• CHD Diagnosis Codes - go to this
• CHD exception reporting codes - go to this
• Rationale - go to this

Total cholesterol Codes (added within last 15 months)

44OE. Plasma total cholesterol level

44P.. Serum cholesterol

44P1. Serum cholesterol normal

44P2. Serum cholesterol borderline

44P3. Serum cholesterol raised

44P4. Serum cholesterol very high

44PH. Total cholesterol measurement

44PJ. Serum total cholesterol level

CHD Diagnosis Codes

G3... Ischaemic heart disease - G330z Angina decubitus NOS

G33z. Angina pectoris NOS - G3401 Double coronary vessel disease

G342. Atherosclerotic cardiovascular disease - G366. Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction

G38.. Postoperative myocardial infarction - G3z.. Ischaemic heart disease NOS

Gyu3. [X]Ischaemic heart diseases

Gyu30 [X]Other forms of angina pectoris

Gyu31 [X]Other current complications following acute myocardial infarction

Gyu32 [X]Other forms of acute ischaemic heart disease

Gyu33 [X]Other forms of chronic ischaemic heart disease

Gyu34 [X]Acute transmural myocardial infarction of unspecified site

Gyu35 [X]Subsequent myocardial infarction of other sites

Gyu36 [X]Subsequent myocardial infarction of unspecified site

CHD exception reporting codes (In last 15 months)

9h0.. Exception reporting: CHD quality indicators

9h01. Excepted from CHD quality indicators: Patient unsuitable

9h02. Excepted from CHD quality indicators: Informed dissent

CHD 7.1 Rationale

A number of trials have demonstrated that cholesterol lowering with statins significantly reduces cardiovascular or all-cause mortality in patients with angina or in patients following myocardial infarction.

Grade C Recommendation SIGN Guidelines 93, 96, 97

Further information: www.sign.ac.uk/guidelines/fulltext/93-97/index.html

It is unclear from the literature how frequently cholesterol measurement should be undertaken, but the English National Framework (NSF) on CHD recommends annually.

The majority of trials include only patients under 75. However, most national guidance makes no distinction on the basis of age, and age ‘cut-offs’ are not generally included.

CHD 7.2 Reporting and verification

Practices should report the percentage of patients on the CHD register who have a record of total cholesterol in the previous 15 months.

In verifying that this information has been correctly recorded, a number of approaches could be taken by a PCO:

1. inspection of the output from a computer search that has been used to provide information on this indicator
2. inspection of a sample of records of patients with CHD to look at the proportion with recorded serum cholesterol
3. inspection of a sample of records of patients for whom a record of serum cholesterol is claimed, to see if there is evidence of this in the medical records.

Prepared By Jean Keenan