Q&A

It is only looking at the newly diagnosed patients as it is about secondary prevention of further fractures.

 

You need to record each of the follow for the patient to appear on the register.

Diagnosis of Osteoporosis

DEXA Scan confirming the diagnosis

Fragility fracture

Overleaf are the QOF Clusters for each of the areas:

 

Version 2 ( EMIS, Vision, Microtest and Torex)

 

CTV3 (SystmOne)
Fragility fracture N331N XaNSP
Fragility fracture due to unspecified osteoporosis N331M XaIIp
DEXA Scan Codes without a value
Forearm DXA scan result osteoporotic 58E4. XaITM
Heel DXA scan result osteoporotic 58EA. XaITR
Hip DXA scan result osteoporotic 58EG. XaITW
Femoral neck DEXA scan result osteoporotic 58EV. XaITb
DXA scan result with a T score value
Forearm DXA scan T score 58E2. XaITK
Heel DXA scan T score 58E8. XaITP
Hip DXA scan T score 58EE. XaITU
Lumbar spine DXA scan T score 58EK. XaITZ
Femoral neck DEXA scan T score 58ES. XaPDy

 

Diagnostic Codes
Osteoporosis N330.

(Excluding N3305, N3307, N3308, N3309, N330A, N330D)

N330.
Primary osteoporosis Xa0AZ
Postoophorectomy osteoporosis with pathological fracture N3312 N3312
Osteoporosis of disuse with pathological fracture N3313
Idiopathic osteoporosis with pathological fracture N3316
Osteoporosis + pathological fracture lumbar vertebrae N3318
Osteoporosis + pathological fracture thoracic vertebrae N3319
Osteoporosis + pathological fracture cervical vertebrae N331A
Postmenopausal osteoporosis with pathological fracture N331B
Postmenopausal osteoporosis N3302
Collapse of cervical vertebra due to osteoporosis N331H
Collapse of lumbar vertebra due to osteoporosis N331J XaD4I
Collapse of thoracic vertebra due to osteoporosis N331K XaD4J
Collapse of vertebra due to osteoporosis NOS N331L
Fragility fracture due to unspecified osteoporosis N331M XaIIp
[X]Other osteoporosis with pathological fracture NyuB0
[X]Other osteoporosis NyuB1
[X]Unspecified osteoporosis with pathological fracture NyuB8
Senile osteoporosis N3301
Idiopathic generalised osteoporosis N3303
Idiopathic osteoporosis in pregnancy X70As
Adult idiopathic generalised osteoporosis X70At

 

 

 

 

 

 

 

 

Diagnosis Codes continued Version 2 ( EMIS, Vision, Microtest and Torex) CTV3 (SystmOne)
Postoophorectomy osteoporosis N3306
Localised disuse osteoporosis XE1GA
Osteoporosis, unspecified N3300
Osteoporosis NOS N330z
Osteoporosis of disuse with pathological fracture N3313
Idiopathic osteoporosis with pathological fracture N3316
Postmenopausal osteoporosis with pathological fracture N331B
[X]Other osteoporosis with pathological fracture NyuB0
[X]Other osteoporosis NyuB1
[X]Unspecified osteoporosis with pathological fracture NyuB8
Osteoporosis localised to spine XaC12

 

 

 

 

There are 6 points but for 3 you need to enter a ‘yes’ to having regular meeting to discuss the patients -MDT meeting etc. On CQRS if you are unsure how to manually enter the 4 ‘yes’ answers that are required across three areas: palliative, cytology and smoking. The CQRS/GPES help file can be found on this website under EHS.

 

 

 

Yes, the Business Rules were written using SNOMED codes, as discussed at the original training session there are Read codes that will sit within the QOF clusters that do not belong there. NHS Digital  Business Rules team are aware of this and are working hard to sort out the coding issues before the final release which will be used for end of year 18/19.

The issues so far area:

  • Post-concussion syndrome – showing on the Dementia Register and showing the need for a Dementia care review. The SNOMED code it is picking up is 492615014, this will be removed from the cluster
  • Ankylosing Spondylitis – showing on the Rheumatoid Arthritis register showing the registers indicator alerts. The SNOMED code it is picking up is 9631008, this will be removed from the cluster
  • Fragility Fracture – showing in the Osteoporosis diagnosis cluster putting patients on the register due to having a fracture alone

Please let me know if you discover any other coding issues, we can share the information which will save staff unnecessary time investigating why

 

The exception codes for LVD were removed from the business rules when changes were made to the rules confirming Diagnosis of HF due to LVD a couple of years ago (see question below)

The exception codes are as follows:

XaMJ9   Exception reporting: heart failure quality indicators

XaMJB   Excepted from heart failure quality indicators: Informed dissent

XaMJA   Excepted from heart failure quality indicators: Patient unsuitable

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