• COPD Exclusion codes - go to this
• COPD codes - go to this
• Rationale - go to this

COPD Annual Review(Added in last 15 months)

66YM. Chronic obstructive pulmonary disease annual review

 

And one of these added in the last 15 months:

COPD Codes

H3... Chronic obstructive pulmonary disease

H31.. Chronic bronchitis

H310. Simple chronic bronchitis

H3100 Chronic catarrhal bronchitis

H310z Simple chronic bronchitis NOS

H311. Mucopurulent chronic bronchitis

H3110 Purulent chronic bronchitis

H3111 Fetid chronic bronchitis

H311z Mucopurulent chronic bronchitis NOS

H312. Obstructive chronic bronchitis

H3120 Chronic asthmatic bronchitis

H3121 Emphysematous bronchitis

H3123 Bronchiolitis obliterans

H312z Obstructive chronic bronchitis NOS

H313. Mixed simple and mucopurulent chronic bronchitis

H31y. Other chronic bronchitis

H31y1 Chronic tracheobronchitis

H31yz Other chronic bronchitis NOS

H31z. Chronic bronchitis NOS

H32.. Emphysema

H320. Chronic bullous emphysema

H3200 Segmental bullous emphysema

H3201 Zonal bullous emphysema

H3202 Giant bullous emphysema

H3203 Bullous emphysema with collapse

H320z Chronic bullous emphysema NOS

H321. Panlobular emphysema

H322. Centrilobular emphysema

H32y. Other emphysema

H32y0 Acute vesicular emphysema

H32y1 Atrophic (senile) emphysema

H32y2 MacLeod's unilateral emphysema

H32yz Other emphysema NOS

H32z. Emphysema NOS

H36.. Mild chronic obstructive pulmonary disease

H37.. Moderate chronic obstructive pulmonary disease

H38.. Severe chronic obstructive pulmonary disease

H39.. Very severe chronic obstructive pulmonary disease

H3y.. Other specified chronic obstructive airways disease

H3y0. Chronic obstructive pulmonary disease with acute lower respiratory infection

H3y1. Chronic obstructive pulmonary disease with acute exacerbation, unspecified

H3z.. Chronic obstructive airways disease NOS

Exclusion codes (Every 15 months)

9h5.. Exception reporting: COPD quality indicators

9h51. Excepted from COPD quality indicators: Patient unsuitable

9h52. Excepted from COPD quality indicators: Informed dissent

COPD 13.1 Rationale

COPD is increasingly recognised as a treatable disease with large improvements in symptoms, health status, exacerbation rates and even mortality if managed appropriately. Appropriate management should be based on NICE clinical guideline 101 and international GOLD guidelines in terms of both drug and non-drug therapy.

In making assessments of the patient¡¦s condition as part of an annual review and when considering management changes it is essential that health care professionals are aware of:

• current lung function
• exacerbation history
• degree of breathlessness (MRC dyspnoea scale).

A tool such as the Clinical COPD Questionnaire could be used to assess current health status46.

Additionally there is evidence that inhaled therapies can improve the quality of life in some patients with COPD. However, there is evidence that patients require training in inhaler technique and that such training requires reinforcement. Where a patient is prescribed an inhaled therapy their technique should be assessed during any review

The MRC dyspnoea scale gives a measure of breathlessness and is recommended as part of the regular review. It is available under Section 1.1, Diagnosing COPD, in table one of the NICE clinical guideline 101 on COPD.

13.2 Reporting and verification

The practice reports the percentage of patients on the COPD register who have had a review of their COPD by a healthcare professional which included an assessment of breathlessness using the MRC dyspnoea score in the preceding 15 months.

Verification - may require randomly selecting a number of case records of patients in which the review has been recorded as taking place to confirm that the defined elements are recorded as having been addressed, if applicable.

46 Clinical COPD Questionnaire. http://www.ccq.nl/

Prepared By Jean Keenan