To help understand the QOF exception rates, access the following support article.


Below outlines the QOF exception coding for this fiscal year (2023/24).


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 test declined


 415572005

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
 QOF (Quality and Outcomes Framework)- FeNO (fractional exhaled nitric oxide) test service not available

148491000000104



Atrial Fibrillation


Excepted from:

Code Term

Concept ID

Whole domain

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)
Anticoagulant adverse reaction



29331003

Generic expiring (will except the patient from the whole indicator)
Anticoagulation contraindicated



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

DM033

Blood test declined

116471000119100

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

Excepted from mental health quality indicators – patient unsuitable

716301000000102

Excepted from mental health quality indicators – informed dissent

717051000000101


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