Hi Jill

With regard to the above support call, the reason that the Recurrent wheezy bronchitis codes are included in extract is because of the way that SNOMED CT codes map to Read codes:

•           Recurrent wheezy bronchitis is a synonym for the SNOMED code 195949008 Chronic asthmatic bronchitis. Our clinicians have confirmed this SNOMED code is a valid COPD code, therefore this code has to be retained in the code cluster COPD_COD for QOF version 41. This does mean that patients with H30.. Recurrent wheezy bronchitis will continue to be included on COPD registers.

We recommend checking whether your system supplier or your regional NHS England Team have provided any guidance regarding how to manage these patients.

If they have not provided any guidance and your clinicians have determined that these patients are not suitable to follow the QOF COPD care pathway then these patients would need to be exception reported for the purposes of QOF

Many thanks.


Service Management Practitioner


I have sent a query to NHS Digital regarding the following two error on behalf of practices who have queried the following issues identified due to the Code matching to SNOMED for SystmOne practices:

I wonder if you are able to advise me please,  we have a patient with Essential thrombocythaemia the Read code is X20FX. This Read code was excluded on V37, it sits within the Coagulation Disorder chapter under the platelet disorder on the CTV3 browser but on V41 it sits with in the Primary malignant neoplasm (372087000) and has been included within the Cancer codes. It has  now carried this patient over on to the Cancer Register, although very small in number this has not been included in the past, can you clarify if this will be corrected please.

 We also have the issue with the CTV3 Read codes where patients with Post-concussion syndrome are now sitting on the Dementia register since the release of V41, these patients do not have Dementia and do not belong on the register. Is this going to be corrected too as it is not appropriate to compete a dementia review with these patients.

Hopefully we can have clarification if this will be updated before 31st March

Your help with this would be very much appreciated



I have sent the following query to NHS Digital regarding patients who are not sitting on the COPD register who does not belong there and am awaiting a reply. There is a small number of practices who have changed the historic  entry to a Bronchitis Read code which is not part of the COPD Cluster:

Could you please advise , on SystmOne there is a historic Read code H30..  Bronchitis:[ unspecified(& chect infect)] or[recur wheezy] – wheezy (other episode) which is no longer in use but there are many patients who have this in their records from historic entries and are now sitting on the COPD due to the code sitting within the  H3.. chapter due to the matching of SNOMED with CTV3 codes. The code did not sit within the COPD diagnosis cluster in the past

 As this data is historic, can it be excluded from the SNOMED COPD cluster or is this going to have to be a change of code by the practices, it does appear to be quite a number who have had this code entered in the past?



You can locate the link on your home page on CQRS or through the NHS Digital link below


One of the contract changes for 2015/16 was that the Alcohol DES was retired from the Enhanced Services and made contractual. NHS England is still collecting the data on an annual basis but the payment is included in the Global sum.

Yes, this should happen at the time of registration as it is still sits as part of your GMS contract under the global sum payment

You will need to record a contraindication code for each therapy within the group (you would need to use 8I25. and 8I2K. and 8I24.) for the patients to be removed from the indicator. The codes overleaf are Expiring exception codes, you will need to record them every 15mths.

Version 2 – Isoft, Vision, EMIS and Microtest.




8I25. Warfarin contraindicated

8I2K.Clopidogrel contraindicated

8I24.Aspirin prophylaxis contra-indicated

8I3E. Warfarin declined

8I3R. Clopidogrel declined

8I38. Aspirin prophylaxis refused

8I65. Warfarin not indicated

8I6B. Clopidogrel not indicated

8I66. Aspirin not indicated

8I71.Warfarin not tolerated

8I6B. Clopidogrel not indicated

8I70. Aspirin not tolerated

8I2R. Anticoagulation contraindicated

8I3d. Anticoagulation declined

8I6N. Anticoagulation not indicated

CTV3 – SystmOne




XaFsz Warfarin contraindicated

XaJ6Y Clopidogrel contraindicated

XaDvH Aspirin prophylaxis contra-indicated

XaIIn Warfarin declined

XaJ6Z Clopidogrel declined

XaFsE Aspirin prophylaxis refused

XaIIh Warfarin not indicated

XaJ5l Clopidogrel not indicated

XaFsE Aspirin prophylaxis refused

XaJ5b Warfarin not tolerated

XaJ5c Clopidogrel not tolerated

XaJ5a Aspirin not tolerated

XaKAB Anticoagulation contraindicated

XaKAD Anticoagulation declined

XaKA7 Anticoagulation not indicated

XaKA0 Anticoagulation not tolerated

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