• Exception reporting codes - go to this
• Codes for Proteinuria - go to this
• Rationale - go to this

Age must be 17 or over with a diagnostic code for diabetes mellitus

Codes for microalbuminuria testing (Added in last 15 months)

467A. 24 hour urine protein output

467E. Urine protein level

467H. Random urine protein level

46W.. Urine microalbumin

46W0. Urine microalbumin positive

46W1. Urine microalbumin negative

46W2. Microalbumin excretion rate

46TC. Urine albumin:creatinine ratio

46N3. Urine total protein

46N4. Urine albumin

46N5. 24 hour urine protein excretion test

46N6. 24 hour urine albumin output

46N7. Urine protein/creatinine index

46N8. Urine microalbumin profile

 

Codes for proteinuria (exception reporting for patients with proteinuria)

R110. [D]Proteinuria

R1100 [D]Albuminuria

R110z [D]Proteinuria NOS

C10EK Type 1 diabetes mellitus with persistent proteinuria

C10FL Type 2 diabetes mellitus with persistent proteinuria

K190X Persistent proteinuria, unspecified

Kyu5G [X]Persistent proteinuria, unspecified

Diabetes exception reporting codes (Added in the last 15 months)

9h4.. Exception reporting: diabetes quality indicators

9h41. Excepted from diabetes quality indicators: Patient unsuitable

9h42. Excepted from diabetes quality indicators: Informed dissent

DM 13.1 Rationale

Diabetic patients are at risk of developing nephropathy. Measurements of urinary albumin loss and serum creatinine are the best screening tests for diabetic nephropathy. Urinary microalbuminuria has been identified as an independent risk factor for cardiovascular complications. Its presence is therefore a pointer to the need for more rigorous management of all cardiovascular risk factors. All patients with diabetes should have their urinary albumin concentration and serum creatinine measured at diagnosis and at regular intervals, usually annually.

Grade D Recommendation SIGN 55

Grade C Recommendation NICE Inherited Guideline F

Further Information: www.sign.ac.uk/guidelines/fulltext/55/index.html
www.nice.org.uk/article.asp?a=27964

Health Technology Assessment Review 2005

Diabetic nephropathy is defined by a raised urinary albumin excretion of greater than 300mg/day (indicating clinical proteinuria). Patients with proteinuria should be separately recorded after urinary tract infection has been excluded.

DM 13.2 Reporting and verification

Practices should report the percentage of patients on the diabetic register who have a record of microalbuminuria testing in the last 15 months and the percentage of patients on the diabetic register who have proteinuria who have not therefore been tested for microalbuminuria.

Prepared By Jean Keenan