QOF

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Diagnosed after 1/4/2006, Confirmed by an echocardiogram or by specialist assessment.

(Added 3 months before diagnosis or up to 12 months after)

Echocardiogram codes

5853. U-S heart scan
58531 Echocardiogram abnormal
585f. Echocardiogram shows left ventricular systolic dysfunction
585g. Echocardiogram shows left ventricular diastolic dysfunction
5C20. Echocardiogram equivocal
33BD. Echocardiogram requested
8HQ7. Referral for echocardiography
R1320 [D]Echocardiogram abnormal
R1322 [D]Ultrasound cardiogram abnormal
5531. Angiocardiography awaited
5533. Angiocardiography abnormal
5538. Angiocardiography equivocal
79380 Angiocardiography of both right and left sides of heart
79382 Angiocardiography of left side of heart NEC
8H4R. Referral to cardiology special interest general practitioner
8HVJ. Private referral to cardiologist
8H44. Cardiological referral
8H7o0 Fast track heart failure referral for transthoracic two dimensional echocardiogram
7P0H6 Contrast echocardiography
8A544 Monitoring of cardiac output using echocardiography
8HTL. Referral to heart failure clinic (v26)
8HTL0 Referral to rapid access heart failure clinic (v26)
79352 Transoesophageal echocardiography (v26)
7P0H. Diagnostic echocardiography (v26)
7P0H0 Transthoracic echocardiography (v26)
7P0H1 Transoesophageal echocardiography (v26)
7P0H4 Stress echocardiography (v26)

Echo Declined (Only lasts for 12 months after diagnosis)

56F1. Echocardiogram declined
5534. Angiocardiography declined
8IBF. Echocardiography not indicated (v29)
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Heart Failure (diagnosed after the 1st April 2006)

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
G5804 Congestive heart failure due to valvular disease
G581. Left ventricular failure
G5810 Acute left ventricular failure
G582. Acute heart failure
G583. Heart failure with normal ejection fraction
G584. Right ventricular failure
G58z. Heart failure NOS
G1yz1 Rheumatic left ventricular failure
662f. New York Heart Association classification - class I
662g. New York Heart Association classification - class II
662h. New York Heart Association classification - class III
662i. New York Heart Association classification - class IV
 

Exclusion codes (Every 12 months)

9hH.. Exception reporting: heart failure quality indicators
9hH0. Excepted from heart failure quality indicators: Patient unsuitable
9hH1. Excepted from heart failure quality indicators: Informed dissent

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Heart failure 002.1 Rationale

This indicator requires that all patients with suspected heart failure should be investigated and this is expected to involve, as a minimum, further specialist investigation (such as echocardiography) and often specialist opinion. Serum natriuretic peptides can be used to determine whether patients with clinically suspected heart failure need referral for echocardiography and their use is recommended as below. Specialists may include GPs identified by their PCO as having a special clinical interest in heart failure. Many heart failure patients will be diagnosed following specialist referral or during hospital admission and some will also have their diagnosis confirmed by tests such as cardiac scintography or angiography rather than echocardiography.

Current NICE guidance (2010/2011) recommends that patients with suspected heart failure should receive both echocardiography and specialist assessment. Serum natriuretic peptides should be measured in patients with suspected heart failure without previous MI. Patients with suspected heart failure who have had a previous MI or who have very high levels of serum natriuretic peptide are considered to require urgent referral due to their poor prognosis. Current SIGN guidance (2007) recommends that echocardiography is performed in patients with suspected heart failure who have either a raised serum natriuretic peptide or abnormal electrocardiograph result to confirm the diagnosis and establish the underlying cause.

Further information:

NICE CG108. Chronic HF: management of chronic HF in adults in primary and secondary care. 2010.
http://guidance.nice.org.uk/CG108/niceguidance/pdf/english (2010)

NICE quality standard. Chronic HF. 2011.
http://www.nice.org.uk/media/D6F/93/CHFQualityStandard.pdf
(2011)

SIGN clinical guideline 95 (2007). Management of chronic heart failure.
http://www.sign.ac.uk/guidelines/fulltext/95/index.html

Heart failure 002.2 Reporting and verification

See indicator wording for requirement criteria.

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Prepared By Jean Keenan