Change Request
 
NHS Information Authority


Data Standards and Information Programme


Reference: Change Request 395
Version No: 1.5
Subject: Additional/New A&E Treatment Codes required
Type of Change: Addition of new Codes
Effective Date: 1 January 2004
Reason for Change: To define codes to record the use of a recently-introduced combined Tetanus/Diphtheria vaccine.

Background:

A Chief Medical Officer's letter of August 2002 (Ref: PL/CMO/2002/4), gave details of the replacement of single antigen Tetanus vaccine by a combined Tetanus/Diphtheria vaccine. The letter was sent from the Department of Health on 16th May 2002 to all Immunisation Coordinators, Pharmacists and GP Practice Managers. The letter specified that the replacement was applicable to both immunisation courses and booster immunisations. The letter also stated that the single antigen tetanus vaccine would continue to be available for individuals who require a Tetanus booster, but who have recently received single antigen low dose Diphtheria vaccine. It was confirmed with Dr. Jane Leese at the Department of Health on the 7th January 2004 that the single vaccine was still being made available, and that this would be the case for the foreseeable future. The NHS Data Dictionary contains codes relating only to single antigen tetanus vaccine. It has therefore been necessary to add appropriate A & E Treatment codes to the NHS Data Dictionary to differentiate between the single and combined vaccines, and to cater for administration of both the combined Tetanus/Diphtheria immunisation course, and the combined Tetanus/Diphtheria booster.

Summary of changes:
 
Attribute Definitions
ACCIDENT AND EMERGENCY TREATMENT    Change to Description
 
Supporting Information
A&E TREATMENT TABLES    Change to Supporting Information

Name: Kevin Shine
Date: 17 May 2004
Sponsor: Data and Information Standards Programme

Note: Additions shown in highlighted with a blue background. Deletions are shown using strikeout.

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ACCIDENT AND EMERGENCY TREATMENT
Change to Attribute: Change to Description

A broad coding of types of treatment or guidance which may be provided to a PATIENT as a result of ACCIDENT AND EMERGENCY ATTENDANCES.

Classification:

a. Dressing
b. Bandage
c. Sutures
d. Wound closure (excluding sutures)
i. steristrips
ii. wound glue
iii. other
e. Plaster of paris
e. Plaster of Paris
f. Splint
g. Prescription
h. Removal of foreign body
i. Physiotherapy
i. manipulation
ii. other physiotherapy
j. Reduction
k. I&D
l. IV cannula
m. Central line
n. Lavage/emesis
o. Intubation
p. Chest drain
q. Urinary catheter
r. Defibrillation/pacing
s. Resuscitation
t. Minor surgery
u. Observation
v. Guidance
i. written
ii. verbal
w. Anaesthesia
i. general anaesthetic
ii. local anaesthetic
iii. regional block
iv. entonox
v. sedation
vii. other
x. Tetanus
i. immune
ii. tetanus toxoid course
iii. tetanus toxoid booster
iv. human immunoglobulin
v. combined tetanus/diphtheria course
vi. combined tetanus/diphtheria booster
y. Nebuliser
z. Parenteral thrombolysis
aa. Other parenteral drugs
ab. Other
ac. None




This attribute is also known by these names:
Context Alias
plural ACCIDENT AND EMERGENCY TREATMENTS





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A&E TREATMENT TABLES
Change to Supporting Information: Change to Supporting Information

Accident and Emergency Clinical Coding Structure
 

ACCIDENT and EMERGENCY CLINICAL CODES

Accident and Emergency Treatment

A broad classification of types of treatment or guidance which may be provided to a patient as a result of ACCIDENT AND EMERGENCY ATTENDANCES.

  1. Certain items are sub-analysed to specify the diagnosis, investigation or treatment more precisely. These are marked with an asterisk. The diagnosis sub-analysis list follows the main diagnosis list, and the treatment sub-analysis list follows the main treatment list.

  1. It is recommended that computerised systems provide a minimum of six character fields for each category in order to accommodate more detailed information if necessary. Where fewer than six characters are required for coding, such as for investigations and treatments, it is recommended that the codes are left-justified and the unused fields left blank.

  1. ACCIDENT AND EMERGENCY TREATMENT is a six character code, comprising:

    2. Condition n2 (see Treatment Table below)
    Sub-Analysis n1 (see Sub-analysis Table below)
    Local use up to an3

    Accident and Emergency Treatment - Treatment

    Treatment Code
    Dressing 01
    Bandage 02
    Sutures 03
    Wound closure, other* 04
    Plaster of Paris 05
    Splint 06
    Prescription 07
    Removal foreign body 08
    Physiotherapy* 09
    Reduction 10
    I&D (Incision & Drainage) 11
    Intravenous cannula 12
    Central line 13
    Lavage/Emesis 14
    Intubation 15
    Chest drain 16
    Urinary catheter 17
    Defibrilation/pacing 18
    Defibrillation/pacing 18
    Resuscitation 19
    Minor surgery 20
    Observation 21
    Guidance* 22
    Anaesthesia* 23
    Tetanus* 24
    Nebuliser 25
    Parenteral thrombolysis 28
    Other Parenteral drugs 29
    Other 27
    None 99

    Items sub-analysed in Table below

    Accident and Emergency Treatment - Sub-analysis

    Sub-analysisTreatment   Code
    Sub-analysis Treatment   Code
    Wound closure, other - steristrips
    - wound glue
    - other    		 1
    2
    3
    Physiotherapy - manipulation
    - other physiotherapy    		 1
    2
    Guidance - written
    - verbal    		 1
    2
    Anaesthesia - general anaesthetic
    - local anaesthetic
    - regional block
    - entonox
    - sedation
    - other    		 1
    2
    3
    4
    5
    6
    Tetanus - immune
    - tetanus toxoid course
    - tetanus toxoid booster
    - human immunoglobulin    		 1
    2
    3
    4
    Tetanus - immune
    - tetanus toxoid course
    - tetanus toxoid booster
    - human immunoglobulin
    - combined tetanus/diphtheria course
    - combined tetanus/diphtheria booster    		 1
    2
    3
    4
    5
    6





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