There was a criteria change for the fragility fracture for the 75yrs and over in 2014/15. The fragility fracture has to have occurred on or after 1st April 2014. See criteria below:
The register is split in to two, the 50-74 year olds and the 75 and over.
For the 50-74 years the patient would require
- A diagnosis at any point in their history of osteoporosis
- A DEXA scan at any point in their history confirming diagnosis
- A fragility fracture after the 1st April 2012.
For the 75yrs and over they only require
- A diagnosis at any point in their history of osteoporosis
- A fragility fracture after the 1st April 2014.
Most elderly people with a fracture in this age group are considered to be a fragility fractures so for the upper age I would do a fracture search and look at those the Hospital have started on the meds such as the calcium and vitamin supplements and discuss with the GP.
Your first step should be:
- Look at all the fractures that have happened after the 1st April 2012. If you have admin staff coding they may not have coded them correctly. The codes required are:
CTV3 Version 2
XaNSP N331N
XaIIp N331M
Look at those who have been started on a supplement by the hospital after a fracture.
Once you have ensured the code is correct for the patients fracture you may need to look back in their history and check a QOF code has been used for the DEXA, as it is at any time in the patients history (If we turn the clock back ten years we used generic codes for diagnostic tests so you may find a DEXA recorded incorrectly)
A number of practices have also found the osteoporosis was not coded just the scan.
Looking at QOF the majority practices have managed to identify patients, the average range is between 1 – 14 patients. I spoke to a practice with 11000 patients yesterday and they have 2 patients. The hardest is ensuring the coding is correct for fractures. This is where the admin staff needs clinical input as not all fragility fractures are clear on the discharge letters.