Patient population with heart failure due to LVD*
*N.B. Codes required to be present from both groups to qualify a patient for
inclusion
Heart Failure
G58.. Heart failure
- G580. Congestive heart failure
- G5800 Acute congestive heart failure
- G5801 Chronic congestive heart failure
- G5802 Decompensated cardiac failure
- G5803 Compensated cardiac failure
- G581. Left ventricular failure
- G5810 Acute left ventricular failure
- G582. Acute heart failure
- G58z. Heart failure NOS
- G1yz1 Rheumatic left ventricular failure
- 662f. New York Heart Association classification -
class I (v9)
- 662g. New York Heart Association classification -
class II (v9)
662h. New York Heart Association classification - class III (v9)
662i. New York Heart Association classification - class IV (v9)
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Codes for LVD
- G581. Left ventricular failure
- G5810 Acute left ventricular failure
- 585f. Echocardiogram shows left ventricular systolic dysfunction
- 585g. Echocardiogram shows left ventricular diastolic dysfunction
- G5yy9 Left ventricular systolic dysfunction
- G5yyA Left ventricular diastolic dysfunction
Exclusion codes (Every 15 months)
9h1.. Exception reporting:
LVD quality indicators (v10) 9h11. Excepted from LVD quality indicators: Patient
unsuitable (v10) 9h12. Excepted from LVD quality indicators: Informed
dissent (v10) -
- 9hH.. Exception reporting: heart failure quality indicators
(v9)
- 9hH0. Excepted from heart failure quality indicators:
Patient unsuitable (v9)
- 9hH1. Excepted from heart failure quality indicators:
Informed dissent (v9)
-
Ace inhibitor contraindications; persistent
- 14LM. H/O: angiotensin converting enzyme inhibitor allergy
- U60C4 [X]Angiotensin-converting-enzyme inhibitors causing adverse effects
in therapeutic use
- ZV14D [V]Personal history of angiotensin-converting-enzyme inhibitor allergy
TJC77 Adverse reaction to captopril
TJC78 Adverse reaction to enalapril
TJC79 Adverse reaction to ramipril
Ace inhibitor contraindications; expiring (15 months)
- 8I28. Angiotensin converting enzyme inhibitors contraindicated
- 8I3D. Angiotensin converting enzyme inhibitor declined
- 8I64. Angiotensin converting enzyme inhibitor not indicated
- 8I74. Angiotensin converting enzyme inhibitor not tolerated
AII antagonist contraindications: persisting
- 14LN. H/O: angiotensin II receptor antagonist allergy
- U60CB [X]Angiotensin II receptor antagonists causing adverse effects in
therapeutic use
- ZV14E [V]Personal history of angiotensin II receptor antagonist allergy
AII antagonist contraindications: expiring (15 months)
- 8I2H. Angiotensin II receptor antagonists contraindicated
- 8I3P. Angiotensin II receptor antagonist declined
- 8I6C. Angiotensin II receptor antagonist not indicated
- 8I75. Angiotensin II receptor antagonist not tolerated
Ace inhibitor prescription codes (prescribed in
the last 6 months)
- bi...%
- bA…%
- bk6..%
AII antagonist prescription codes (prescribed in the last 6 months)
- bk3.. - bk5z.
- bk7.. - bk9z.
- bkB..%
bkD..% (v12)
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Heart failure 3.1 Rationale
The evidence base for treating patients with LVD heart failure with angiotensin
receptor blockers (ARBs) is strong. However, this should only be after first
attempting to initiate ACE inhibitors (Pfeffer et al. Lancet 2003; 362: 759-766).
It should also be noted that it is possible to have a diagnosis of LVD without
heart failure, for example, asymptomatic people who might be identified coincidentally
but who are at high risk of developing subsequent heart failure. In such cases
ACE inhibitors delay the onset of symptomatic heart failure, reduce cardiovascular
events and improve long-term survival. This indicator only concerns patients
with heart failure and thus excludes this other group of patients who should
nevertheless be considered for treatment with ACE inhibitors.
Further information: www.clinicalevidence.com/ceweb/conditions/cvd/0204/0204_I13.jsp
Heart failure 3.2 Reporting and verification
Practices report the number of patients on their heart failure register with
heart failure due to LVD.
Practices report the percentage of these patients whose records show they have
been prescribed an ACE inhibitor or an ARB in the previous six months.
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Prepared By Jean Keenan
