Q&A

Normally with this type of query you will find a duplicate entry in the patient’s record after the referral date. This entry would supersede the referral and re-activate the alert.

I would also recommend you check the read code used. The following codes are within the QOF cluster:

CTV3                      Version 2

XaKGy                   8Hj0.                     Referral to diabetes structured education programme

XaNTQ                 8Hj3.                      Referral to DAFNE diabetes structured education programme

XaNTS                   8Hj4.                     Referral to DESMOND diabetes structured education programme

XaNTT                   8Hj5.                     Referral to XPERT diabetes structured education programme

XaNTH                  9OLM.                   Diabetes structured education programme declined

XaXkZ                    8IE9.                    Referral to diabetes education and self-management for ongoing and newly diagnosed structured programme declined

XaZuQ                   8IEa.                     Referral to DAFNE diabetes structured education programme declined

Yes. As long as it is not a bulk added message. Guidelines state invitations should be directed at the individual patient,  so I would not use this as the main invitation.  A letter, a phone call (where you actually speak to the patient),  a text message or message on the prescription and a verbal invite while sitting with the clinician (if it is not appropriate to carry out the review at that time) are all acceptable, but need to recorded in an appropriate way and at the point of contact.

There is no exception Code only for the treatment. For this patient I would wait until the end of the QOF year and then only if they are preventing you from achieving the maximal point use the high unsuitable code. All that you will have achieved would supersede the exception code so the work done will still be included.

Yes you do, it is part of the foot risk assessment.

Version 2 ( EMIS, Vision, Microtest and Torex)

C10.. Diabetes mellitus

C109K Hyperosmolar non-ketotic state in type 2 diabetes mellitus

C10C. Diabetes mellitus autosomal dominant

C10D. Diabetes mellitus autosomal dominant type 2

C10E. % Type 1 diabetes mellitus

C10F.% Type 2 diabetes mellitus (Excluding C10F8)

C10G.% Secondary pancreatic diabetes mellitus

C10H.% Diabetes mellitus induced by non-steroid drugs

C10M.% Lipoatrophic diabetes mellitus

C10N.% Secondary diabetes mellitus

CTV3 (SystmOne)

C10.. Diabetes mellitus

XaOPu Latent autoimmune diabetes mellitus in adult

XaOPt Maternally inherited diabetes mellitus

X40J4% Type 1 diabetes mellitus

X40J5% Type 2 diabetes mellitus (Excluding C10F8)

X40J6 Insulin treated Type 2 diabetes mellitus

X40JA % Secondary diabetes mellitus

X40JG% Genetic syndromes of diabetes mellitus

C1011 Type 2 diabetes mellitus with ketoacidosis

C1010 Type 1 diabetes mellitus with ketoacidosis

C1030 Type 1 diabetes mellitus with ketoacidotic coma

C1031 Type II diabetes mellitus with ketoacidotic coma

XaIrf Hyperosmolar non-ketotic state in type II diabetes mellitus

X40JZ Diabetes-deafness syndrome maternally transmitted

XSETp Diabetes mellitus due to insulin receptor antibodies

XM1Xk% Unstable diabetes

C10G.% Secondary pancreatic diabetes mellitus

C10H.% Diabetes mellitus induced by non-steroid drugs

C10M.% Lipoatrophic diabetes mellitus

C10N.% Secondary diabetes mellitus

You need to check the Read code used to record the amputation is a QOF code.

Both codes are part of QOF so there is not an issue there and both results have been sent by the lab for about a year now. The 42W5 being the International Federation of Clinical Chemistry and Laboratory Medicine standardised and the more familiar code 42W4.HbA1c level (DCCT aligned)

We should be working towards familiarising ourselves with the new levels although there has not been any change to the rule sets regarding the 42W4, this is still acceptable at the moment

Comparing DCCT-HbA1c and IFCC-HbA1c Results

The chart below allows the practices to convert the levels and I would be surprised if practices did not have a copy, we did hand them out to the audit clerks last year

DCCT-HbA1c (%)             IFCC-HbA1c (mmol/mol)

6                                                              42

6.5                                                          48

7                                                              53

7.5                                                          59

8                                                              64

9                                                              75

To achieve this indicator you would need to have patients diagnosed with proteinuria or micro-albuminuria that you would treat with an ACE inhibitors (or A2 antagonists). If you are aware of patients with a diagnosis of either proteinuria or micro-albuminuria, you need to check the Read Codes used.

It is recommended you still discuss the three topics with patients as CQRS are extracting this data. Although the results will not be used to assess practice achievement

CTV3                      Version 2

XaRFa                    8IB4.                     Pregnancy advice for patients with epilepsy not indicated

XaRFb                   8IB3.                     Pre-conception advice for patients with epilepsy not indicated

XaRFc                    8IB2.                     Contraceptive advice for patients with epilepsy not indicated

The new Read Codes are listed below with the conversion table:

International Federation of Clinical Chemistry (IFCC) Standardization of HbA1c conversion table

Version 2

42W5.   Haemoglobin A1c level – International Federation of Clinical Chemistry and Laboratory Medicine standardised

CTV3

XaPbt    Haemoglobin A1c level – International Federation of Clinical Chemistry and Laboratory Medicine standardised