To help understand the QOF exception rates, access the following support article.
Below outlines the QOF exception coding for this fiscal year (2024/25).
Asthma
Excepted from: | Code Term | Concept ID |
Whole domain | Excepted from asthma quality indicators - service unavailable | 1108701000000106 |
Excepted from asthma quality indicators - patient unsuitable | 717291000000103 | |
Excepted from asthma quality indicators - informed dissent | 716491000000100 | |
Asthma monitoring declined | 763221007 | |
AST011 | Spirometry |
|
Spirometry testing contraindicated | 285671000000103 | |
Unable to perform spirometry | 711382009 | |
QOF (Quality and Outcomes framework) diagnostic spirometry service not available | 1109901000000102 | |
Spirometry not indicated | 415570002 | |
Spirometry reversibility testing not indicated | 279261000000103 | |
Spirometry reversibility testing contraindicated | 415571003 | |
Feno | 148491000000104 |
Atrial Fibrillation
Excepted from: | Code Term | Concept ID |
Whole domain (Please note - these codes will not except patients from AF008) | Excepted from atrial fibrillation quality indicators - informed dissent | 717381000000109 |
Excepted from atrial fibrillation quality indicators - patient unsuitable | 715941000000109 | |
AF008
| Generic persisting (will except the patient from the whole indicator) | 29331003 |
Generic expiring (will except the patient from the whole indicator) | 413558003 | |
Anticoagulation not tolerated | 413561002 | |
Anticoagulation declined | 413559006 | |
DOAC (persisting) DOAC (direct-acting oral anticoagulant) not tolerated |
912861000000104 | |
DOAC (direct-acting oral anticoagulant) contraindicated | 912841000000100 | |
Direct-acting oral anticoagulant adverse reaction | 293332005 | |
Apixaban adverse reaction | 985211000000107 | |
Apixaban allergy | 985271000000102 | |
Apixaban contraindicated | 985631000000101 | |
Apixaban not tolerated | 985331000000105 | |
Dabigatran contraindicated | 846181000000104 | |
Dabigatran not tolerated | 846321000000102 | |
Rivaroxaban adverse reaction | 985231000000104 | |
Rivaroxaban allergy | 985251000000106 | |
Rivaroxaban not tolerated | 985351000000103 | |
Rivaroxaban contraindicated | 985661000000106 | |
DOAC (expiring) DOAC (direct-acting oral anticoagulant) declined |
912661000000103 | |
DOAC (direct-acting oral anticoagulant) not indicated | 912881000000108 | |
Dabigatran not indicated | 846221000000109 | |
Warfarin (persisting) Warfarin contraindicated | 315061006 | |
Warfarin adverse reaction | 293344008 | |
Warfarin not indicated | 134392003 | |
Warfarin not tolerated | 88181000000106 | |
Indirect acting anticoagulant adverse reaction | 293341000 | |
Allergy to acenocoumarol | 294880008 | |
Allergy to phenindione | 294883005 | |
Allergy to indanedione | 782560008 | |
Adverse reaction to coumarin | 81777003 | |
Warfarin (expiring) Warfarin declined |
134398004 |
Cancer
Excepted from: | Code Term | Concept ID |
Whole domain | Excepted from cancer quality indicators - informed dissent | 717601000000107 |
Excepted from cancer quality indicators - patient unsuitable | 716511000000108 |
CKD
Excepted from: | Code Term | Concept ID |
Whole domain | Excepted from chronic kidney disease quality indicators - informed dissent | 716881000000104 |
Excepted from chronic kidney disease quality indicators - patient unsuitable | 716891000000102 |
Cholesterol
Excepted from: | Code Term | Concept ID |
CHOL001 Please note -if a patient has been exception reported from a statin, they should be given the opportunity for an alternative lower lipid therapy (LLT). In order to record a complete exception, the patient needs to be excepted from EACH type of medication (statin and LLT).
| Statin (expiring) Statin declined
|
134396000 |
Statin not indicated | 134391005 | |
Statins contraindicated | 315363002 | |
Statins (persisting) Statin not tolerated |
413174003 | |
History of rhabdomyolysis due to statin | 16524331000119104 | |
HMG COA reductase inhibitor adverse reaction | 293432006 | |
Adverse reaction caused by fluvastatin | 293434007 | |
Adverse reaction caused by pravastatin | 293435008 | |
Allergy to fluvastatin | 294972000 | |
Allergy to pravastatin | 294973005 | |
Rhabdomyolysis due to statin | 787206005 | |
Adverse reaction caused by simvastatin | 293433001 | |
Statin allergy | 294970008 | |
Allergy to simvastatin | 294971007 | |
LLT Adverse reaction to bempedoic acid |
1326581000000108 | |
Bempedoic acid contraindicated | 1326611000000102 | |
Bempedoic acid declined | 1326631000000105 | |
Bempedoic acid not indicated | 1326601000000104 | |
Ezetimibe declined | 1326721000000102 | |
Ezetimibe not indicated | 1326701000000106 | |
Adverse reaction to Ezetimibe | 1134341000006104 | |
Ezetimibe contraindicated | 1326711000000108 | |
Adverse reaction to Icosapent Ethyl | 14340011000006105 | |
Icosapent ethyl contraindicated | 1556841000000104 | |
Icosapent ethyl not indicated | 1556881000000107 | |
Icosapent ethyl declined | 1556871000000105 | |
Inclisiran declined | 1362061000000100 | |
Allergy to Inclisiran | 1362871000000100 | |
Inclisiran not indicated | 1362041000000101 | |
Inclisiran contraindicated | 1362051000000103 | |
Adverse reaction to inclisiran | 1362881000000103 | |
PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor declined | 1326761000000105 | |
PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor not indicated | 1326741000000109 | |
Adverse reaction to alirocumab | 1365441000000102 | |
Allergy to alirocumab | 1365431000000106 | |
Alirocumab not indicated | 1365401000000100 | |
Alirocumab declined | 1365421000000109 | |
Alirocumab contraindicated | 1365411000000103 | |
Adverse reaction to evolocumab | 1365341000000108 | |
Allergy to evolocumab | 1365331000000104 | |
Evolocumab not indicated | 1365361000000109 | |
Evolocumab declined | 1365381000000100 | |
Evolocumab contraindicated | 1365371000000102 | |
LLT (persisting) Lipid-lowering drug adverse reaction |
293417004 | |
LLT (expiring) Lipid lower therapy contraindicated |
135822005 | |
Lipid lower therapy not indicated | 135807000 | |
Lipid lower therapy declined | 135826008 | |
LLT (max tolerated) Patient on maximal tolerated lipid lowering therapy |
407568002 | |
CHOL002 | Lipid screening declined | 141851000119107 |
Lipid disorder monitoring declined | 301111000000107 | |
Cholesterol test declined | 203151000000104 | |
Hyperlipidaemia screening test declined | 9471000175101 |
COPD
Excepted from: | Code Term | Concept ID |
Whole domain | Excepted from COPD quality indicators - informed dissent | 716311000000100 |
Excepted from COPD quality indicators - patient unsuitable | 716291000000101 | |
Excepted from COPD (chronic obstructive pulmonary disease) quality indicators - services unavailable | 1108721000000102 |
Dementia
Excepted from: | Code Term | Concept ID |
Whole domain | Excepted from dementia quality indicators - unsuitable | 716341000000104 |
Excepted from dementia quality indicators – informed dissent | 716131000000105 |
Diabetes
Excepted from: | Code Term | Concept ID |
Whole domain | Excepted from diabetes quality indicators – patient unsuitable | 717421000000100 |
Excepted from diabetes quality indicators – informed dissent | 716031000000106 | |
DM006 If the patient is not prescribed one of these medications due to decline or contraindication, then they need to be excepted from BOTH ACEi and ARB | ACEi (expiring) Angiotensin converting enzyme inhibitor declined | 134397009 |
Angiotensin converting enzyme not indicated | 134390006 | |
Angiotensin converting enzyme not tolerated | 407564000 | |
Angiotensin converting enzyme contraindicated | 315364008 | |
ARB (expiring) Angiotensin II receptor antagonist declined | 401084003 | |
Angiotensin II receptor antagonist not indicated | 407572003 | |
Angiotensin II receptor antagonist not tolerated | 407565004 | |
Angiotensin II receptor antagonists contraindicated | 394987009 | |
ACEi (persisting) Non-allergic hypersensitivity to benazepril | 18321000122100 | |
Non-allergic hypersensitivity to moexipril | 18361000122109 | |
Non-allergic hypersensitivity to imidapril | 18401000122101 | |
Angiotensin-converting-enzyme inhibitor adverse reaction | 293500009 | |
Captopril adverse reaction | 293501008 | |
Lisinopril adverse reaction | 2953502001 | |
Quinapril adverse reaction | 293503006 | |
Ramipril adverse reaction | 293504000 | |
Cilazapril adverse reaction | 293505004 | |
Trandolapril adverse reaction | 293506003 | |
Enalapril adverse reaction | 293507007 | |
Fosinopril adverse reaction | 293508002 | |
Perindopril adverse reaction | 293509005 | |
Angiotensin converting enzyme (ACE) inhibitor-aggravated angioedema | 371627004 | |
Acute renal failure due to ACE inhibitor | 422593004 | |
Angiotensin-converting-enzyme (ACE) inhibitor-aggravated angioedema | 371627004 | |
Acute renal failure due to ACE inhibitor | 422593004 | |
Angiotensin converting enzyme inhibitor allergy | 609537003 | |
Non-allergic hypersensitivity to captopril | 609538008 | |
Non-allergic hypersensitivity to cilazapril | 609539000 | |
Non-allergic hypersensitivity to enalapril | 609540003 | |
Non-allergic hypersensitivity to fosinopril | 609541004 | |
Non-allergic hypersensitivity to lisinopril | 605942006 | |
Non-allergic hypersensitivity to perindopril | 609543001 | |
Non-allergic hypersensitivity to trandolapril | 609546009 | |
Non-allergic hypersensitivity to quinapril | 609544007 | |
Non-allergic hypersensitivity to ramipril | 609545008 | |
H/O: angiotensin converting enzyme inhibitor pseudoallergy | 609550002 | |
ARB (persisting) Adverse reaction caused by losartan | 293513003 | |
Angiotensin II receptor antagonist adverse reaction | 407590002 | |
Non-allergic hypersensitivity to losartan | 609534005 | |
Angiotensin II receptor antagonist allergy | 609549002 | |
Adverse reaction caused by telmisartan | 720672008 | |
Adverse reaction caused by valsartan | 720673003 | |
Adverse reaction caused by olmesartan | 720674009 | |
Adverse reaction caused by irbesartan | 720675005 | |
Adverse reaction caused by eprosartan | 720676006 | |
Adverse reaction caused by candesartan | 720677002 | |
Adverse reaction caused by azilsartan | 720678007 | |
DM020 DM021 | Blood test declined Patient on maximal tolerated therapy for diabetes | 116471000119100 407569005 |
| DM033 | Blood pressure procedure declined Patient on maximal tolerated antihypertensive therapy | 413123006 407567007 |
DM012 | Patient on maximal tolerated therapy diabetes | 407569005 |
Diabetic foot examination not indicated | 408397002 | |
Diabetic foot examination declined | 412752009 | |
Foot pulse declined | 699053009 | |
Patient unsuitable for foot pulse check | 729241000000105 | |
DM014 | Diabetes structured education programme not available | 885931000000100 |
Diabetes structured education programme declined | 306591000000103 | |
Referral to diabetes education and self management for ongoing and newly diagnosed structured programme declined | 781161000000107 | |
Referral to DAFNE (dose adjustment for normal eating) diabetes structured education programme declined | 860981000000106 | |
DM022 DM023 | Patient on maximal tolerated lipid lowering therapy | 407568002 |
Statin declined | 134396000 | |
Statin not tolerated | 413174003 | |
Statin not indicated | 134391005 | |
Statins contraindicated | 315363002 | |
Stain allergy | 294970008 | |
Statin adverse reaction | 293432006 | |
History of rhabdomyolysis due to statin | 16524331000119104 |
Heart Failure
Excepted from: | Code Term | Concept ID |
Whole domain | Excepted from heart failure quality indicators – patient unsuitable | 717481000000104 |
Excepted from diabetes quality indicators – informed dissent | 717491000000102 | |
Excepted from diabetes quality indicators – service unavailable | 1108711000000108 | |
HF008 | Echocardiography not indicated | 901701000000101 |
HF003 | ACE Contraindications (expiring) Angiotensin converting enzyme inhibitor not indicated | 134390006 |
Angiotensin converting enzyme inhibitor contraindicated | 315364008 | |
Angiotensin converting enzyme inhibitor not tolerated | 407564000 | |
ACE adverse reactions (persisting) Angiotensin-converting-enzyme inhibitor adverse reaction | 293500009 | |
Captopril adverse reaction | 293501008 | |
Lisinopril adverse reaction | 293502001 | |
Ramipril adverse reaction | 293504000 | |
Enalapril adverse reaction | 293507007 | |
Acute renal failure due to ACE inhibitor | 422593004 | |
Angiotensin-converting-enzyme inhibitor allergy | 609537003 | |
H/O: Angiotensin converting enzyme inhibitor pseudoallergy | 609550002 | |
ACE declined (expiring) Angiotensin converting enzyme inhibitor declined | 134397009 | |
ACE II contraindicated (expiring) Angiotensin II receptor antagonists contraindicated | 394987009 | |
Angiotensin II receptor antagonists not tolerated | 407565004 | |
Angiotensin II receptor antagonists not indicated | 407572003 | |
ACE II adverse reaction (persisting) Angiotensin II receptor antagonists adverse reaction | 407590002 | |
Angiotensin II receptor antagonists allergy | 609549002 | |
ACE II declined (expiring) Angiotensin II receptor antagonists declined | 401084003 | |
HF006
| Beta blocker contraindicated (expiring) Beta blocker contraindicated | 315062004 |
Beta blocker not indicated | 315214003 | |
Bisoprolol not indicated | 508741000000103 | |
Carvedilol not indicated | 508771000000109 | |
Nebivolol not indicated | 508801000000107 | |
Bisoprolol not tolerated | 508831000000101 | |
Carvedilol not tolerated | 508861000000106 | |
Nebivolol contraindicated | 736004008 | |
Carvedilol contraindicated | 736006005 | |
Beta blocker not tolerated | 88201000000105 | |
Beta blocker adverse reactions (persisting) Beta-adrenoceptor blocking drug adverse reaction | 292419005 | |
Acebutolol adverse reaction | 292421000 | |
Bisoprolol adverse reaction | 292425009 | |
Metoprolol adverse reaction | 292428006 | |
Nadolol adverse reaction | 292430008 | |
Carvedilol adverse reaction | 292432000 | |
Labetalol adverse reaction | 292435003 | |
Oxprenolol adverse reaction | 292437006 | |
Practolol adverse reaction | 292439009 | |
Propranolol adverse reaction | 292440006 | |
Sotalol adverse reaction | 292441008 | |
Timolol adverse reaction | 292442003 | |
Beta-adrenoceptor blocking drug allergy | 293962009 | |
Bisoprolol allergy | 293967003 | |
Carvedilol allergy | 293974008 | |
Atenolol adverse reaction | 418370000 | |
Nebivolol allergy | 10535910… | |
Nebivolol adverse reaction | 10536010… | |
Atenolol sensitivity | 419869001 | |
Beta blocker therapy refused (expiring) Beta Blocker therapy refused | 315020006 | |
Bisoprolol therapy refused | 508921000000108 | |
Carvedilol therapy refused | 508951000000103 | |
Nebivolol therapy refused | 698758004 |
Hypertension
Excepted from: | Code Term | Concept ID |
Whole domain | Patient on maximal tolerated antihypertensive therapy | 407567007 |
Blood pressure procedure refused | 413123006 | |
Excepted from hypertension quality indicators – patient unsuitable | 716821000000100 | |
Excepted from hypertension quality indicators – informed dissent | 716771000000106 |
Mental Health
Excepted from: | Code Term | Concept ID |
Whole domain
Please note - this does NOT except patients from MH021, this indicator requires a decline code for each element. | Excepted from mental health quality indicators – patient unsuitable | 716301000000102 |
Excepted from mental health quality indicators – informed dissent | 717051000000101 | |
Decline codes for MH021 | Body weight measurement declined | 736013005 |
Blood pressure procedure refused | 413123006 | |
Cholesterol test declined | 203151000000104 | |
Blood glucose test declined | 698473004 | |
Declined to give smoking status | 1098881000000103 | |
Alcohol consumption screening test declined | 428073005 | |
Declines to state current alcohol consumption | 858861000000101 |
Non-Diabetic Hyperglycaemia
Excepted from: | Code Term | Concept ID |
Whole domain | Excepted from non-diabetic hyperglycaemia quality indicators – patient unsuitable | 148551000000106 |
Excepted from non-diabetic hyperglycaemia quality indicators – informed dissent | 148541000000108 | |
NDH002 | Blood glucose test declined | 698473004 |
Osteoporosis
Excepted from: | Code Term | Concept ID |
Whole domain | Excepted from osteoporosis quality indicators – patient unsuitable | 753791000000106 |
Excepted from osteoporosis quality indicators – informed dissent | 753831000000104 |
PAD
Excepted from: | Code Term | Concept ID |
Whole domain | Excepted from peripheral arterial disease quality indicators – patient unsuitable | 822641000000104 |
Excepted from peripheral arterial disease quality indicators – informed dissent | 822671000000105 |
Stroke & TIA
Excepted from: | Code Term | Concept ID |
Whole domain | Excepted from stroke quality indicators – patient unsuitable | 716581000000101 |
Excepted from stroke quality indicators – informed dissent | 716021000000109 | |
STIA007
Note that if the patient is not prescribed a medication from ONE of these groups then they need to be excepted from ALL of them using one code from each group - PLEASE REFER TO THE ARDENS ‘Stroke and TIA’ TEMPLATE FOR INFORMATION ON GROUPS. | Aspirin not indicated | 134394002 |
Aspirin prophylaxis contra-indicated | 312451002 | |
Aspirin not tolerated | 88171000000109 | |
Adverse reaction to salicylate | 269722001 | |
Aspirin adverse reaction | 292044008 | |
Aspirin allergy | 293586001 | |
Aspirin-induced asthma | 407674008 | |
Aspirin prophylaxis refused | 315023008 | |
Aspirin declined | 985721000000109 | |
Oral anticoagulant contraindicated (expiring) Warfarin not indicated | 134392003 | |
Warfarin contraindicated | 315061006 | |
Anticoagulation contraindicated | 413558003 | |
Anticoagulation not indicated | 413560001 | |
Anticoagulation not tolerated | 413561002 | |
Dabigatran contraindicated | 846181000000104 | |
Dabigatran not indicated | 846221000000109 | |
Warfarin not tolerated | 88181000000106 | |
Novel oral anticoagulant contraindicated | 912841000000100 | |
Novel oral anticoagulant not tolerated | 912861000000104 | |
Novel oral anticoagulant not indicated | 912881000000108 | |
Apixaban not tolerated | 985331000000105 | |
Rivaroxaban not tolerated | 985351000000103 | |
Apixaban contraindicated | 985631000000101 | |
Rivaroxaban contraindicated | 985661000000106 | |
Oral anticoagulant adverse reaction (persisting) Anticoagulant adverse reaction | 293331003 | |
Adverse reaction to nicoumalone | 293343002 | |
Warfarin adverse reaction | 293344008 | |
Adverse reaction to phenindione | 293346005 | |
Anticoagulant allergy | 294869008 | |
Warfarin allergy | 294881007 | |
Apixaban adverse reaction | 985211000000107 | |
Rivaroxaban adverse reaction | 985231000000104 | |
Rivaroxaban allergy | 985251000000106 | |
Apixaban allergy | 985271000000102 | |
Oral anticoagulant declined (expiring) Warfarin declined | 134398004 | |
Anticoagulation declined | 413559006 | |
Dabigatran declined | 845121000000109 | |
Novel oral anticoagulant declined | 912661000000103 | |
Apixaban declined | 985291000000103 | |
Rivaroxaban declined | 985311000000102 | |
Clopidogrel contraindicated (expiring) Clopidogrel not indicated | 407571005 | |
Clopidogrel contraindicated | 407582002 | |
Clopidogrel not tolerated | 88191000000108 | |
Clopidogrel adverse reaction (persisting) Adverse reaction to clopidogrel | 419253001 | |
History of clopidogrel allergy | 89731000000101 | |
Clopidogrel declined Clopidogrel declined | 407583007 | |
Dipyridamole contraindicated (expiring) Dipyridamole not indicated | 196041000000105 | |
Dipyridamole contraindicated | 7611000175100 | |
Dipyridamole not tolerated | 196011000000109 | |
Dipyridamole contraindicated (persisting) Dipyridamole adverse reaction | 293539000 | |
Dipyridamole declined Dipyridamole declined | 196051000000108 | |
STIA0014 STIA0015 | Patient on maximal tolerated antihypertensive therapy | 407567007 |
Blood pressure procedure refused | 413123006 |
*persisting - only needs to be entered once
*expiring - needs to be entered annually