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  • Update to COVID-19 National Clinical Coding Standards and Guidance – nMABs

    Published November 2021

    Dear Colleague, 

    The COVID-19 National Clinical Coding Standards have been updated to include a coding standard for Neutralising monoclonal antibodies (nMABs) for the treatment of COVID-19 for episodes ending on or after 01 November 2021.

    The downloadable format of the COVID-19 National Clinical Coding Standards (01 November 2021) has been updated along with the summary of changes.

    Kind regards,

    Terminology & Classifications Delivery Service

    Read All News Articles

    By Greg Tait 11 months ago

    Read this article

  • COVID-19 coded data review, England, 2020-21

    Dear Colleagues,

    Following publication of the COVID-19 National Clinical Coding Standards and guidance, we have analysed the coded data recorded in HES Admitted Patient Care 2020-21 to evaluate adherence to the standards. We have evaluated the coding of COVID-19 pneumonia and the implementation of the new OPCS-4.9 code E85.6 Continuous positive airway pressure. Our findings can be found here or via COVID-19 National Clinical Coding Standards and Guidance.

    This article is aimed at clinical coding professionals working in secondary care, and those with an interest in coded data, to highlight the importance of accurate and consistent clinical coding for quality COVID-19 data. We hope you find this information interesting. We intend to publish more of this type of information and we welcome feedback on the format and also suggestions for any other areas of interest you would like us to review.

     Kind regards

     Terminology and Classifications Delivery Service

    By Victoria Tudge 11 months ago

    Read this article

  • 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

    Read All News Articles

    By Victoria Tudge 1 year ago

    Read this article

  • 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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  • ICD-10 Emergency use codes for COVID-19 (U07.6 and U07.7)

    Published February 2021

    Dear Colleague,

    The following two ICD-10 codes in category U07 are now available for use with immediate effect for episodes ending on or after 01 February 2021. 

    U07.6 Need for immunization against COVID-19

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

    These codes must be used with the COVID-19 Clinical Coding Standards and Guidance which have been updated to instruct coders on their use.

    Note that the conditions at codes U07.6 and U07.7 were designated by the World Health Organization (WHO) at categories U11 and U12 for countries that are unable to report codes at four-character level. However, as these categories are not currently included as part of the NHS ICD-10 5th Edition data file, the WHO has agreed that countries which are technically constrained from using the issued three-character categories may utilise available emergency four-character codes already included at U07. Further information is available on the COVID-19 and ICD-10 page on Delen.

    The emergency codes and descriptions and associated COVID-19 clinical coding standards and guidance are available on the COVID-19 National Clinical Coding Standards and Guidance page.

    The eVersion shared notes reflecting the code descriptions of the Emergency use codes within categories U06 and U07 released in November 2020 have been updated to include the additional codes at U07.6 and U07.7. The notes can be downloaded from the Classifications Browser and e-Versions page on Delen.

    Kind regards, 

    Terminology and Classifications Delivery Service 

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    By Victoria Tudge 1 year ago

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  • ICD-10 codes for COVID-19 vaccination

    ICD-10 codes for COVID-19 vaccination

    Published: January 2021

    Dear Colleague,

    Further ICD-10 emergency use codes to classify COVID-19 vaccination are being considered by the World Health Organization (WHO).  As a WHO Family of International Classifications (WHO-FIC) Collaboration Centre we are involved in the current discussions with WHO.  The codes being considered are for:

    • Need for immunisation against COVID-19 as a reason for encounter
    • COVID-19 vaccine causing adverse reaction 

    The codes and descriptions have yet to be finalised by WHO and will be supplemented by national guidance. 

    As soon as WHO publish the two new codes and national guidance has been agreed with the home nations, we will send a notification about the codes with any relevant instructions on their use.  This information will be posted under COVID-19 National Clinical Coding Standards and Guidance on our collaboration website. 

    Kind regards, 

    Terminology and Classifications Delivery Service

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    By Claire Fennell 1 year ago

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  • ICD-10 Emergency use codes for COVID-19

    Published: November 2020

    Dear Colleague, 

    The following three ICD-10 codes in category U07 are now available for use for episodes ending on or after 01 November 2020 to identify conditions that occur in the context of COVID-19. 

    U07.3 Personal history of COVID-19

    U07.4 Post COVID-19 condition

    U07.5 Multisystem inflammatory syndrome associated with COVID-19

    These codes are for use with immediate effect. There is no expectation for episodes already coded on or after 01 November to be recoded, unless there is a local requirement to do so.

    These codes must be used with the COVID-19 Clinical Coding Standards and Guidance which have been updated to instruct coders on their use.

    Note that the conditions at codes U07.3, U07.4 and U07.5 were designated by the World Health Organisation (WHO) at categories U08, U09 and U10 for countries that are unable to report codes at four-character level. However, as these categories are not currently included as part of the NHS ICD-10 5th Edition data file, the WHO has agreed that countries which are technically constrained from using the issued three-character categories may utilise available emergency four-character codes already included at U07. Further information is available on the COVID-19 and ICD-10 page on Delen.

    The emergency codes and descriptions and associated COVID-19 clinical coding standards and guidance are available on the COVID-19 National Clinical Coding Standards and Guidance page.

    Kind regards,

    Terminology and Classifications Delivery Service

    Read All News Articles

    By Victoria Tudge 1 year ago

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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 2 years ago

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  • Update to COVID-19 National Clinical Coding Standards and Guidance

    Published: April 2020

    We have received a large number of queries through the product support helpdesk regarding the COVID-19 standards and guidance. Therefore the COVID-19 National Clinical Coding Standards and Guidance have been updated throughout to provide clarification based on these queries.

    We have also sought further guidance from the WHO on the assignment of U07.2 Emergency use of U07.2 for cases of clinically diagnosed COVID-19 with a negative test result. We can confirm that U07.2 must be assigned when laboratory testing for COVID-19 is negative, reported as inconclusive, or has not been carried out but the responsible consultant confirms a diagnosis of COVID-19 based on clinical or epidemiological evidence (i.e. COVID-19 is clinically diagnosed and therefore not ruled out).

    We recommend you familiarise yourself with this updated guidance and if this answers a previously submitted helpdesk query that no longer requires a resolution please contact information.standards@nhs.net quoting your service desk reference number to retract your query.

    Kind regards

    Terminology & Classifications Delivery Service

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    By Greg Tait 2 years ago

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