QOF

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Patients will be included for this indicator if they are female and aged from 25 to 64 in England and Northern Ireland, from 20 to 60 in Scotland and from 20 to 64 in Wales and have:

(They will be rejected if they are solely on Lithium treatment)

Cervical Smear codes (In the preceding 5 years)

4K22. Cervical smear: negative
4K23. Cerv.smear: mild dyskaryosis
4K24. Cerv.smear: severe dyskaryosis
4K25. Cerv.smear:severe dysk.?inv.ca
4K26. Cervical smear: ? gland neopl.
4K27. Cervical smear:atrophic change
4K28. Cerv.smear: mod.dyskaryosis
4K29. Cerv.smear: borderline changes
4K2C. Smear NAD - no endocervical cells present
4K2H. Cervical smear epithelial cells absent
4K2F. Cervical smear pus cells present
4K2G. Cervical smear red blood cells present
4K3E. HPV - Human papillomavirus test negative(v25)
4KA1. Vaginal vault smear negative
4KA3. Vaginal vault smear-atrophic
4KA4. Vaginal vault smear abnormal
6856. Ca cervix screen - up to date
6859. Ca cervix - screen done
685B. Ca cervix screen normal
685C. Ca cervix screen abnormal
685D. Ca cervix screen + fee claim
685R Liquid based cervical cytology screening
7E2A2 Papanicolau smear NEC
7E2A3 Vaginal vault smear
ZV762 [V]Screening for malignant neoplasm of cervix
7E2A0 Exam female genital tract under anaesth & papanicolau smear
4K2Q. Cervical smear - human papillomavirus negative
4K2R. Cervical smear - human papillomavirus positive
4K2N. Cervical smear - ?endocervical type glandular neoplasia
4K2P. Cervical smear - ?non-cervical type glandular neoplasia
4K291 Cervical smear - borderline change in endocervical cells
4K290 Cervical smear - borderline change in squamous cells
4K2M. Crv smr - hi grade dyskaryosis? invasive squamous carcinoma
4K2K. Cervical smear - high grade dyskaryosis (moderate)
4K2J. Cervical smear - low grade dyskaryosis
4K2L. Cervical smear - high grade dyskaryosis (severe)
4K55. Cervical cytology test
4K3E. HPV - Human papillomavirus test negative

Exclusion codes (In the previous 5 years)

6853. Ca cervix screen - not wanted
685L. Cervical smear refused
8I6K Cervical smear not indicated
9O8Q Cerv. smear disclaimer received

Mental Health Exception reporting codes (in the previous 12 months)

9h9.. Exception reporting: mental health quality indicators
9h91. Excepted from mental health quality indicators: Patient unsuitable
9h92. Excepted from mental health quality indicators: Informed dissent

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Exception codes as having had a hysterectomy or equivalent. (ever)

685H. No smear- benign hysterectomy
685I. No smear-amputation of cervix
685K. No smear - no cervix
9O8Y No cervical smear required - no uterus
7E05. Vaginal excision of uterus
7E050 Vaginal hysterocolpectomy and excision of periuterine tissue
7E051 Vaginal hysterectomy and excision of periuterine tissue NEC
7E052 Vaginal hysterocolpectomy NEC
7E053 Vaginal hysterectomy NEC
7E054 Laparoscopic vaginal hysterectomy
7E055 Vaginal hysterectomy with conservation of ovaries
7E056 Laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy
7E058 Vaginal hysterectomy and left salpingo-oophorectomy (v30)
7E057 Vaginal hysterectomy and right salpingo-oophorectomy (v30)
7E05y Other specified vaginal excision of uterus
7E05z Vaginal excision of uterus NOS
7E040 Abdominal hysterocolpectomy and excision periuterine tissue
7E042 Abdominal hysterocolpectomy NEC
7E043 Total abdominal hysterectomy NEC
7E046 Radical hysterectomy
7E049 TAH - Tot abdom hysterectomy and BSO - bilat salpingophorect
7E04B Lapar total abdominal hysterect bilat. salpingo-oophorectomy
7E04G Total abdominal hysterectomy with conservation of ovaries
7E04P Radical hysterectomy with bilateral salpingo-oophorectomy (v30)
7E04N Radical hysterectomy with conservation of ovaries (v30)
7L0A. Clearance of pelvis, etc
7L0A0 Total exenteration of pelvis
7L0A1 Anterior exenteration of pelvis
7L0A2 Posterior exenteration of pelvis
7L0Ay Other specified clearance of pelvis
7L0Az Clearance of pelvis NOS
26L3. Uterine cervix absent
 
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Exception codes for in remission from serious mental illness (Added after their latest diagnosis)

E1005 Schizophrenia in remission
E1015 Hebephrenic schizophrenia in remission
E1025 Catatonic schizophrenia in remission
E1035 Paranoid schizophrenia in remission
E1055 Latent schizophrenia in remission
E1075 Schizo-affective schizophrenia in remission
E1106 Single manic episode in full remission
E1116 Recurrent manic episodes, in full remission
E1146 Bipolar affective disorder, currently manic, in full remission
E1156 Bipolar affective disorder, currently depressed, in full remission
Eu317 [X]Bipolar affective disorder, currently in remission
E1166 Mixed bipolar affective disorder, in full remission
E1176 Unspecified bipolar affective disorder, in full remission
Eu329 [X]Single major depressive episode, severe, with psychosis, psychosis in remission
Eu32A [X]Recurrent major depressive episodes, severe, with psychosis, psychosis in remission
Eu26. [X]Nonorganic psychosis in remission
Eu223 [X]Paranoid state in remission

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Psychosis, schizophrenia and bipolar affective disease codes (the earliest code (v15))

E10..% Schizophrenic disorders
E110.% Manic disorder, single episode
E111.% Recurrent manic episodes
E1124 Single major depressive episode, severe, with psychosis
E1134 Recurrent major depressive episode, severe, with psychosis
E114% Bipolar affective disorder, currently manic
E115% Bipolar affective disorder, currently depressed
E116% Mixed bipolar affective disorder
E117% Unspecified bipolar affective disorder
E11y.% Other and unspecified manic-depressive psychoses (excluding E11y2 Atypical depressive disorder)
E11z. Other and unspecified affective psychoses
E11z0 Unspecified affective psychoses NOS
E11zz Other affective psychosis NOS
E12..% Paranoid states (v9)
E13..% Other nonorganic psychoses (excluding E135.. Agitated depression)

E2122 Schizotypal personality
Eu2..% [X]Schizophrenia, schizotypal and delusional disorders
 
Eu30. [X]Manic episode
Eu300 [X]Hypomania
Eu301 [X]Mania without psychotic symptoms
Eu302 [X]Mania with psychotic symptoms
Eu30y [X]Other manic episodes
Eu30z [X]Manic episode, unspecified
Eu31. [X]Bipolar affective disorder
Eu310 [X]Bipolar affective disorder, current episode hypomanic
Eu311 [X]Bipolar affective disorder, current episode manic without psychotic symptoms
Eu312 [X]Bipolar affective disorder, current episode manic with psychotic symptoms
Eu313 [X]Bipolar affective disorder, current episode mild or moderate depression
Eu314 [X]Bipolar affective disorder, current episode severe depression without psychotic symptoms
Eu315 [X]Bipolar affective disorder, current episode severe depression with psychotic symptoms
Eu316 [X]Bipolar affective disorder, current episode mixed
Eu317 [X]Bipolar affective disorder, currently in remission
Eu318 [X]Bipolar affective disorder type I (v21)
Eu319 [X]Bipolar affective disorder type II (v21)

Eu31y [X]Other bipolar affective disorders
Eu31z [X]Bipolar affective disorder, unspecified
Eu323 [X]Severe depressive episode with psychotic symptoms
Eu328 [X]Major depression, severe with psychotic symptoms (v16)
Eu329 [X]Single major depressive episode, severe, with psychosis, psychosis in remission (v18)
Eu32A [X]Recurrent major depressive episodes, severe, with psychosis, psychosis in remission (v18)
Eu333 [X]Recurrent depressive disorder, current episode severe with psychotic symptoms (v9)

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Mental health 008.1 Rationale

A report by the Disability Rights Commission based on the primary care records of 1.7 million primary care patients found that women with schizophrenia were less likely to have had a cervical sample taken in the previous five years (63 per cent) compared with the general population (73 per cent). This did not apply to patients with bipolar affective disorder. This finding may reflect an underlying attitude that such screening is less appropriate for women with schizophrenia. This indicator therefore encourages practices to ensure that women with schizophrenia, bipolar affective disorder or other psychoses are given cervical screening according to devolved national guidelines.

Mental health 008.2 Reporting and verification

See Indicator wording for requirement criteria.

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Prepared By Jean Keenan