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Non-haemorrhagic stroke codes

G63y0 Cerebral infarct due to thrombosis of precerebral arteries
G63y1 Cerebral infarction due to embolism of precerebral arteries
G64.. Cerebral arterial occlusion
G640. Cerebral thrombosis
G6400 Cerebral infarction due to thrombosis of cerebral arteries
G641. Cerebral embolism
G6410 Cerebral infarction due to embolism of cerebral arteries
G64z. Cerebral infarction NOS
G64z0 Brainstem infarction
G64z1 Wallenberg syndrome
G64z2 Left sided cerebral infarction
G64z3 Right sided cerebral infarction
G64z4 Infarction of basal gangli

G6760 Cerebral infarction due to cerebral venous thrombosis, nonpyogenic

G6W.. Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries
G6X.. Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries
Gyu63 [X]Cerebrl infarctn due/unspci occlusn or sten/cerebrl artrs
Gyu64 [X]Other cerebral infarction
Gyu65 [X]Occlusion and stenosis of other precerebral arteries
Gyu66 [X]Occlusion and stenosis of other cerebral arteries
Gyu6G [X]Cereb infarct due unsp occlus/stenos precerebr arteries
OR
 

TIA Codes

G65.. Transient cerebral ischaemia
G650. Basilar artery syndrome
G651. Vertebral artery syndrome
G6510 Vertebro-basilar artery syndrome
G652. Subclavian steal syndrome
G653. Carotid artery syndrome hemispheric
G654. Multiple and bilateral precerebral artery syndromes
G656. Vertebrobasilar insufficiency
G657. Carotid territory transient ischaemic attack
G65y. Other transient cerebral ischaemia
G65z. Transient cerebral ischaemia NOS
G65z0 Impending cerebral ischaemia
G65z1 Intermittent cerebral ischaemia
G65zz Transient cerebral ischaemia NOS
F4236 Amaurosis fugax
ZV12D [V]Personal history of transient ischaemic attack
Fyu55 [X]Other transient cerebral ischaemic attacks and related syndromes
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Stroke - anti-coagulant drug therapy or an anti-platelet drug therapy

Salicylate contra-indications: persistent

14LK. H/O: aspirin allergy
ZV148 [V]Personal history of aspirin allergy
U6051 [X]Salicylates causing adverse effects in therapeutic use
TJ53. Adverse reaction to salicylates

Salicylate contra-indications: expiring (12 months)

8I24. Aspirin prophylaxis contra-indicated
8I38. Aspirin prophylaxis refused
8I66. Aspirin not indicated
8I70. Aspirin not tolerated

Warfarin contraindications: persistent

14LP. H/O: warfarin allergy
TJ42. Adverse reaction to anticoagulants
TJ421 Adverse reaction to warfarin sodium
TJ422 Adverse reaction to nicoumalone
TJ423 Adverse reaction to phenindione
TJ42z Adverse reaction to anticoagulants NOS
U6042 [X]Anticoagulants causing adverse effects in therapeutic use
ZV14A [V]Personal history of warfarin allergy

Warfarin contraindications: expiring (12 months)

8I25. Warfarin contraindicated
8I3E. Warfarin declined
8I65. Warfarin not indicated
8I71. Warfarin not tolerated
8I2R. Anticoagulation contraindicated
8I3d. Anticoagulation declined
8I6N. Anticoagulation not indicated
8I7A. Anticoagulation not tolerated
8I2o. Dabigatran contraindicated
8IES. Dabigatran declined
8I611 Dabigatran not indicated
8I7R. Dabigatran not tolerated
8I2u. Novel oral anticoagulant contraindicated (v29)
8IH1. Novel oral anticoagulant declined (v29)
8I6s. Novel oral anticoagulant not indicated (v29)
8I7V. Novel oral anticoagulant not tolerated (v29)
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Clopidogrel contraindications: persistent

14LQ. H/O: clopidogrel allergy
U6048 [X]Clopidogrel causing adverse effects in therapeutic use
ZV14B [V]Personal history of clopidogrel allergy

Clopidogrel contraindications: expiring (12 months)

8I2K. Clopidogrel contraindicated
8I3R. Clopidogrel declined
8I6B. Clopidogrel not indicated
8I72. Clopidogrel not tolerated

Dipyridamole contraindications: persistent

14LX. H/O: dipyridamole allergy
TJC44 Adverse reaction to dipyridamole
U60C3 [X]Coronary vasodilators causing adverse effects in therapeutic use, not elsewhere classified

Dipyridamole contraindications: expiring (12 months)

8I2b. Dipyridamole contraindicated
8I3n. Dipyridamole declined
8I6a. Dipyridamole not indicated
8I7J. Dipyridamole not tolerated

OTC salicylate codes ( in last 12 months)

67I8. Advice about taking aspirin
8B63. Salicylate prophylaxis
8B3T. Over the counter aspirin therapy
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Salicylate prescription codes (prescribed in last 12 months)

bu2..%
di1..%
j11..%
blm..%
bu4..%

Clopidogrel prescription codes (prescribed in last 12 months)

bu5..%
8B6P. Clopidogrel prophylaxis

Warfarin prescription codes (prescribed in last 12 months)

bs...%
8B2K. Anticoagulant prescribed by third party

Dipyridamole prescription codes (prescribed in last 12 months)

bu1..%
(excluding bu13., bu1z.)
bu4..%
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Stroke exception reporting codes

9h2.. Exception reporting: stroke quality indicators
9h21. Excepted from stroke quality indicators: Patient unsuitable
9h22. Excepted from stroke quality indicators: Informed dissent

 

STIA 007.1 Rationale

Long term antiplatelet therapy reduces the risk of serious vascular events following a stroke by about a quarter. Antiplatelet therapy, should be prescribed for the secondary prevention of recurrent stroke and other vascular events in patients who have sustained an ischaemic cerebrovascular event.

The British National Formulary (62) makes the following treatment recommendations:

Following a TIA, long-term treatment with modified-release dipyridamole 200 mg twice daily in combination with aspirin 75 mg once daily is recommended. If patients are intolerant of aspirin, or it is contraindicated, then modified-release dipyridamole alone is recommended. If patients are intolerant of dipyridamole, or it is contraindicated, then aspirin alone is recommended. Patients who are intolerant of both aspirin and dipyridamole should receive clopidogrel alone [unlicensed use].

Following an ischaemic stroke (not associated with atrial fibrillation - see below), clopidogrel 75 mg once daily is recommended as long-term treatment. If clopidogrel is contraindicated or not tolerated, patients should receive modified-release dipyridamole 200 mg twice daily in combination with aspirin 75 mg once daily. If both aspirin and clopidogrel are contraindicated or not tolerated, then modified-release dipyridamole alone is recommended. If both dipyridamole and clopidogrel are contraindicated or not tolerated, then aspirin alone is recommended.

It is advised that patients with stroke associated with atrial fibrillation should be reviewed for long-term treatment with warfarin or an alternative anti-coagulant (see the atrial fibrillation disease area indicator set).

Further information
The British National Formulary (62).
http://bnf.org/bnf/index.htm

NICE technology appraisal guidance 210. Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events (review of technology appraisal guidance 90) (2010).
www.nice.org.uk/guidance/TA210

STIA 007.2 Reporting and verification

See indicator wording for requirement criteria.

 
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Prepared By Jean Keenan