOF Recognised Codes


Diagnosis Of Asthma

Only the following codes are accepted by QOF for the diagnosis of asthma

Code Term
H33 Asthma
(Excluding H333 - Acute Exacerbation of Asthma)
H3120 Chronic asthmatic bronchitis
173A Exercise induced asthma
H3B Asthma-chronic obstructive pulmonary disease overlap syndrome

Patients with the following codes will be excluded from the register

Code Term
21262 Asthma resolved
212G Asthma resolved

Spirometry

QOF recognised Spirometry codes for asthma

Code Term
33G1 Spirometry reversibility positive
33H1 Positive reversibility test to salbutamol
33I1 Positive reversibility test to Ipratropium bromide
33J1 Positive reversib test to combin of salbutamol + Ipratropium br
33K1 Positive reversibility test to corticosteroids
745D4 Post bronchodilator spirometry
663J Airways obstruction reversible
8HRC Referral for spirometry

Peak Flow

QOF recognised peak flow codes for asthma.

Code Term
339n Serial peak expiratory flow rate abnormal
33950 Diurnal variation of peak expiratory flow rate
339A Peak flow rate before bronchodilation
339B Peak flow rate after bronchodilation
339c Peak expiratory flow rate pre steroids
339d Peak expiratory flow rate post steroids
339g Serial peak expiratory flow rate
66YX Peak expiratory flow rate monitoring
66YY Peak expiratory flow rate monitoring using diary
66Yc Number of cons days less than 80% peak expiratory flow rate

Asthma Review Codes

QOF recognised asthma review codes

Code Term
66YJ Asthma annual review
66YK Asthma follow-up
66YQ Asthma monitoring by nurse
66YR Asthma monitoring by doctor
8B3j Asthma medication review
9OJA Asthma monitoring check done

RCP Questions – 1. Asthma Affecting Exercise?

QOF recognised codes

Code Term
6635 Increasing exercise wheeze
663P Asthma limiting activities
663Q Asthma not limiting activities
663e Asthma restricts exercise
663e0 Asthma sometimes restricts exercise
663e1 Asthma severely restricts exercise
663f Asthma never restricts exercise
663w Asthma limits walking up hills or stairs
663x Asthma limits walking on the flat
663P0 Asthma limits activities 1 to 2 times per month
663P1 Asthma limits activities 1 to 2 time per week
663P2 Asthma limits activities most days

RCP Question – 2. Asthma Affecting Sleep?

QOF recognised codes

Code Term
663N Asthma disturbing sleep
663N0 Asthma causing night waking
663N1 Asthma disturbs sleep weekly
663N2 Asthma disturbs sleep frequently
663O Asthma not disturbing sleep
663O0 Asthma never disturbs sleep
663r Asthma causes night symptoms 1 to 2 times per month
66YP Asthma night-time symptoms
66Ys Asthma never causes night symptoms
66Yq Asthma causes night time symptoms 1 to 2 times per week
66Yr Asthma causes symptoms most nights

RCP Question – 3. Asthma Causing Daytime Symptoms?

QOF recognised codes

Code Term
663q Asthma daytime symptoms
663s Asthma never causes daytime symptoms
663t Asthma causes daytime symptoms 1 to 2 times per month
663u Asthma causes daytime symptoms 1 to 2 times per week
663v Asthma causes daytime symptoms most days





Atrial Fibrillation

Indicators

Indicator ID Description
AF001 The contractor establishes and maintains a register of patients with atrial fibrillation.
AF006 The percentage of patients with atrial fibrillation in whom stroke risk has been assessed using the CHA2DS2-VASc score risk stratification scoring system in the preceding 12 months (excluding those patients with a previous CHADS2 or CHA2DS2-VASc score of 2 or more)
AF007 In those patients with atrial fibrillation with a record of a CHA2DS2-VASc score of 2 or more, the percentage of patients who are currently treated with anticoagulation drug therapy

QOF Recognised Codes


Diagnosis of Atrial Fibrillation

Only the following codes are accepted by QOF for the diagnosis of atrial fibrillation

Code Term
G573 Atrial fibrillation and flutter

Patients with the following codes will be excluded from the register

Code Term
212R Atrial fibrillation resolved

CHA2DS2 Scoring

Code Term
38DE0 CHA2DS2 – vascular disease, age, sex category score





Blood Pressure

Patients over the age of 45yrs require to have a blood pressure reading sometime in the past 5 years before the achievement date. Only the following code is recognised with an associated systolic and diastolic blood pressure value.

Code Term
246 o/e – blood pressure reading





Cancer

Indicators

Indicator ID Description
CAN001 The contractor establishes and maintains a register of all cancer patients defined as a 'register of patients with a diagnosis of cancer excluding non-melanotic skin cancers diagnosed on or after 1 April 2003'.
CAN003 The percentage of patients with cancer, diagnosed within the preceding 15 months, who have a patient review recorded as occurring within 6 months of the date of diagnosis.

QOF Recognised Codes


Diagnosis of Cancer

Only the following codes are accepted by QOF for the diagnosis of cancer. Any of the sub-codes can also be used as long as they are not the ones highlighted in red below.

Code Term
B0 Malignant neoplasm of lip, oral cavity and pharynx
B1 Malignant neoplasm of digestive organs and peritoneum
B2 Malig neop of respiratory tract and inthrathoracic organs
B3 Malig neop of bone, connective tissue, skin and breast
(Excluding B33 - Other malignant neoplasm of skin)
B4 Malignant neoplasm of genitourinary organ
B5 Malignant neoplasm of other and unspecified sites
B6 Malignant neoplasm of lymphatic and haemopoietic tissue
(Excluding B677 - Myelodysplatic and myeloproliferative disease)
Byu [X]Additional neoplasm classification terms
(Excluding Byu42 - [X]oth malignant neoplasm/skin of oth+unspecified parts of the face, Byu43 - [X] Malignant neoplasm of the skin, unspecified.)
Byu0 [X]Malignant neoplasm of lip, oral cavity and pharynx
Byu1 [X]Malignant neoplasm of digestive organs
Byu2 [X]Maligannt neoplasm of respiratory and inthrathoracic orga
Byu3 [X]Malignant neoplasm of bone and articular cartilage
Byu4 [X]Melanoma and malignant melanomas of the skin
(Excluding Byu42 - [X]oth malignant neoplasm/skin of oth+unspecified parts of the face, Byu43 - [X] Malignant neoplasm of the skin, unspecified.)
Byu5 [X]Malignant neoplasm of mesothelial and soft tissue
Byu6 [X]Malignant neoplasm of breast
Byu7 [X]Malignant neoplasm of female genital organ
Byu8 [X]Malignant neoplasm of male genital organ
Byu9 [X]Malignant neoplasm of the urinary tract
ByuA [X]Malignant neoplasm of eye, brain and other parts of cent
ByuB [X]Malignant neoplasm of thyroid and other endocrine glands
ByuC [X]Malignant neoplasm of ill-defined, secondary and unspeci
ByuD [X]Malignant neoplasm of lymphoid, haemapoietic and rela
ByuE [X]Malignant neoplasm/independent (primary) multiple sites
K1323 Acquired renal cysts with neoplastic changes
K01w1 Drash syndrome
68W24 Bowel scope (flexible sigmoidoscopy) screen : cancer detected
C184 Multiple endocrine neoplasia syndrome type 1

Cancer Review

Only the following code is recognised by QOF for doing a cancer care review.

Code Term
8BAV Cancer care review





Coronary Heart Disease (CHD)

Indicators

Indicator ID Description
CHD001 The contractor establishes and maintains a register of patients with coronary heart disease.
CHD002 The percentage of patients with coronary heart disease in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less.
CHD005 The percentage of patients with coronary heart disease with a record in the preceding 12 months that aspirin, an alternative anti-platelet therapy, or an anti-coagulant is being taken.
CHD007 The percentage of patients with coronary heart disease who have had influenza immunisation in the preceding 1 August to 31 March.

QOF Recognised Codes


Diagnosis of CHD

The following are QOF recognised diagnosis of CHD. Only the following 2 codes are valid and none of the sub-codes are recognised.

Code Term
G3 Ischaemic heart disease
Gyu3 [X]Ischaemic heart disease

Chronic Kidney Disease(CKD)

Indicators

Indicator ID Description
CKD005 The contractor establishes and maintains a register of patients aged 18 years or over with CKD with classification of categories G3a to G5 (previously stage 3 to 5)

QOF Recognised Codes


Diagnosis of CKD

Only the following codes are accepted by QOF for the diagnosis of CKD. The following has to be the latest codes in the notes. Even if the patients have the following codes but have latest diagnosis code of CKD1, CKD2 or CKD resolved then these patients won’t be picked up in the CKD register.

Code Term
1Z12 Chronic kidney disease 3
1Z13 Chronic kidney disease 4
1Z14 Chronic kidney disease 5
1Z15 Chronic kidney disease 3A
1Z16 Chronic kidney disease 3B
1Z1B Chronic kidney disease stage 3 with proteinuria
1Z1C Chronic kidney disease stage 3 without proteinuria
1Z1D Chronic kidney disease stage 3A with proteinuria
1Z1E Chronic kidney disease stage 3A without proteinuria
1Z1F Chronic kidney disease stage 3B with proteinuria
1Z1G Chronic kidney disease stage 3B without proteinuria
1Z1H Chronic kidney disease stage 4 with proteinuria
1Z1J Chronic kidney disease stage 4 without proteinuria
1Z1K Chronic kidney disease stage 5 with proteinuria
1Z1L Chronic kidney disease stage 5 without proteinuria
1Z1T CKD with GFR category G3a & albuminuria category A1
1Z1V CKD with GFR category G3a & albuminuria category A2
1Z1W CKD with GFR category G3a & albuminuria category A3
1Z1X CKD with GFR category G3b & albuminuria category A1
1Z1Y CKD with GFR category G3b & albuminuria category A2
1Z1Z CKD with GFR category G3b & albuminuria category A3
1Z1a CKD with GFR category G4 & albuminuria category A1
1Z1b CKD with GFR category G4 & albuminuria category A2
1Z1c CKD with GFR category G4 & albuminuria category A3
1Z1d CKD with GFR category G5 & albuminuria category A1
1Z1e CKD with GFR category G5 & albuminuria category A2
1Z1f CKD with GFR category G5 & albuminuria category A3
K053 Chronic kidney disease stage 3
K054 Chronic kidney disease stage 4
K055 Chronic kidney disease stage 5





Chronic Obstructive Pulmonary Disease (COPD)

Indicators

Indicator ID Description
COPD001 The contractor establishes and maintains a register of patients with COPD.
COPD002 The percentage of patients with COPD (diagnosed on or after 1 April 2011) in whom the diagnosis has been confirmed by post bronchodilator spirometry between 3 months before and 12 months after entering on to the register.
COPD003 The percentage of patients with COPD who have had a review, undertaken by a healthcare professional, including an assessment of breathlessness using the Medical Research Council dyspnoea scale in the preceding 12 months.
COPD004 The percentage of patients with COPD with a record of FEV1 in the preceding 12 months
COPD005 The percentage of patients with COPD and Medical Research Council dyspnoea grade ≥3 at any time in the preceding 12 months, with a record of oxygen saturation value within the preceding 12 months.
COPD007 The percentage of patients with COPD who have had influenza immunisation in the preceding 1 August to 31 March.

QOF Recognised Codes


Diagnosis of COPD

Only the following codes are accepted by QOF for the diagnosis of COPD including sub-codes except the ones highlighted in red

Code Term
H3 Chronic obstructive pulmonary disease
(Excludine H3101 - Smoker's cough, H31y0 - Chronic tracheitis, H3122 - acute exacerbation of chronic obstructive airways disease, H3y0 - Chronic obstruct pulmonary dis with acute lower resp infect,
H3y1 - Chron obstruct pulmonary dis with acute exacerbation, unpec)
H31 Chronic bronchitis
(Excludine H3101 - Smoker's cough, H31y0 - Chronic tracheitis, H3122 - acute exacerbation of chronic obstructive airways disease)
H32 Emphysema
H36 Mild chronic obstructive pulmonary disease
H37 Moderate chronic obstructive pulmonary disease
H38 Severe chronic obstructive pulmonary disease
H39 Very severe chronic obstructive pulmonary disease
H3A End stage chronic obstructive airways disease
H3B Asthma-chronic obstructive pulmonary disease overlap syndrome
H3y Other specified chronic obstructive airways disease
(Excluding H3y0 - Chronic obstruct pulmonary dis with acute lower resp infect, H3y1 - Chron obstruct pulmonary dis with acute exacerbation, unpec)
H3z Chronic obstructive airways disease NOS
H4640 Chronic emphysema due to chemical fumes
H4641 Obliterative bronchiolitis due to chemical fumes
Hyu30 [X]Other emphysema
Hyu31 [X]Other specified chronic obstructive pulmonary disease
H5832 Eosinophilic bronchitis

Spirometry

Only the following spirometry codes are recognised by QOF for COPD

Code Term
745D4 Post bronchodilator spirometry
8HRC Referral for spirometry

COPD Review

Only the following COPD review codes are recognised by QOF

Code Term
66YM Chronic obstructive pulmonary disease annual review
66YB0 Chronic obstructive pulmonary disease 3 monthly review
66YB1 Chronic obstructive pulmonary disease 6 monthly review

MRC Breathlessness Scale

Only the following MRC breathlessness scale codes are recognised by QOF for COPD

Code Term
173H MRC Breathlessness Scale: grade 1
173I MRC Breathlessness Scale: grade 2
173J MRC Breathlessness Scale: grade 3
173K MRC Breathlessness Scale: grade 4
173L MRC Breathlessness Scale: grade 5

FEV1

Only the following FEV1 codes are recognised by QOF for COPD

Code Term
3398 FEV1/FVC ratio normal
3399 FEV1/FVC ration abnormal
339M FEV1/FVC ration
339O Forced expiratory volume in 1 second
339R FEV1/FVC percent
339S Percent predicted FEV1
339T FEV1/FVC > 70% predicted
339U FEV1/FVC < 70% predicted
339a FEV1 before bronchodilation
339b FEV1 after bronchodilation
339e FEV1 pre steroids
339f FEV1 post steroids
339j FEV1/FVC ratio pre steroids
339k FEV1/FVC ratio post steroids
339l FEV1/FVC ratio before bronchodilator
339m FEV1/FVC ratio after bronchodilator
33971 Forced expiratory volume in 1 second percentage change
33972 FEV1 after change of bronchodilator
339O0 Forced expiratory volume in 1 second reversibility
339S0 Percentage predicted FEV1 after bronchodilation
339O1 Forced expiratory volume in one second/vital capacity ratio

Oxygen Saturation

The following are the QOF recognised code for oxygen saturation and requires an associated value between 1 and 100.

Code Term
66YA0 Oxygen saturation at periphery
44YA1 Peripheral blood oxygen saturation on room air at rest
44YA3 Peripheral blood oxygen saturation supplimentl oxygen at rest
44YA5 Baseline SpO2 (oxygen saturation at periphery)





Contraception

Indicators

Indicator ID Description
CON001 The contractor establishes and maintains a register of women aged 54 or under who have been prescribed any method of contraception at least once in the last year, or other clinically appropriate interval e.g. last 5 years for an IUS.
CON003 The percentage of women, on the register, prescribed emergency hormonal contraception one or more times in the preceding 12 months by the contractor who have received information from the contractor about long acting reversible methods of contraception at the time of or within 1 month of the prescription.

QOF Recognised Codes


Advice on Long Active Reversible Contraception

To be picked up in CON003, the following code needs to be in the record within a month of prescribing emergency contraception
Either:

Code Term
8CAw Advise about long active reversible contraception
679k2 Education for intrauterine system

Or a combination of one from the following tables on the same date:

Code Term
8CAw2 Written advice about long acting reversible contraception
8CEF Intrauterine device contraception leaflet given
8CEG Long acting reversible contraception leaflet given

And

Code Term
8Caw1 Verbal advice about long acting reversible contraception





Dementia

Indicators

Indicator ID Description
DEM001 The contractor establishes and maintains a register of patients diagnosed with dementia
DEM004 The percentage of patients diagnosed with dementia whose care plan has been reviewed in a face-to-face review in the preceding 12 months
DEM005 The percentage of patients with a new diagnosis of dementia recorded in the preceding 1 April to 31 March with a record of FBC, calcium, glucose, renal and liver function, thyroid function tests, serum vitamin B12 and folate levels recorded between 12 months before or 6 months after entering on to the register

QOF Recognised Codes


Diagnosis of Dementia

Only the following codes are accepted by QOF for the diagnosis of dementia including sub-codes.

Code Term
Eu02 [X]Dementia and other disease classified elsewhere
E00 Senile and presenile oganic psychotic conditions
Eu01 [X] Vascular dementia
E02y1 Drug-induced dementia
E012 Other alchoholic dementia
Eu00 [X]Dementia in Alzheimer's disease
E041 Dementia in conditions EC
F110 Alzheimer's disease
F1100 Alzheimer's disease with early onset
F1101 Alzheimer's disease with late onset
F111 Pick's disease
F112 Senile degeneration of the brain
F116 Lewy body disease
A411 Jacob-Creutzfeldt disease
F118 Frontotemporal degeneration
F21y2 Biswanger's disease
A410 Kuru
Eu107 [X]Men & behave dis due alcoh: resid & late-onset psychot dis
F11x7 Cerebral degeneration due to Jakob - Creutzfeldt disease

Dementia Care Plan and Review Codes

Only the following codes are recognised by QOF

Code Term
8CMZ Dementia care plan
8CSA Dementia advanced care plan agreed
8CMe0 Dementia advanced care plan
8CMZ0 Dementia care plan agreed
8CMG2 Review of dementia advanced care plan
8CMZ1 Dementia care plan reviewed





Depression

Indicators

Indicator IDDescription
DEP003The percentage of patients aged 18 or over with a new diagnosis of depression in the preceding 1 April to 31 March, who have been reviewed not earlier than 10 days after and not later than 56 days after the date of diagnosis

QOF Recognised Codes


Diagnosis of Depression

Only the following codes are accepted by QOF for the diagnosis of depression including sub-codes.

CodeTerm
E0013Presenile dementia with depression
E0021Senile dementia with depression
E112Single major depressive episode
E113Recurrent major depressive episode
E118Seasonal affective disorder
E11y2Atypical depressive episode
E130Reactive depressive psychosis
E135Agitated depression
E2003Anxiety with depression
E291Prolonged depressive reaction
E2BDepressive disorder NEC
E2B1Chronic depression
Eu204[X]Post-schizophrenic depression
Eu251[X]Schizoaffective disorder, depressive type
Eu32[X]Depressive episode
(Excluding
Eu32A - Recurrent major depressive episodes, with psychosis, psychosis in remission,
Eu328 - Antenatal depression,
Eu329 - Single major depressive episode, severe, with psychosis, psychosis in remission)
Eu33[X]Recurrent depressive episode
Eu341Dysthymia
Eu412[X]Mixed anxiety and depressive episode

Patients with the following code will be excluded from the register

CodeTerm
212SDepression resolved

Depression Review Codes

Only the following depression review codes are accepted by QOF

CodeTerm
9H91Depression medication review
9H92Depression interim review





Diabetes

Indicators

Indicator IDDescription
DM017The contractor establishes and maintains a register of all patients aged 17 or over with diabetes mellitus, which specifies the type of diabetes where a diagnosis has been confirmed
DM002The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less
DM003The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/80 mmHg or less
DM004The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) is 5 mmol/l or less
DM006The percentage of patients with diabetes, on the register, with a diagnosis of nephropathy (clinical proteinuria) or micro-albuminuria who are currently treated with an ACE-I (or ARBs)
DM007The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c is 59 mmol/mol or less in the preceding 12 months
DM008The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c is 64 mmol/mol or less in the preceding 12 months
DM009The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA1c is 75 mmol/mol or less in the preceding 12 months
DM012The percentage of patients with diabetes, on the register, with a record of a foot examination and risk classification: 1) low risk (normal sensation, palpable pulses), 2) increased risk (neuropathy or absent pulses), 3) high risk (neuropathy or absent pulses plus deformity or skin changes in previous ulcer) or 4) ulcerated foot within the preceding 12 months
DM014The percentage of patients newly diagnosed with diabetes, on the register, in the preceding 1 April to 31 March who have a record of being referred to a structured education programme within 9 months after entry on to the diabetes register
DM018The percentage of patients with diabetes, on the register, who have had influenza immunisation in the preceding 1 August to 31 March

QOF Recognised Codes


Diagnosis of Diabetes

Only the following codes are accepted by QOF for the diagnosis of diabetes including sub-codes.

CodeTerm
C10Diabetes Mellitus(Excluding C10F8 - Raven's syndrome)
C109JInsulin treated type 2 diabetes mellitus
C109KHyperosmolar non-ketotic state in type 2 diabetes mellitus
C10CDiabetes mellitus autosomal dominant
C10DDiabetes mellitus autosomal dominant type 2
C10EType 1 diabetes mellitus
C10F Type 2 diabetes mellitus(Excluding C10F8 - Raven's syndrome)
C10GSecondary pancreatic diabetes mellitus
C10HDiabetes mellitus induced by non-steroid drugs
C10MLipoatrophic diabetes mellitus
C10NSecondary diabetes mellitus
C10PDiabetes mellitus in remission
C10QMaturity onset diabetes of the young type 5
PKyPDiab insipidus, diab mell, optic atrophy and deafness

The following codes will exclude the patient from the diabetes register. If patient’s diabetes in remission use C10P – Diabetes mellitus in remission.

CodeTerm
21263Diabetes resolved
212HDiabetes resolved

Diabetic Foot Assessment

QOF recognised codes for diabetic foot assessment.

CodeTerm
2G5EO/E - Right diabetic foot at low risk
2G5FO/E - Right diabetic foot at moderate risk
2G5GO/E - Right diabetic foot at high risk
2G5HO/E - Right diabetic foot - ulcerated
2G5IO/E - Left diabetic foot at low risk
2G5JO/E - Left diabetic foot at moderate risk
2G5KO/E - Left diabetic foot at high risk
2G5LO/E - Left diabetic foot - ulcerated
2G5dLeft diabetic foot at increased risk
2G5eRight diabetic foot at increased risk

Referral to Structured Education Programme

QOF recognised codes for referral to structured education programme

CodeTerm
BHj0Referral to diabetes structured education programme
BHj3Referral to DAFNE diabetes structured education programme
BHj4Referral to DESMOND diabetes structured education programme
BHj5Referral to XPERT diabetes structured education programme





Epilepsy

Indicators

Indicator IDDescription
EPIL001The contractor establishes and maintains a register of patients aged 18 or over receiving drug treatment for epilepsy

QOF Recognised Codes


Diagnosis of Epilepsy

Only the following codes are accepted by QOF for the diagnosis of depression including sub-codes.

CodeTerm
F25Epilepsy
(Excluding
F2504 - Jeuvenile absence epilepsy,
F2511 - Neonatal myoclonic epilepsy,
F2516 - Grand mal seizures,
F256 - Infantile spasm,
F258 - post-ictal state,
F259 - Early infact epileptic encephalopathy with suppression bursts,
F25A - Jeuvenile myoclonic epilepsy,
F25G - Severe myoclonic epilepsy in infancy,
F2501 - Pykno epilepsy,
F25y4 - Benign Rolandic epilepsy,
F25H - Generalised seizure)
F1321Progressive myoclonic epilepsy
SC200Traumatic epilepsy

Patients with the following codes will be excluded from the register

CodeTerm
21260Epilepsy resolved
212JEpilepsy resolved





Heart Failure (HF)

Indicators

Indicator IDDescription
HF001The contractor establishes and maintains a register of patients with heart failure.
HF002The percentage of patients with a diagnosis of heart failure (diagnosed on or after 1 April 2006) which has been confirmed by an echocardiogram or by specialist assessment 3 months before or 12 months after entering on to the register
HF003In those patients with a current diagnosis of heart failure due to left ventricular systolic dysfunction, the percentage of patients who are currently treated with an ACE-I or ARB
HF004In those patients with a current diagnosis of heart failure due to left ventricular systolic dysfunction who are currently treated with an ACE-I or ARB, the percentage of patients who are additionally currently treated with a beta-blocker licensed for heart failure

QOF Recognised Codes


Diagnosis of Heart Failure

Only the following codes are accepted by QOF for the diagnosis of heart failure including sub-codes.

CodeTerm
G58Heart failure
G1yz1Rheumatic left ventricular failure
662fNew York Heart Association Classification - Class I
662gNew York Heart Association Classification - Class II
662hNew York Heart Association Classification - Class III
662iNew York Heart Association Classification - Class IV

Echocardiogram

Only the following echocardiogram codes are picked up by QOF searches

CodeTerm
5853U-S heart scan
58531Echocardiogram abnormal
585fEchocardiogram shows left ventricular systolic dysfunction
585gEchocardiogram shows left ventricular diastolic dysfunction
5C20Echocardiogram equivocal
33BDEchocardiogram requested
8HQ7Referral for echocardiography
R1320[D]Echocardiogram abnormal
R1322[D]Ultrasound cardiogram abnormal
5531Angiocardiography awaited
5533Angiocardiography abnormal
5538Angiocardiography equivocal
79380Angiocardiography of both right and left sides of the heart
79382Angiocardiography of left side of the heart NEC
8H4RReferral to cardiology special interest general practitioner
8HVJPrivate referral to cardiologist
8H44Cardiological referral
8H7o0Fast track HF referral for transthoracic 2D echocardiogram
7P0H6Contrast echocardiography
8A544Monitoring of cardiac output using echocardiography
8HTLReferral to heart failure clinic
8HTL0Referral to rapid access heart failure clinic
79352Transoesophageal echocardiography
7P0HDiagnostic echocardiography
7P0H0Transthoracic echocardiography
7P0H1Transoesophageal echocardiography
7P0H4Stress echocardiography





Hypertension

Indicators

Indicator IDDescription
HYP001The contractor establishes and maintains a register of patients with established hypertension
HYP006The percentage of patients with hypertension in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less

QOF Recognised Codes


Diagnosis of Hypertension

Only the following codes are accepted by QOF for the diagnosis of hypertension including sub-codes excepted the ones highlighted in red.

CodeTerm
G20Essential Hypertension
G24Secondary Hypertension
(Excluding G24z1 - Hypertension secondary to drug, G2400 - Secondary malignant renovascular hypertension, G2410 - secondary benign renovascular hypertension)
G25Stage I hypertension (NICE - Nat Ins for Hth Clin Excl 2011)
G26Severe hypertension (Nat Inst for Health Clinical Ex 2011)
G28Stage 2 hypertension (NICE - Nat Ins for Hth Clin Excl 2011)
G2yOther specified hypertensive disease
G2 Hypertensive disease
(Excluding G24z1 - Hypertension secondary to drug, G2400 - Secondary malignant renovascular hypertension, G2410 - secondary benign renovascular hypertension)
Gyu2[X]Hypertensive diseases
Gyu20[X] Other secondary hypertension

Patients with the following codes will be excluded from the register

CodeTerm
21261Hypertension resolved
212KHypertension resolved





Learning Disability

Indicators

Indicator IDDescription
LD004The contractor establishes and maintains a register of patients with learning disabilities

QOF Recognised Codes


Diagnosis of Learning Disability

Only the following codes are accepted by QOF for the diagnosis of learning disability including sub-codes.

CodeTerm
E3Mental retardation
Eu7[X]Mental retardation
Eu814[X]Moderate learning disability
Eu815[X]Severe learning disability
Eu816[X]Mild learning disability
Eu817[X]Profound learning disability
Eu81z[X]Development disorder of scholastic skills, unspecified
Eu818[X]Specific learning disability
918eOn learning disability register





Mental Health

Indicators

Indicator IDDescription
MH001The contractor establishes and maintains a register of patients with schizophrenia, bipolar affective disorder and other psychoses and other patients on lithium therapy
MH002The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive care plan documented in the record, in the preceding 12 months, agreed between individuals, their family and/or carers as appropriate
MH003The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of blood pressure in the preceding 12 months
MH007The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of alcohol consumption in the preceding 12 months
MH008The percentage of women aged 25 or over and who have not attained the age of 65 with schizophrenia, bipolar affective disorder and other psychoses whose notes record that a cervical screening test has been performed in the preceding 5 years
MH009The percentage of patients on lithium therapy with a record of serum creatinine and TSH in the preceding 9 months
MH010The percentage of patients on lithium therapy with a record of lithium levels in the therapeutic range in the preceding 4 months

QOF Recognised Codes


Mental Health Diagnosis

Only the following codes are accepted by QOF for the Mental Health diagnosis including sub-codes.

CodeTerm
E10Schizophrenic disorders
E110Manic disorder, single episode
E111Recurrent manic episodes
E1124Single major depressive episode, severe, with psychosis
E1134Recurrent major depressive episodes, severe, with psychosis
E114Bipolar affective disorder, currently manic
E115Bipolar affective disorder, currently depressed
E116Mixed bipolar affective disorder
E117Unspecified bipolar affective disorder
E11yOther and unspecified manic-depressive psychoses
(Excluding E11y2 - Atypical depressive disorder)
E11zOther and unspecified affective psychoses
E11z0Unspecified affective psychoses NOS
E11zzOther affective psychoses NOS
E12Paranoid states
E13Other nonorganic psychoses
(Excluding E135 - Agitated depression)
E2122Schizotypal personality
Eu2[X]Schizophrenia, schizotypal and delusional disorders
Eu30[X]Manic episode
Eu31[X]Bipolar affective disorder
Eu323[X]Severe depressive episode with psychotic symptoms
Eu333[X]Severe depress disorder cur epi severe with psyc symp
Eu328[X]Major depression, sever with psychotic symptoms
Eu32ARecurrent major depressive episodes, severe, with psychosis, psychosis in remission
Eu329Single major depressive episode, severe, with psychosis, psychosis in remission

Care Plan Agreed Codes

The following codes are the only recognised QOF codes for care plan agreed

CodeTerm
8CYMental Health Care Programme Approach
8CG6Care Programme Approach review
8CS7Agreeing on mental health care plan
8CG62Discharge Care Programme Approach review
8CG60Initial Care Programme Approach review
8CG61Ongoing Care Programme Approach review
8CMG1Review of mental health care plan





Obesity

Indicators

Indicator IDDescription
OB002The contractor establishes and maintains a register of patients aged 18 years or over with a BMI ≥30 in the preceding 12 months.

QOF Recognised Codes


Obesity Diagnosis

Patients who have a BMI of greater than 30 are picked up on the register plus those with the following QOF codes are also picked regardless of whether they have a BMI recorded or not.

CodeTerm
22K5Body mass home 30+ - obesity
22K7Body mass home 40+ - severely obese
22KCObese class I (body mas home 30.0 - 34.9)
22KDObese class II (body mass home 35.0 - 39.9)
22KEObese class III (BMI equal to or greater than 40.0)





Osteoporosis

Indicators

Indicator IDDescription
OST004The contractor establishes and maintains a register of patients:

1. Aged 50 or over and who have not attained the age of 75 with a record of a fragility fracture on or after 1 April 2012 and a diagnosis of osteoporosis confirmed on DXA scan, and

2. Aged 75 or over with a record of a fragility fracture on or after 1 April 2014 and a diagnosis of osteoporosis.
OST002The percentage of patients aged 50 or over and who have not attained the age of 75, with a fragility fracture on or after 1 April 2012, in whom osteoporosis is confirmed on DXA scan, who are currently treated with an appropriate bone-sparing agent.
OST005The percentage of patients aged 75 or over with a record of a fragility fracture on or after 1 April 2014 and a diagnosis of osteoporosis, who are currently treated with an appropriate bone-sparing agent.

QOF Recognised Codes


Fracture Diagnosis

Codes recognised by QOF for Diagnosis of fracture (fragility fracture)

CodeTerm
N331NFragility fracture
N331MFragility fracture due to unspecified osteoporosis

Osteoporosis Diagnosis

Codes recognised by QOF for Diagnosis of Osteoporosis including sub-codes except those highlighted in red

CodeTerm
N330Osteoporosis
(Excluding N3308 - Localised osteoporosis - Lequesne, N3309 - Osteoporosis in multiple myelomatosis)
N3312Postoophorectomy osteoporosis with pathological fracture
N3313Osteoporosis of disuse with pathological fracture
N3316Idiopathic osteoporosis with pathological fracture
N3318Osteoporosis + pathological fracture lumbar vertebrae
N3319Osteoporosis + pathological fracture thoracic vertebrae
N331AOsteoporosis + pathological fracture cervical vertebrae
N331BPostmenapausal osteoporosis with pathological fracture
N331HCollapse of cervical vertebra due to osteoporosis
N331JCollapse of thoracic vertebra due to osteoporosis
N331KCollapse of lumbar vertebra due to osteoporosis
N331LCollapse of vertebra due to osteoporosis NOS
N331MFragility fracture due to unspecified osteoporosis
NyuB0[X]Other osteoporosis with pathological fracture
NyuB1[X]Other osteoporosis
NyuB8[X]Unspecified osteoporosis with pathological fracture
N3314Postsurgical malabsorption osteoporosis with path fracture
N3315Drug-induced osteoporosis with path fracture
N3746Osteoporotic kyphosis
NyuB2[X]Osteoporosis of other disorders classified elsewhere

DEXA Scan

Only the following DEXA scan codes are recognised by QOF
Either:

CodeTerm
58EGHip DXA scan result osteoporotic
58EMLumbar DXA scan result osteoporotic
58EVFemoral neck DEXA scan result osteoporotic

OR the following codes with a value of less than -2.5

CodeTerm
58EEHip DXA scan T score
58EKLumar spine DXA scan T score
58ESFemoral neck DEXA scan T score





Peripheral Arterial Disease (PAD)

Indicators

Indicator IDDescription
PAD001The contractor establishes and maintains a register of patients with peripheral arterial disease.
PAD002The percentage of patients with peripheral arterial disease in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less.
PAD004The percentage of patients with peripheral arterial disease with a record in the preceding 12 months that aspirin or an alternative anti-platelet is being taken.

QOF Recognised Codes


PVD Diagnosis

Codes recognised by QOF for Diagnosis of PAD including sub-codes except those highlighted in red

CodeTerm
G73Other peripheral vascular disease (excluding G73z1 - spasm of peripheral artery)
G734Peripheral artery disease
G73yOther specific peripheral vascular disease
G73zPeripheral vascular disease NOS (Except G73z1 - Spasm of peripheral artery)
Gyu74[X]Other specific peripheral vascular disease





Rheumatoid Arthritis (RA)

Indicators

Indicator IDDescription
RA001The contractor establishes and maintains a register of patients aged 16 or over with rheumatoid arthritis.
RA002The percentage of patients with rheumatoid arthritis, on the register, who have had a face-to-face review in the preceding 12 months.

QOF Recognised Codes


Rheumatoid Arthritis Diagnosis

Codes recognised by QOF for Diagnosis of rheumatoid arthritis including sub-codes except those highlighted in red

CodeTerm
N040Rheumatoid arthritis
N041Felty's syndrome
N042Other rheumatoid arthropathy + visceral/systemic involvement (Escluding N0420 - Rheumkatic carditis)
N047Seropositive errosive rheumatoid arthritis
N04XSeropositive rheumatoid arthritis, unspecified
N04y0Rheumatoid lung
N04y2Adult-onset Still's disease
Nyu11[X]Other seropositive rheumatoid arthritis
Nyu12[X]Other specified rheumatoid arthritis
Nyu1G[X]Seropositive rheumatoid arthritis, unspecified
Nyu10[X]Rheumatoid arthritis+involvement/other organs or systems
G5yARheumatoid carditis
G5y8Rheumatoid myocarditis

Rheumatoid Arthritis Annual Review

The only QOF recognised code for annual review:

CodeTerm
66HB0Rheumatoid arthritis annual review





Stroke and Transient Ischaemic Attack

Indicators

Indicator IDDescription
STIA001The contractor establishes and maintains a register of patients with stroke or TIA.
STIA008The percentage of patients with a stroke or TIA (diagnosed on or after 1 April 2014) who have a record of a referral for further investigation between 3 months before or 1 month after the date of the latest recorded stroke or the first TIA.
STIA003The percentage of patients with a history of stroke or TIA in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less.
STIA007The percentage of patients with a stroke shown to be non-haemorrhagic, or a history of TIA, who have a record in the preceding 12 months that an anti-platelet agent, or an anti-coagulant is being taken.
STIA009The percentage of patients with stroke or TIA who have had influenza immunisation in the preceding 1 August to 31 March.

QOF Recognised Codes


Stroke and Transient Ischaemic Attack Diagnosis

Codes recognised by QOF for diagnosis of stroke and/or transient ischaemic attack including sub-codes except those highlighted in red

CodeTerm
G61Intracerebral haemorrhage (Excluding G617 - Intracerebral haemorrhage, intraventricular)
G63y0Cerebral infarct due to thrombosis of precerebral arteries
G63y1Cerebral infarction due to embolism of precerebral arteries
G64Cerebral artery occlusion
G66Stroke and cerebrovascular accident unspecified (Excluding G669 - Cerebral palsy, not congenital or infantile, acute)
G6760Cereb infarct due cerebral venous thrombosis, nonpyogenic
G6WCereb infarct due unsp occlus/stenos precerebr arteries
G6XCerebrl infractn due/unspcf occlusn or sten/cerebrl artrs
G65Transcient cerebral ischaemia (Excluding G655 - Transcient global amnesia)
Gyu63[X]Cerebrl infractn due/unspecf occlusn or sten/cerebrl artrs
Gyu64[X]Other cerebral infarction
Gyu65[X]Occlusion and stenosis of other precerebral arteries
Gyu66[X]Occlusion and stenosis of oher cerebral arteries
Gyu6F[X]Intracerebral haemorrhage in hemisphere, unspecified
Gyu6G[X]Cereb infarct due unsp occlus/stenos precerebr arteries
ZV12D[X]Personal history of transient ischaemic attack
Fyu55[X]Other transnt cerebral ischaemic attacks+related syndroms
Gyu62[X]Other intracerebral haemorrahge

Referral for Further Investigation

QOF recognised codes for referral for further investigation

CodeTerm
567Computerised axial tomography
5671CAT scan requested
5672CAT scan normal
5673CAT scan abnormal
569Nuclear magnetic resonance
5691Nuclear magn.reson.requested
5692Nuclear magn reson normal
5693Nuclear magn.reson. abnormal
5675CAT can - brain
567CCAT scan brain -abnormal
5694Magnetic resonance imaging of brain abnormal
5C00CT scan brain - normal
5C12Computerised tomography brain scan abnormal
8HQ3Refer for NMR scanning
8HQ4Refer for CAT scanning
8HBJStroke / transient ischaemic attack referral
8HTQReferral to stroke clinic
569FMagnetic resonance imaging of brain normal
569K0Magnetic resonance imaging of brain
8HQFReferral for open MRI scan