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• Update to April 2021 Coding Clinic

  Dear Colleague,

  The April 2021 Coding Clinic has been republished with corrections to 'Suspension, mesh, infracoccygeal vault' on page 37 and 'Removal of mesh implanted during previous repair of vaginal vault prolapse, partial' on page 41 and is available to download from the Publications & Resources page on Delen.

  Kind regards,

  Terminology and Classifications Delivery Service

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  By Victoria Tudge 1 year ago

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• Updated Clinical Coding Trainer and Auditor Programme documents

  Dear Colleague,

  The following updated documents are now available for download from the Publications and Resources area on the Delen homepage:

  CCTP Handbook 2021-22

  Approved Clinical Coding Trainer Code of Conduct 2021-22

  CCAP Handbook 2021-22

  Approved Clinical Coding Auditor Code of Conduct 2021-22

  Approved Clinical Coding Auditor Guide to Best Practice 2021-22

  For candidates sitting either the CCAP or CCTP Assessment Days in May and June respectively, it is important you review the relevant programme handbook(s) as there are some important changes to the content of the written assessment papers and bibliographies for 2021-22.

  Kind regards,

  Terminology and Classifications Delivery Service

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  By Chris Brooke 1 year ago

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• Coding Clinic April 2021

  Dear Colleague, 

  The April 2021 Coding Clinic [V9.0] is available for download from the Publications & Resources page on Delen.

  Kind regards, 

  Terminology and Classifications Delivery Service

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  By Claire Fennell 1 year ago

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• Classifications Query Resolution Form: 01 April 2021

  Dear colleague,

  A new Query Resolution Form has been uploaded to the Clinical Coding Query Mechanism for use from 01 April 2021.

  You can access the form here.

  Kind regards

  Terminology & Classifications Delivery Service

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  By Claire Fennell 1 year ago

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• Terminology and Classifications Delivery Service external newsletter: March 2021

  

  Terminology and Classifications Delivery Service Newsletter
  
  

  
  
  

  Welcome to the March 2021 Newsletter. In this issue, we feature:

  • The NHS Digital Terminology Server

  • 2021-22 SNOMED CT UK Edition Release Schedule

  • OPCS-4.9 Development

  • COVID-19 Codes and Clinical Coding Standards

  • Coding Clinic release

  • Terminology and Classifications Delivery Service Annual Customer Survey – final call for responses

  

  The NHS Digital Terminology Server

  The NHS Digital Terminology Server is a FHIR®-compliant solution that holds and disseminates assured international terminologies and classifications (such as SNOMED-CT and ICD-10) and national terminologies (such as NHS Data Model and Dictionary codes).

  We have developed the NHS Digital Terminology Server to deliver assured content in FHIR®-compliant, machine-readable formats, regardless of which terminology is being accessed. The accuracy of the content is maintained through tightly managed editorial controls. This will remove the need to manually update systems with downloaded content from TRUD and other terminology sites.

  The server also incorporates a syndication feed (API) which enables content to be syndicated across a group of terminology servers, allowing users to share their terminologies with others.

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  2021-22 SNOMED CT UK Edition Release Schedule

  Details of the 2021-22 release can be found here.

  

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   OPCS-4.9 Development

  The process to update OPCS-4.9 has begun and we anticipate that, subject to approval by the Data Alliance Partnership Board) OPCS-4.10 will be scheduled for release to systems suppliers in November 2022, for NHS implementation on 1 April 2023. If you would like to submit a change to be considered for inclusion in the OPCS-4.10 release, please do this via the Request Submission Portal by 1 October 2021. We intend to process requests as they are received and would appreciate early submissions, so that we can carry out the necessary research and engagement as soon as possible, rather than wait until after the submission deadline.

  When you visit the Request Submission Portal, please take a moment to review the OPCS-4 requests that have already been submitted before submitting your own, in case your request is covered by an existing one.

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  COVID-19 Codes and Clinical Coding Standards

  The diagram below shows the emergency use ICD-10 codes designated for coding of COVID-19 conditions for use in the UK:

  

  In February 2021, we published two new emergency use ICD-10 codes for morbidity coding under the direction of the World Health Organization, to classify:

  U07.6 Need for immunization against COVID-19

  and

  U07.7 COVID-19 vaccines causing adverse effects in therapeutic use

  The COVID-19 National Clinical Coding Standards section ‘Post COVID-19 condition (U07.4)’ was also updated to ensure that - in a long episode of care where acute COVID-19 and a subsequent post COVID-19 condition are both recorded - these can be coded.

  In response to feedback from the coding service, the following changes were made to the COVID-19 National Clinical Coding Standards for implementation from 1 April 2021:

  • minor textual changes to provide clarity on instructions within the standards
  • deletion of standards associated with routine testing as this has now become standard practice on hospital admissions
  • additional examples to illustrate the use of the COVID-19 emergency use codes
  • publication of the COVID-19 standards in a downloadable format
  • inclusion of an implementation timeline for the COVID-19 codes and a Summary of Changes for the coding standards and guidance

  As more information emerges about COVID-19 and where changes to the COVID-19 standards or guidance are necessary, Delen and the COVID-19 National Clinical Coding Standards will be updated.

  We would like to thank those of you who have sent in information and queries about the coding of COVID-19 and the standards; these have allowed us to understand new and arising COVID-19 situations that need to be reflected in the clinical coding standards and guidance.

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  Coding Clinic release

  Following collaboration with clinical representatives of the NHS England Mesh Registry sub-group, we have developed a guidance table for inclusion in the April 2021 Coding Clinic to assist coders in the coding of procedures performed for female Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP) that are not easily reached using the OPCS-4 Alphabetical Index. For more information, please refer to Ref 121: Procedures performed for female pelvic organ prolapse and stress urinary incontinence in the Coding Clinic, which you can read here.

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  Terminology and Classifications Delivery Service Annual Customer Survey – final call for responses

  We would like to thank everyone who has already responded to the survey and to remind anyone who hasn’t yet done so that the survey closes on 31 March. Your feedback helps us understand how useful our products and services are, as well as where we should aim to make improvements. Please try to find time to respond to our annual customer survey.

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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 Claire Fennell 1 year ago

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• Re-release of National Clinical Coding Standards OPCS-4 Reference Book (2021) and publication of COVID-19 National Clinical Coding Standards (01 April 2021)

  Published March 2021

  Dear Colleague, 

  The National Clinical Coding Standards OPCS-4 reference book (2021) has been re-released with the addition of a new coding standard PCSK10: Renewal of pacemaker generator/battery (K73.- and K74.-) and a minor correction to PCSU9: Bone densitometry (U13.1). It is now available to download from the Publications & Resources page on Delen.

  We apologise for any inconvenience this may cause.

  In response to feedback from the coding service, we have published the COVID-19 National Clinical Coding Standards (01 April 2021) in a downloadable format for use from 01 April 2021. Based on feedback received through the Product Support Helpdesk, the standards have been updated as follows:

  • Minor textual changes to provide clarity on the instruction within the standard
  • Deletion of standards associated with routine testing as this has now become standard practice on hospital admissions
  • Additional examples to illustrate the use of the COVID-19 emergency use codes

  All changes can be found in the Summary of Changes section with a rationale for the change where applicable. These changes will take effect from 01 April 2021, at which point the COVID-19 Delen page will also be updated.

  Kind regards

  Terminology & Classifications Delivery Service

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  By Victoria Tudge 1 year ago

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• NCCQ(UK) Syllabus, Framework, Bibliography and Self-directed Learning Framework 2021-22

  Published March 2021

  The NCCQ (UK) Syllabus, Framework and Bibliography 2021-22 and NCCQ (UK) Self-Directed Learning Framework 2021-22 have been updated for 2021-22. These documents can be found on the NCCQ(UK) Delen page.

  The Self-directed Learning Framework has minor changes to reflect the examination being taken in an online environment.

  In collaboration with IHRIM the Bibliography has been updated to simplify the resources for Clinical Coding Audit and Healthcare Resource Groups.

  The latest IHRIM information about the 2021/22 NCCQ (UK) Examination can be found on the IHRIM website.

  Kind regards

  Terminology & Classifications Delivery Service

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  By Greg Tait 1 year ago

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• COVID-19 Vaccination Codes

  Published March 2021

  Dear Colleague, 

  1324761000000100

  Document Change Log

  Date	Version	Description
  13/11/2020	1.0	FINAL document approved by NHS Digital COVID-19 vaccine programme	Jeremy Rogers Jo Goulding Helen Harger
  26/11/2020	1.1	Updated dm+d descriptions for ‘Courageous’ – now ‘COVID-19 mRNA Vaccine BNT162b2’	Jo Goulding
  07/12/2020	1.2	·       embedded hyperlinks to TermBrowser updated (now agnostic of SNOMED release) ·       minor typo and other text corrections ·       Addition of new pack size for BNT162b2 vaccine to allow GTIN addition (2D datamatrix will be on the outer box of 195vials, not on individual vials)	Jeremy Rogers Jo Goulding
  13/12/2020	1.3	Addition of new dm+d concepts for “Astute” vaccine (Janssen/J&J) ·       Additions in dm+d release 14/12/2020 ·       Due in SNOMED CT Browser February 2021	Jo Goulding
  06/01/2021	1.4	Updated descriptions for Project Talent (Oxford/AstraZeneca) vaccine Addition of GTIN information to new packsizes Note – new dm+d additions not currently in SNOMED CT. Hyperlinks to be added once information available in SNOMED CT release.	Jo Goulding
  20/01/2021	1.5	Addition of new dm+d concepts for ‘Renown’ vaccine (Moderna, Inc) New VTM for all vaccine products Note – new dm+d additions not currently in SNOMED CT. Hyperlinks to be added once information available in SNOMED CT release. Updated descriptions for ‘first dose’ SNOMED CT codes to reflect use in single dose vaccination schedules	Jo Goulding
  01/02/2021	1.6	Amendments to Pfizer (‘Courageous’) vaccines: ·       Pack size change to 6 dose multidose vials (from 5 dose) Note – no change to product, only change to recommendations for use. Therefore, amended pack size descriptions not new products added. ·       Word order update in description to follow pattern from other vaccines ·       Supplier change to Pfizer Ltd	Jo Goulding
  11/02/2021	1.7	Addition of new dm+d concepts for Valneva vaccine. Note – new dm+d additions not currently in SNOMED CT. Hyperlinks to be added once information available in SNOMED CT release.	Jo Goulding
  19/03/2021	1.8	Addition of new dm+d concepts for Novavax vaccine Addition of single vial (10 dose) VMPP and AMPP concepts for Moderna vaccines Note – new dm+d additions not currently in SNOMED CT. Hyperlinks to be added once information available in SNOMED CT release.	Jo Goulding

  
  

  SNOMED CT codes relating to COVID-19 Vaccination

  The following is the list of SNOMED CT procedure and product codes intended to support a mass vaccination campaigns in the UK specifically against COVID-19.

  The range and intended use of the codes shown here is similar to that already available for other established mass immunisation campaigns – in particular those for which the primary immunisation schedule also involves more than one vaccine dose administration event.

  However, unlike the SNOMED CT codesets available for some other national immunisation programmes, much of the administrative detail relating to a patient’s journey through a call:recall system are not covered. This aspect of running the overall campaign will be carried out by a central system that neither needs nor uses SNOMED CT codes specifically in order to represent (for example) when a patient has been sent an urgent SMS notification advising them of a late change to their next immunisation appointment date. Instead, many of the various patient states that this call-recall engine will be required to reason over will be represented only within that system and by some other non-SNOMED CT means, and does not need to be also shared more widely into other live clinical systems as SNOMED CT codes.

  The currently available SNOMED CT expressivity, therefore, aims to cover only the core clinical information about an individual’s immunisation journey that should be shareable with any other clinician for whom an understanding of the patient’s immunisation status could influence subsequent clinical decisions.

  Which specific vaccine preparation was used at any specific vaccination event will be co-recorded as a separate dm+d code for the vaccine preparation.

  The codeset is presented twice; first the raw list of codes and preferred terms and then again but with each code further accompanied by text clarifying its intended clinical meaning and scope.

  Scope

  This document only details SNOMED CT content related directly to COVID-19 Vaccination.

  It does not cover other SNOMED CT content pertaining to COVID-19 disease, complications, treatment etc. (e.g., 1325161000000102 Post-COVID-19 syndrome)

  
  

  CODE LIST FOR SARS-CoV-2 VACCINATION

  
  Codes shown in black are already published; those in red are new codes added in the 28 October 2020 release of SNOMED CT UK Edition and subsequent releases.
  (Codes are hyperlinked to termbrowser.nhs.uk)

  See following “list with scope notes” for further explanation.

  CLINICAL FINDING

  1240601000000108        High priority for SARS-CoV-2 vaccination 

  1240631000000102        Did not attend SARS-CoV-2 vaccination
  1324831000000104        Did not attend for first dose of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine
  1324841000000108        Did not attend for second dose of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine

  1324661000000105       Adverse reaction to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine
  1324711000000102       Allergy to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine

  PROCEDURE

  1324671000000103 Immunisation course to achieve immunity against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2)
  1324681000000101 Administration of first dose of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine
  1324691000000104 Administration of second dose of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine

  SITUATION WITH EXPLICIT CONTEXT

  1324731000000105 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course not indicated
  1324761000000100 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course contraindicated
  1324811000000107 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course declined
  1324821000000101 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course not done
  1324851000000106 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course started
  1324861000000109 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course abandoned
  
  1324721000000108 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination dose declined
        1324741000000101 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination first dose declined
        1324751000000103 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination second dose declined
  1324771000000107 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination dose not given
        1324781000000109 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination first dose not given
        1324791000000106 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination second dose not given

  PHARMACEUTICAL / BIOLOGIC PRODUCT

  All COVID-19 Vaccine VMPs linked to:

  VTM: 39330711000001103 COVID-19 vaccine

  Project Courageous (Pfizer):

  VMP: 39116111000001100 Generic COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials
  AMP: 39115611000001103 COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials (Pfizer Ltd)

  VMPP: 39115311000001108 Generic COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials 6 dose

  VMPP: 39214411000001100 Generic COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials 1170 dose – 195 x 6 dose vials

  AMPP: 39115711000001107 COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials (Pfizer Ltd) 6 dose

  AMPP: 39214511000001101 COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials (Pfizer Ltd) 1170 dose – 195 x 6 dose vials                                        GTIN: 00359267100023

  Project Talent (AstraZeneca):

  VMP: 39116211000001106 Generic COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials
  AMP: 39114911000001105 COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca) 
  VMPP: 39114711000001108 Generic COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials 8 dose
  VMPP: 39114811000001100 Generic COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials 10 dose

  VMPP: 39301011000001100 Generic COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials 80 dose 10 x 8 dose vials
  VMPP: 39301111000001104 Generic COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials 100 dose 10 x 10 dose vials

  AMPP: 39115011000001105 COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca) 8 dose
  AMPP: 39115111000001106 COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca) 10 dose

  AMPP: 39301211000001105 COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca) 80 dose 10 x 8 dose vials                                                        GTIN: 05000456063876
  AMPP: 39301311000001102 COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca) 100 dose 10 x 10 dose vials                                      GTIN: 05000456063821

  Project Astute (Janssen-Cilag):

  VMP: 39233911000001100 Generic Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials
  AMP: 39230211000001104 Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials (Janssen-Cilag Ltd) 
  VMPP: 39230011000001109 Generic Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials 5 dose
  VMPP: 39230111000001105 Generic Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials 50 dose
  AMPP: 39230311000001107 Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials  (Janssen-Cilag Ltd) 5 dose
  AMPP: 39230411000001100 Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials (Janssen-Cilag Ltd) 50 dose                                                                

  Project Renown (Moderna):

  VMP: 39326811000001106 Generic COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5mL dose dispersion for injection multidose vials
  AMP: 39326911000001101 COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5mL dose dispersion for injection multidose vials (Moderna, Inc) 
  VMPP: 39375311000001106 Generic COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5ml dose dispersion for injection multidose vials 10 dose

  VMPP: 39326611000001107 Generic COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5ml dose dispersion for injection multidose vials 100 dose 10 x 10 dose vials

  AMPP: 39375411000001104 COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5ml dose dispersion for injection multidose vials (Moderna, Inc) 10 dose

  AMPP: 39327011000001102 COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5ml dose dispersion for injection multidose vials (Moderna, Inc) 100 dose 10 x 10 dose vials                                                                                      GTIN: 30380777700688

  Valneva:

  VMP: 39375211000001103 Generic COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials
  AMP: 39373511000001104 COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials (Valneva UK Ltd)
  VMPP: 39373011000001107 Generic COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials 10 dose

  VMPP: 39373111000001108 Generic COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials 100 dose 10 x 10 dose vials
  AMPP: 39374411000001100 COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials (Valneva UK Ltd) 10 dose

  AMPP: 39374711000001106 Generic COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials (Valneva UK Ltd) 100 dose 10 x 10 dose vials                                       GTIN: 09120040710330

   
  Novavax:

  VMP: 39330711000001103 Generic COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials

  VMPP: 39472811000001101 Generic COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials 10 dose

  VMPP: 39472911000001106 Generic COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials 100 dose 10 x 10 dose vials

  AMP: 39473011000001103 COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials (Baxter Oncology GmbH)

  AMPP: 39473111000001102 COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials (Baxter Oncology GmbH) 10 dose

  AMPP: 39473211000001108 COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials (Baxter Oncology GmbH) 100 dose 10 x 10 dose vials                                                                        GTIN: 00380631100103

  END.               

  
  

  CODE LIST FOR SARS-CoV-2 VACCINATION, WITH SCOPE NOTES

  Codes shown in black are already published; those in red are proposed new codes.
  Codes in brown are published but now unlikely to be used.
  Codes in grey are published but now inactive and should never be used.

  CLINICAL FINDING

  1240601000000108  High priority for SARS-CoV-2 vaccination

                                    Subject is in one or more cohorts prioritised for vaccination 

  1240631000000102  Did not attend SARS-CoV-2 vaccination

  Subject did not attend a scheduled appointment where they were due to receive a vaccine dose.

  New entries into individual patient records should NEVER use this code: they should instead be expressed only using one of its child codes stating exactly which dose of the primary immunisation schedule had been missed.

  This code has value mainly only when constructing queries to retrieve patients who have missed either dose.

        1324831000000104 Did not attend for first dose of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine

  Subject did not attend a scheduled appointment where they were due to receive the first vaccine dose (or the only dose of a single dose schedule vaccine)              

        1324841000000108 Did not attend for second dose of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine

                                          Subject did not attend a scheduled appointment where they were due to receive the second vaccine dose

  1324661000000105 Adverse reaction to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine
  1324711000000102 Allergy to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine

  Subject experienced some kind of adverse or allergic reaction to at least one vaccine dose.

  PROCEDURE

  1324671000000103 Immunisation course to achieve immunity against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2)

  The idea of a course of therapy intended to induce an immunity to SARS-CoV-2 infection.
  This code exists mainly as a technical byproduct of creating the more specific codes (below) by which the stages of a course of treatment to immunise an individual patient can be recorded.
  When recorded on its own and “as is”, this code in fact indicates that such a course was completed on that record date; this code must therefore NOT be used to record when such a course has merely started.
  An immunisation course will comprise one or more vaccine dose administration events, to be coded as:

  1324681000000101 Administration of first dose of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine                              The subject was given the first dose of a vaccine against SARS-CoV-2 on the date recorded.

  This includes the administration of the only dose of a single dose schedule vaccine (need for a subsequent dose will be informed by inspecting the record of the specific vaccine used).

  1324691000000104 Administration of second dose of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccine                The subject was given the second dose of a vaccine against SARS-CoV-2 on the date recorded

  SITUATION WITH EXPLICIT CONTEXT

  1324731000000105 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course not indicated

  The subject has no clinical indication for commencing a primary immunisation schedule against SARS-CoV-2

  e.g. because they are not at (sufficient) risk.

  Different from saying that only one or other dose is not indicated, for which other codes exist.

  The course may be indicated at the start, but at some later point in time one of its doses is not.

  Conversely, however, if the course is not indicated at the outset then by implication none of its doses are either – though it is usually considered redundant to record both that the course as a whole is not indicated and also separately that neither dose is.

  1324761000000100 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course contraindicated

  The entire primary immunisation schedule was not started because of e.g. Immunosuppression or other comorbidity.

  Although usually permanent, such contraindications may be only temporary, and so the subject is not necessarily permanently excluded from all future enrolment in a course of vaccination.

  By contrast, contraindication to a dose (see below) is more likely to be only temporary .. but a more permanent contraindication to completing the schedule is also not excluded.
  Operationally, the presence of this code in the EPR as an active problem implies that no future vaccine doses should be given, at least not without careful clinical scrutiny of the record

  Note that other codes also carry this or a similar implication.

  See also the ‘vaccine dose contraindicated’ codes below.

  1324811000000107 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course declined

  The subject declined an offer to begin the primary immunisation schedule against SARS-CoV-2, and so was never invited to receive even the first dose
  Different from declining individual dosing events, for which separate codes exist.

  A subject may agree to being immunised, decline the first dose event due to temporary illness, be rescheduled and then go on to complete the course as planned

  1324851000000106 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course started

  The subject accepted an offer to begin the primary immunisation schedule against SARS-CoV-2, and either has been or will be invited to receive at least the first dose

  1324821000000101 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course not done

  The patient has a valid indication and did not decline vaccination, but the vaccination course was never started for some other reason (e.g. policy change)

  Different from “abandoned” (see below), which implies that the course WAS started

  1324861000000109 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) immunisation course abandoned

  A primary immunisation course was started, but either zero or only the first dose was ever actually given before the attempt was permanently abandoned. No further doses will be given.

  Valid reasons for recording “abandoned” could include e.g. that the patient has unfortunately already contracted COVID-19 or developed a new contraindicaiton; the patient withdraws consent to proceed; the vaccine product has to be withdrawn from the market

  1. If a new contraindication emerges, this should always be recorded as at least a contraindication code.

  1240651000000109 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination declined

  The subject declined to receive at least one vaccine dose

  Technically different from contraindicated but note that the reason a subject may decline an individual dose could include that they currently feel unwell, and the underlying suspected condition causing that illness may also be a contraindication.

  More common reasons could include e.g. that the appointment slot has become inconvenient or impractical for them to access, or that a child subject or needle phobic adult became too distressed to receive it

  New entries into individual patient records should however ideally not be made using this code but instead only using one of its child codes that specify which vaccine dose was declined.

  This code has value mainly only when constructing queries to retrieve patients for whom either dose was ever specifically declined

        1324741000000101 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination first dose declined

  The subject declined to receive the first vaccine dose (or the only dose of a single dose schedule vaccine), on the record date

  Where the vaccinator declines to administer the vaccine to the subject for any reason (e.g physical aggression from an elderly and confused subject), a different “not given” code should be used

        1324751000000103 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination second dose declined

  The subject declined to receive the second vaccine dose, on the record date

  Where the vaccinator declines to administer the vaccine to the subject for any reason (e.g physical aggression from an elderly and confused subject), a different “not given” code should be used

  1324771000000107 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination dose not given

                                    Administration of at least one vaccine dose could not be performed

  New entries into individual patient records should however ideally not be made using this code but instead only using one of its child codes that specify which vaccine dose was declined.

  This code has value mainly only when constructing queries to retrieve patients for whom either dose could not be given for any reason

        1324781000000109 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination first dose not given

  A scheduled administration of the first vaccine dose (or the only dose of a single dose schedule vaccine) could not be performed, on the record date, for any reason EXCEPT those separately codeable (did not attend, contraindicated, declined)

  Reasons could include e.g. lack of vaccine dose supply; aggressive behaviour toward the vaccinator by the subject

        1324791000000106 SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination second dose not given

  A scheduled administration of the second vaccine dose could not be performed, on the record date, for any reason EXCEPT those separately codeable (did not attend, contraindicated, declined)

  Reasons could include e.g. lack of vaccine dose supply; aggressive behaviour toward the vaccinator by the subject

  PHARMACEUTICAL / BIOLOGIC PRODUCT

  39115611000001103 COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials (Pfizer Ltd)

  39114911000001105 COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca) 

  39230211000001104 Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials (Janssen-Cilag Ltd) 

  39326911000001101 COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5mL dose dispersion for injection multidose vials (Moderna, Inc) 

  39373511000001104 COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials (Valneva UK Ltd)

  39473011000001103 COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials (Baxter Oncology GmbH)

  The above codes correspond to the actual manufactured vaccine products (AMP) and should be used to share information concerning vaccine administration (i.e. to represent which vaccine was given to an individual patient). They must not be confused with other related codes (see below) corresponding to manufacturer packs containing more than one vaccine dose (VMPP and AMPP below) or to the abstract notion of a manufacturer-agnostic formulation (VMP).

  However, the GTIN (‘barcode’), when available, will be linked to the AMPP code and therefore AMPPs will need to be recognised for scanned input of product. Using relationships provided within dm+d natively and in its SNOMEDised derivative, AMPP codes obtained by scanning should then be coerced into a related AMP code (as above) in order for the AMP code only to be communicated as the record of the vaccine product actually administered to an individual patient.

  VMP: 39116111000001100 Generic COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials
  VMPP: 39115311000001108 Generic COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials 6 dose

  VMPP: 39214411000001100 Generic COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials 1170 dose – 195 x 6 dose vials

  AMPP: 39115711000001107 COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials (Pfizer Ltd) 6 dose

  AMPP: 39214511000001101 COVID-19 mRNA Vaccine Pfizer-BioNTech BNT162b2 30micrograms/0.3ml dose concentrate for suspension for injection multidose vials (Pfizer Ltd) 1170 dose – 195 x 6 dose vials                               GTIN: 00359267100023

  VMP: 39116211000001106 Generic COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials
  VMPP: 39114711000001108 Generic COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials 8 dose
  VMPP: 39114811000001100 Generic COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials 10 dose

  VMPP: 39301011000001100 Generic COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials 80 dose 10 x 8 dose vials
  VMPP: 39301111000001104 Generic COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials 100 dose 10 x 10 dose vials

  AMPP: 39115011000001105 COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca) 8 dose
  AMPP: 39115111000001106 COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca) 10 dose

  AMPP: 39301211000001105 COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca) 80 dose 10 x 8 dose vials                                                               GTIN: 05000456063876
  AMPP: 39301311000001102 COVID-19 Vaccine AstraZeneca (ChAdOx1 S [recombinant]) 5x10,000,000,000 viral particles/0.5ml dose solution for injection multidose vials (AstraZeneca) 100 dose 10 x 10 dose vials                                                                      GTIN: 05000456063821

  VMP: 39233911000001100 Generic Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials
  VMPP: 39230011000001109 Generic Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials 5 dose
  VMPP: 39230111000001105 Generic Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials 50 dose
  AMPP: 39230311000001107 Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials  (Janssen-Cilag Ltd) 5 dose
  AMPP: 39230411000001100 Astute 100,000,000,000 (100 billion) viral particles/0.5ml dose solution for injection multidose vials (Janssen-Cilag Ltd) 50 dose

  VMP: 39326811000001106 Generic COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5mL dose dispersion for injection multidose vials
  VMPP: 39375311000001106 Generic COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5ml dose dispersion for injection multidose vials 10 dose

  VMPP: 39326611000001107 Generic COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5ml dose dispersion for injection multidose vials 100 dose 10 x 10 dose vials

  AMPP: 39375411000001104 COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5ml dose dispersion for injection multidose vials (Moderna, Inc) 10 dose

  AMPP: 39327011000001102 COVID-19 mRNA (nucleoside modified) Vaccine Moderna 0.1mg/0.5ml dose dispersion for injection multidose vials (Moderna, Inc) 100 dose 10 x 10 dose vials                                                                                                              GTIN: 30380777700688

  VMP: 39375211000001103 Generic COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials
  VMPP: 39373011000001107 Generic COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials 10 dose

  VMPP: 39373111000001108 Generic COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials 100 dose 10 x 10 dose vials
  AMPP: 39374411000001100 COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials (Valneva UK Ltd) 10 dose

  AMPP: 39374711000001106 Generic COVID-19 Vaccine Valneva (inactivated adjuvanted whole virus) 40antigen units/0.5mL dose suspension for injection multidose vials (Valneva UK Ltd) 100 dose 10 x 10 dose vials                                                        GTIN: 09120040710330

  VMP: 39330711000001103 Generic COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials

  VMPP: 39472811000001101 Generic COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials  10 dose

  VMPP: 39472911000001106  Generic COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials 100 dose 10 x 10 dose vials

  AMPP: 39473111000001102 COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials (Baxter Oncology GmbH) 10 dose

  AMPP: 39473211000001108 COVID-19 Vaccine Novavax (adjuvanted) 5micrograms/0.5ml dose suspension for injection multidose vials (Baxter Oncology GmbH) 100 dose 10 x 10 dose vials                                                                                                   GTIN: 00380631100103

  
  

  UNUSED

  The codes below, although both published and still active in SNOMED CT, are considered now unlikely to be used within the UK: 

  1240781000000106  SARS-CoV-2 vaccination invitation short message service text message sent 

  This code is expected to be supplanted within the national immunisation system by codes internal to that system.

  It is believed that this level of administrative detail does not need sharing into the wider clinical systems

  1240701000000101  SARS-CoV-2 vaccine not available

  This code is expected to be supplanted within the national immunisation system by codes internal to that system.

  It is believed that this level of administrative detail does not need sharing into the wider clinical systems.

  If a vaccine dose could not be administered because no dose was available, this may be messaged to the wider clinical system using one of the “dose not given” codes above.

  WITHDRAWN

  The codes below were added earlier in 2020 to the UK SNOMED Edition but are now made inactive and should not be used.

  1240491000000103 Severe acute respiratory syndrome coronavirus 2 vaccination (procedure)
  1240661000000107 Severe acute respiratory syndrome coronavirus 2 vaccination contraindicated (situation)
  1240651000000109 Severe acute respiratory syndrome coronavirus 2 vaccination declined (situation)
  1240681000000103 Severe acute respiratory syndrome coronavirus 2 vaccination not done (situation)
  1240671000000100 Severe acute respiratory syndrome coronavirus 2 vaccination not indicated (situation)

  END.

  Kind regards, 

  Terminology and Classifications Delivery Service

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  By Claire Fennell 1 year ago

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• 2021-22 Classifications Training Schedule - COVID-19 Update

  Published: February 2021

  Dear Colleague,

  Following publication of the government’s coronavirus roadmap on 22 February 2021, which in part announced that hotels and other hospitality venues are due to reopen on 17 May, we can confirm that we intend to honour the originally published 2021-22 Classifications Training Schedule. We will of course continue to review matters in line with any alterations to government guidance relating to COVID-19 and communicate any changes as necessary.

  Kind regards,

  Terminology and Classifications Delivery Service

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  By Chris Brooke 1 year ago

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• Update to ICD-10 COVID-19 Standard Post COVID-19 condition (U07.4)

  Published: February 2021

  Dear Colleague,

  Based on feedback received through the product support helpdesk we have updated the COVID-19 National Clinical Coding Standards and Guidance section ‘Post COVID-19 condition (U07.4)’. This update ensures that in a long episode where acute COVID-19 and a subsequent post COVID-19 condition are both documented these can be coded.

  Kind regards,

  Terminology and Classifications Delivery Service

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  By Victoria Tudge 1 year ago

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