• Exception reporting codes - go to this
• Rationale - go to this

Lifestyle Advice code (The latest in the 15 months previous to the end of the current QOF Financial Year.) There are only two acceptable codes.

67H.. Lifestyle counselling

67H8. Lifestyle advice regarding hypertension (v16)

Hypertension (The latest first or new episode (v15) after 1st April 2009)

G2... Hypertensive disease

G20.. Essential hypertension

G200. Malignant essential hypertension

G201. Benign essential hypertension
G202. Systolic hypertension
G203. Diastolic hypertension

G20z. Essential hypertension NOS

G24.. Secondary hypertension

G240. Secondary malignant hypertension

G2400 Secondary malignant renovascular hypertension

G240z Secondary malignant hypertension NOS

G241. Secondary benign hypertension

G2410 Secondary benign renovascular hypertension

G241z Secondary benign hypertension NOS

G244. Hypertension secondary to endocrine disorders

G24z. Secondary hypertension NOS

G24z0 Secondary renovascular hypertension NOS

G24zz Secondary hypertension NOS

G2y.. Other specified hypertensive disease

G2z.. Hypertensive disease NOS

Gyu2. [X]Hypertensive diseases
Gyu20 [X]Other secondary hypertension
Gyu21 [X]Hypertension secondary to other renal disorders

 

Without hypertension resolved (after diagnosis date)

21261 Hypertension resolved

212K. Hypertension resolved

Cardio Vascular Disease Risk Assessment exception codes (Added in the last 15 months)

9hJ0. Excepted from cardiovascular disease quality indicators: patient unsuitable
9hJ1. Excepted from cardiovascular disease quality indicators: informed dissent

Primary prevention 2.1 Rationale

There is considerable evidence to support the positive impact of increasing physical activity, smoking cessation, reducing unsafe alcohol consumption, and improving diet on cardiovascular health.

Patients with hypertension are at increased risk of developing CVD and this risk can be reduced, not only by treating their hypertension, but by also reducing lifestyle risks.

This advice should be reiterated on an annual basis.

Practices should refer to recognised guidance and advice on advising patients on lifestyle risk.

Further information
NICE public health guidance 10 (2008): Smoking cessation services in primary care, pharmacies, local authorities and NICE. http://guidance.nice.org.uk/PH10/Guidance/pdf/English

NHS Health Scotland (2010). A guide to smoking cessation in Scotland.
http://www.healthscotland.com/documents/4661.aspx

NICE public health guidance 6 (2007). Behaviour change at population, community and individual levels. http://guidance.nice.org.uk/PH6/Guidance/pdf/English

NICE public health guidance 25 (2010). Prevention of cardiovascular disease. http://guidance.nice.org.uk/PH25/Guidance/pdf/English

NICE public health guidance 24 (2010). Alcohol use disorders - preventing harmful drinking. http://guidance.nice.org.uk/PH24/Guidance/pdf/English

SIGN clinical guideline 74 (2008). The management of harmful drinking and alcohol dependence in primary care. http://www.sign.ac.uk/guidelines/fulltext/74/index.html

Plan for Action on Alcohol Problems Update Scottish Government 2008 http://www.scotland.gov.uk/Publications/2007/02/19150222/12

Preventing Overweight and Obesity in Scotland: A Route Map Towards Healthy Weight http://www.scotland.gov.uk/Publications/2010/02/17140721/0

Scottish Government (2008). Diet and physical activity. Healthy Eating, Active Living: An action plan to improve diet, increase physical activity and tackle obesity.
http://www.scotland.gov.uk/Publications/2008/06/20155902/10

NICE public health guidance 2 (2006). Four commonly used methods to increase physical activity: brief interventions in primary care, exercise referral schemes, pedometers and community-based exercise programmes for walking and cycling. http://guidance.nice.org.uk/PH2/Guidance/pdf/English

NICE clinical guideline 67 (2008). Management of lifestyle factors can be found in Lipid Modification: Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of CVD. http://guidance.nice.org.uk/CG67/NICEGuidance/pdf/English

Primary prevention (PP) 2.2Reporting and verification

The practice reports the percentage of people diagnosed with hypertension on or after 1 April 2009 who have been given lifestyle advice in the preceding 15 months for: increasing physical activity, smoking cessation, safe alcohol consumption and healthy diet.

Verification – may require randomly selecting a number of case records of patients in which this advice has been recorded as taking place to confirm that the four key issues are recorded as having been addressed, if applicable

Prepared By Jean Keenan