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  • Summary of changes to Delen COVID-19 Standards: July 2020

    Published: June 2020

    Dear Colleague,

    Following discussions with data analysts we have made changes to the sequencing of COVID-19 (U07.1 Emergency use of U07.1 and U07.2 Emergency use of U07.2) with codes for unrelated conditions. This will ensure that time series analysis can continue to effectively identify the main condition treated or investigated during the relevant episode of healthcare, even where COVID-19 is treated but is not necessarily considered the main condition by the responsible consultant.

    The sequencing of U07.1 and U07.2 must be in line with DGCS.1: Primary Diagnosis and applies to episodes ending on or after 01 July 2020.

    The COVID-19 National Clinical Coding Standards and Guidance has been updated to reflect the changes and are outlined in the attached document. Red strikethrough indicates what has been deleted and blue underline indicates what has been added.

    Kind regards

    Terminology & Classifications Delivery Service

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    By Katy Park 1 year ago

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  • Terminology and Classifications Delivery Service Newsletter: June 2020

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    Terminology and Classifications Delivery Service Newsletter

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    Welcome to the June 2020 Newsletter. In this issue, we feature:

     

     

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    COVID-19 SNAP updates

    Our bi-weekly SNAP updates provide a summary of the activity relating to COVID-19 in relation to our Terminology and Classifications products, featuring the following:

    • Resources available
    • Classifications ICD-10 and OPCS-4
    • Pathology Tests and Results
    • SNOMED CT Clinical and Drug Extensions

    If you would like to subscribe to future SNAP updates, please email COVID19information.standards@nhs.net

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    COVID-19 & ICD-10 Classification

    In March, we launched a dedicated COVID-19 area on Delen to provide COVID-19 information from the World Health Organisation, information on the classification of COVID-19 in ICD-10 and a single authoritative location for COVID-19 national clinical coding standards for Admitted Patient Care in England.

    Coders must use the COVID-19 National Clinical Coding Standards and Guidance page on Delen in preference to DCS.XXII.5 within the ICD-10 Reference book 2020.

    We are continually reviewing the standards and guidance and will continue to update these pages as the pandemic progresses. These reviews will reflect the developing clinical knowledge of the condition, recurring issues and problems identified from helpdesk resolutions and any changes provided to us by WHO. We are working at pace to ensure the standards reflect current clinical knowledge and practice and to support the coding community, so that coders have the most up to date information to aid accurate and timely coding.

    We have taken a different approach from usual to the communication of the coding standards for COVID-19 by publishing them directly on Delen so that they are easily accessible to all and can be amended at short notice if required. The evolving nature of the pandemic, has meant that we have had to make amendments to the COVID-19 standards at a much shorter interval than would be expected. In some cases, the COVID-19 standards have contradicted existing clinical coding standards and we have received feedback that the new COVID-19 standards do not align. However, because of the exceptional nature of the pandemic, this has been necessary to ensure that current and future analysis of the pandemic in an admitted patient care setting is accurate, meaningful, and complete. We can also assure you that the standards we have released align with the advice and information we have received from the WHO.

    We have seen a large increase in queries related to COVID-19 and continue to prioritise both their resolution and publication on the Query Resolution Database. Please continue to send us COVID-19 related queries, along with supporting documentation, as they inform the current standards and guidance. However, please ensure that you have searched the Query Resolution Database before sending a query, to check whether it has already been addressed. This will help us to manage resolution response times.

    We realise that it has been a difficult time for coders working in Trusts and are aware of the changes you have had to make to your working practices and the difficulties you have had in accessing local information. We would like to thank those of you who have sent in information and queries about the coding of COVID-19 and for raising issues and asking questions about the standards as these have allowed us to understand what new and arising COVID-19 situations need to be reflected in the standards and guidance.

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    SNOMED CT News

    A further interim release of the UK SNOMED CT Clinical Release Edition is scheduled for 17 June. Further information about new SNOMED CT Concepts, including the metadata concepts for simple map reference sets, needed for filing pathology results into Primary Care systems can be found in the 05 June SNAP update.

    A consultation on the release timetable and content for the remainder of the 2020 calendar has now closed and the outcomes will be published in our Consultation area on Delen.

    NHS Digital continues to work with the Professional Records Standard body (PRSB) to raise awareness of the SNOMED CT response to COVID-19 and to gather, coordinate and prioritise multi-professional input into new content requests.  Further information can be found by visiting the COVID-19 Information Standards page and the PRSB FAQ page.

    Our SNOMED CT Terminology Releases page on Delen provides information about:

    • SNOMED CT UK Clinical Edition
    • NICIP
    • UK SNOMED CT Drug Extension

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    2020/21 Classifications Training Schedule update

    Following our previous update published on Delen in March 2020, we recognise that we won’t be able to compress a full year’s delivery schedule into six months. We have updated our 2020/21 training schedule, which will remain subject to possible revision based on government guidance and social distancing restrictions due to the COVID-19 pandemic.

    The five ‘Introduction to Classifications’ events for trainers are planned to go ahead during September and November – approved trainers should refer to the Approved Trainer Workspace for further information.

    Regrettably, we have cancelled the Clinical Coding Auditor and Clinical Coding Trainer Programme Assessment Days and associated courses for this financial year as we have to remain vigilant and mindful about the potential social distancing logistics hosting these programmes would cause due to the high number of applicants involved. We appreciate that cancelling these two programmes is not ideal and will be a huge disappointment to those candidates who had submitted successful applications. Further information relating to the cancellation of these programmes can be found on Delen

    We will post further updates on Delen as and when required and always in line with the latest government guidance and social distancing criteria.

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    Clinical Coding Training Programme & Clinical Coding Auditor Programme Framework Consultation

    Our consultation describes how elements of the Clinical Coding Auditor Programme, and Clinical Coding Trainer Programme frameworks can be adapted or expanded to make the requirements framework more robust.

    We would appreciate your comments on this proposal, which is open for feedback until 30 June 2020.

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    Classifications Query Resolution Form

    For all classifications-related queries, please use the new Query Resolution form which is available on the Clinical Coding Query Mechanism page.

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    NHS Digital Classifications Browser

    The NHS Digital Classifications Browser was updated in March to include the OPCS-4.9 Classification, National Clinical Coding Standards for ICD-10 and OPCS-4 2020 and Chemotherapy Regimens Clinical Coding Standards and Guidance 2020. The links within the OPCS-4.9 Classification go directly to the National Clinical Coding Standards OPCS-4 2020. You can now access OPCS-4.8 and OPCS-4.9 in the Browser.

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    OPCS-4.9 eVersion & National Clinical Coding Standards Guidance

    For those who continue to use the eVersions, the OPCS-4.9 eVersion Book and National Clinical Coding Standards (NCCS) reference book (2020) are available to download from TRUD.

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    Chemotherapy Regimens Clinical Coding Standards Guidance

    The Chemotherapy Regimens Clinical Coding Standards and Guidance April 2017 were updated, for use from 1 April 2020, to remove any reference to the use of high cost drugs to align with the changes made to the High Cost Drugs Clinical Coding Standards. The chemotherapy Procurement and Delivery codes (X70-X74) have not changed in OPCS-4.9 and the regimens list 17-18 remains the same. Coders must continue to code chemotherapy regimens using the OPCS-4 classification codes, Clinical Coding Standards and Guidance and the 17-18 regimens list from April 2020.

    We previously advised that the April 2017 standards and regimens would be the last planned update to the regimen list by NHS England and Improvement in this format, as they were working on a revised approach to capturing information about chemotherapy delivery mechanisms and generating appropriate reimbursement ready for implementation in 2019/20. This revised approach is still being agreed and the collection of OPCS-4 codes for chemotherapy are still required.

    We will communicate further when the revised approach has been agreed and the effect on OPCS-4 codes and standards is known.

    The Chemotherapy Regimens Clinical Coding Standards and Guidance 2020 and the Regimens List 17-18 are available from Delen and the Classifications Browser.

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    March & September 2020 NCCQ Examinations - COVID-19

    Due to the current situation regarding the COVID-19 precautions, IHRIM announced the cancellation of the March 2020 and more recently the September 2020 National Clinical Coding Qualification (UK) Examinations. Further details can be found on the IHRIM website.

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    National Clinical Coding Standards ICD-10 & OPCS-4 Reference Books (2020)

    In February, we published the National Clinical Coding Standards ICD-10 and OPCS-4 reference books for use from 01 April 2020, the OPCS-4.9 Supplementary Information and OPCS-4.9 Key Learning Points on the Publications & Resources page.

    Following the initial release of the reference books, they were both updated in March with minor alterations:

    ICD-10 Reference Book (2020)

    The clinical coding standard DCS.XXII.5: Novel Coronavirus (2019-nCoV) (U07.1) was updated to DCS.XXII.5: COVID-19 (U07.1) to reflect the change to the name designated by WHO.  Although there was no change to the coding instruction for hospital providers, additional guidance was provided, however coders must use the COVID-19 National Clinical Coding Standards and Guidance page on Delen in preference to DCS.XXII.5 within the reference book.

    OPCS-4 Reference Book (2020)

    PCSX24: High Cost Drugs (X81 – X98) was updated following feedback from the National Casemix Office to make it clear that X90.4 Intravenous nutrition Band 1 must be assigned once on every episode that a patient receives parenteral nutrition.

    Only the updated versions are available on Delen and from the Classifications Browser and eVersion books for download from TRUD.

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    Have your say

    If you would like more information about any aspect of our products and services, please let us know. Just write to us at information.standards@nhs.net, quoting “T+CD Newsletter” in the “Subject” field and providing details of what you would like us to cover.

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    By Katy Park 2 years ago

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  • 2020/21 Classifications Training Schedule Update (June 2020)

    Published: June 2020

    Dear colleague,

    Following on from our previous update published on Delen in March 2020, and recognising that we won’t be able to compress a full year’s delivery schedule into six months, we have agreed the following updates to our 2020/21 training schedule, all of which will remain subject to possible revision based on government guidance and social distancing restrictions due to the COVID-19 pandemic.

    Trainer Refresher Course and associated Re-Certification assessments (TR1a/TR1b/TR1c) – rescheduled from May 2020 15-17 September 2020 London – venue TBC
    Trainer Refresher Course and associated Re-Certification assessments (TR2a/TR2b/TR2c) 20-22 October 2020 The Met, Leeds
    Train the Trainer Course – rescheduled from March 2020 23-27 November 2020 Montague on the Gardens, Holborn, London
    Auditor Forum (AF1) 03 March 2021 Future Inn, Bristol City Centre
    Auditor Forum (AF2) 10 March 2021 Delta Hotels (Marriott), Milton Keynes
    Auditor Forum (AF3) 17 March 2021 Montague on the Gardens, Holborn, London
    Auditor Forum (AF4) 24 March 2021 The Met, Leeds


    The five ‘Introduction to Classifications’ events for trainers are planned to go ahead during September and November – approved trainers should refer to the Approved Trainer Workspace for further information.

    Regrettably, we will have to cancel the Clinical Coding Auditor and Clinical Coding Trainer Programme Assessment Days and associated courses for this financial year as we have to remain vigilant and mindful about the potential social distancing logistics hosting these programmes would cause due to the high number of applicants involved. We appreciate that cancelling these two programmes is not ideal and will be a huge disappointment to those candidates who had submitted successful applications. We will however automatically carry over the successful applications to 2021/22 and advise candidates to liaise with their finance departments to close the existing Purchase Order (PO) numbers for this year. New POs will need to be raised next year.

    Our records show that 80% of UK Trusts currently have at least one approved auditor, trainer, or both in post so we are confident that cancelling the programmes for one year will not prove too detrimental to organisations, given the exceptional circumstances. We will, of course, give due consideration as to how we can potentially avoid compromising anyone eligible to apply in 2021/22.

    We will post further updates as and when required and always in line with the latest government guidance and social distancing criteria.

    Kind regards

    Terminology & Classifications Delivery Service

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    By Katy Park 2 years ago

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  • 2020-21 National Clinical Coding Training Handbook - Now Available

    Published: June 2020

    Dear colleague,

    The 2020-21 National Clinical Coding Training Handbook is now available to download from our Publications and Resource page.

    Kind regards

    Terminology & Classifications Delivery Service

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    By Katy Park 2 years ago

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