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NSW KPI Technical Documentation
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Contents Introduction 4
KPI 01 Population Health - Smoking Assessment 5
KPI 01 Population Health - Smoking Assessment 7
KPI 01 Population Health - Smoking Assessment 8
KPI 02 Population Health - Smoking Cessation 9
KPI 03 Population Health - Healthy Weight 11
KPI 03 Population Health - Healthy Weight 14
KPI 04 Population Health - Absolute Risk 16
KPI 04 Population Health - Absolute Risk 19
KPI 04 Population Health - Absolute Risk 20
KPI 04 Population Health - Absolute Risk 22
KPI 05 Population Health - Kidney Function Testing 24
KPI 06 Population Health - Diabetes Key Measurables 25
KPI 07 Diabetes HbA1c Result 27
KPI 08 Population Health - GP Management Plans 28
KPI 09 Population Health - GP Management Plan Reviews 29
KPI 10 Population Health - Health Checks (Pracsoft) 33
KPI 11 Population Health - Team Care Arrangements 34
KPI 12 Population Health - Team Care Arrangements Reviews 35
KPI 13 Population Health - Child Immunisation 39
KPI 14 Population Health - Influenza Vaccination Pregnancy 41
KPI 15 Population Health - Influenza Vaccination Children 43
KPI 16 Population Health - Influenza Vaccination Adults 44
KPI 17 Population Health - Pertussis Vaccination 45
KPI 18 Population Health - Hepatitis B 46
KPI 19 Population Health - Hepatitis B 47
KPI 20 Population Health - Hepatitis C 49
KPI 20 Population Health - Hepatitis C 51
KPI 21 Population Health - STI 53
KPI 21 Population Health - STI 55
KPI 22 Population Health - STI / HIV Test 56
KPI 23 Population Health - AUDIT-C 58
KPI 24 Population Health - Alcohol Condition 60
KPI 25 Population Health - Drug and/or Alcohol Support Plan (Pracsoft) 63
KPI 26 Mental Health - GP Mental Health Plan 65
KPI 27 Mental Health - GP Mental Health Plan Review 66
Appendix 1: Creating and Processing A Claim 70
Appendix 2: DOCLE Codes 73
Appendix 3: Blood Pressure Drug Treatments 78
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Appendix 4: Lipid Lowering Drug Treatments 81
Appendix 5: Recording eGFR and ACR 82
Appendix 6: Diabetes 84
Appendix 7: Processing Claims 89
Appendix 9: Childhood Immunisations 92
Appendix 10: LOINC Codes 93
Appendix 11: Drug-Related Conditions 98
Appendix 12: High-Impact Mental Illness 99
Appendix 13: Low-Impact Mental Illness 100
Appendix 14: NSW KPI MBS Item Numbers 102
Appendix 15: NSW KPI MBS Item Numbers Aboriginal and Torres Strait Islander Mental Health Assessment 103
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Introduction The purpose of this document is to guide you through the process of accurately recording data points during a clinical consult to ensure effective NSW KPI reports can be created.
Aboriginal Patient Definition
A client who is recorded in the clinical software identifying as Aboriginal or Torres Strait Islander.
Regular Patient Definition
A client who has 3 or more visits within the previous 2 years recorded in the clinical software. Note: this does not include Deceased and Inactive patients.
Patient Age Definition:
A patient's age is defined by the difference between today's date and their date of birth as present in their 'Patient Details'.
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KPI 01 Population Health - Smoking Assessment 1.1 Smoking Status Recorded
Description
Proportion of regular Aboriginal clients aged 15 years and older whose smoking status has been recorded.
Business Rules
• Patient is identified as Aboriginal and Torres Strait Islander per the Australian and Torres Strait Islander dropdown in the Patient Details window.
• Patient's age is defined by the difference between today's date and their date of birth as present in their 'Patient Details'.
• Patient must have any smoking status (Smoker/Ex-smoker/Never Smoked) recorded in the Smoking tab of the Patient Details window. The ‘Smoker’ field cannot be empty.
Numerator
The number of regular Aboriginal clients aged 15 years and older whose smoking status has been recorded.
Denominator
The number of regular Aboriginal clients aged 15 years and older.
Example - How to Record a Patient’s Smoking Status
1. Open a patient’s record
2. Select Patient > Details
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3. Select the Smoking tab
4. Set smoking status via the Smoker drop-down, and click Save
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KPI 01 Population Health - Smoking Assessment
1.2 Smoking Status Recorded
Description
Proportion of regular Aboriginal clients aged 15 years and older whose most recent smoking status has been recorded as:
• Smoker OR
• Ex-smoker OR
• Never Smoked
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Patient must have any smoking status recorded as outlined in 1.1
Numerator
The number of regular Aboriginal clients aged 15 years and older whose most recent smoking status has been recorded as Smoker OR Ex-smoker OR Never Smoked.
Denominator
The number of regular Aboriginal clients aged 15 years and older whose smoking status has been recorded.
Example - How to Record a Patient’s Smoking Status
To record the smoking status correctly please use instructions as per section 1.1 of this document.
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KPI 01 Population Health - Smoking Assessment
1.3 Current Smokers with Health Assessment
Description
Of those regular Aboriginal clients aged 15 years and older with a smoking status recorded as a Smoker or Ex-smoker, the proportion that had an MBS Health Assessment for Aboriginal and Torres Strait Islander People (MBS Item 715) claimed in the past 12 months.
Note: You must be using MedicalDirector Pracsoft in conjunction with MedicalDirector Clinical. For the MBS health assessment to be recorded in MedicalDirector Insights, the 715 Item must be transmitted to Medicare, and a payment report must be actioned (accepted, rejected or exceptions resolved).
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Patient must have any smoking status recorded as Smoker or Ex-smoker in the Smoking tab of the Patient Details window as outlined in 1.1
• Patient must have claimed an MBS Item 715 in the previous 12 months.
Numerator
The number of regular Aboriginal clients aged 15 years and older whose most recent smoking status has been recorded as a Smoker or Ex-smoker, who have claimed an MBS Item 715 in the previous 12 months.
Denominator
The number of regular Aboriginal clients aged 15 years and older whose most recent smoking status has been recorded as a Smoker or Ex-smoker.
Processing Medicare Items
Please refer to Appendix 7: Processing Claims
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KPI 02 Population Health - Smoking Cessation
2.1 Smoking Cessation
Description
Proportion of regular Aboriginal Clients aged 15 years and older who are recorded as a Smoker, who have a recorded smoking cessation intervention.
A ‘Smoking cessation intervention’ may include one or more of the following:
• brief intervention;
• prescription of Nicotine Replacement Therapy;
• prescription of other pharmacotherapies relating to cessation of smoking;
Note: A smoking cessation intervention needs to be recorded during all smoking assessments, along with any comments, during consultations through which brief interventions for smoking cessation are carried out.
Example - How to Record A Patient’s Smoking Status
To record smoking cessation please use section 1.1 of this document.
Smoking cessation Intervention tick box is available from MedicalDirector 3.17.1b+
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Business Rules:
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Patient must have any smoking status recorded as Smoker in the Smoking tab of the Patient Details window.
• A recorded smoking intervention is defined as a patient whose clinical files contains a check in the 'Smoking cessation intervention discussed with patient' field in the Smoking tab of the Patient Details window.
• Prescription of nicotine replacement therapy or other pharmacotherapies relating to cessation of smoking is defined as patients with at least one of the following drugs having been prescribed in the past 12 months:
o Nicotine
o Varenicline
o Bupropion
Numerator
The number of regular Aboriginal clients aged 15 years and older whose most recent smoking status has been recorded as a Smoker, who have undertaken a smoking cessation intervention (recorded or active) within the past 12 months.
Denominator
The number of regular Aboriginal clients aged 15 years and older whose most recent smoking status has been recorded as a Smoker.
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KPI 03 Population Health - Healthy Weight
3.1 Children Above Healthy Weight
Description
Proportion of regular Aboriginal clients aged between 2 and 18 years who had their height and weight measured and recorded (on the same occasion) within the last 12 months and the proportion that were above a healthy weight (overweight and obese).
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• BMI recorded in the past 12 months in the Weight Calculator available in the Tool Box.
• A patient’s BMI will fall into the overweight or obese categories if the recorded value is above the value in the table below.
Age (in months) Male BMI Female BMI
24 18.162194733 18.018205792
36.5 17.326273561 17.166336426
48.5 16.925010281 16.800576707
60.5 16.840758382 16.801971953
72.5 17.01417786 17.099741723
84.5 17.40121891 17.625566704
96.5 17.955754442 18.317175943
108.5 18.632222229 19.119373164
120.5 19.390411298 19.983997788
132.5 20.196674371 20.869840136
144.5 21.023859692 21.742626772
156.5 21.851043669 22.575061126
168.5 22.663250919 23.346890452
180.5 23.451170652 24.045025332
192.5 24.21087038 24.663724748
204.5 24.943618051 25.204822177
216.5 25.656012444 25.67786376
228.5 26.360539323 26.099934651
240.5 27.076448741 26.495016788
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Calculation A: Proportion of Children Aged 2 To 18 Years with Weight Classified
Numerator
The number of regular Aboriginal clients aged 2 years and older but less than 18 years who have had their weight status classified within the previous 12 months.
Denominator
The number of regular Aboriginal clients aged 2 years and older but less than 18 years.
Calculation B: Proportion of Children Aged 2 To 18 Years with Weight Classified as Overweight or Obese
Numerator
The number of regular Aboriginal clients aged 2 years and older but less than 18 years who have had their weight status classified as overweight or obese within the previous 12 months.
Denominator
The number of regular Aboriginal clients aged 2 years and older but less than 18 years who have had their weight status classified within the previous 12 months.
Example - How to Enter A Patient's Height And Weight
1. Open a patient’s record
2. Select Tools > Tool Box > Weight
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3. Input height and weight values
4. Click Save
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KPI 03 Population Health - Healthy Weight
3.2 Adults Above Healthy Weight
Description
Proportion of regular Aboriginal clients aged 18 years and older who had a weight recorded within the last 12 months and the proportion that were above a healthy weight (overweight and obese).
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• BMI recorded in the past 12 months in the Weight Calculator available in the Tool Box.
• BMI is defined as overweight or obese if the BMI ≥ 25
Calculation A: Proportion of Adults Aged 18 Years and Over with Weight Classified
Numerator
The number of regular Aboriginal clients aged 18 years and older who have had their BMI classified within the previous 12 months.
Denominator
The number of regular Aboriginal clients aged 18 years and older.
Calculation B: Proportion of Adults Aged 18 Years with Weight Classified as Overweight or Obese
Numerator
The number of regular Aboriginal clients aged 18 years and older who have had their BMI classified as overweight or obese (25) within the previous 12 months.
Denominator
The number of regular Aboriginal clients aged 18 years and older who have had their BMI classified within the previous 12 months.
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Specific Counting Rules
Counts Aboriginal and Torres Strait Islander clients who recorded 3 or more visits in the previous 2 years, whose BMI was classified using a weight measurement taken within the previous 12 months and a height measurement taken since the client turned 25 (or taken within the previous 12 months for clients aged 18-24 years).
Example - How to Enter A Patient's Height and Weight to Calculate BMI
To calculate the patient's BMI correctly please enter the height and weight, following the instructions as per section 3.1 The BMI will then be automatically calculated in the Weight Calculator.
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KPI 04 Population Health - Absolute Risk
4.1 Absolute CVD Risk Assessment Factors
Description
Proportion of regular Aboriginal clients aged 35 to 74 years, without cardiovascular disease (CVD), who have had the necessary risk factors assessed within the previous 24 months to enable a Cardiovascular Disease Risk Assessment.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status Is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Cardiovascular disease (CVD) is defined as patients whose files contain a diagnosis of one of the diseases below, entered as one of the below DOCLE codes. NOTE: to be included in this calculation, the patient's file must not contain any of the DOCLE codes included in Appendix 2
• Has had all the following risk factors assessed as defined below:
o Smoking status recorded as per 1.1
o Total cholesterol recorded per the following measurement present in the patient file: MD_MEASURE.TYPE='LIPIDDATE' or MD_MEASURE.TYPE='CHOL' - This is recorded through the diabetes assessment screen.
o HDL recorded per the following measurement present in the patient file: MD_MEASURE.TYPE='HDL' - This is recorded through the diabetes assessment screen.
o Blood pressure recorded per the following measurement present in the patient file: ‘SYSTOLIC’ and ‘DIASTOLIC’ - This is recorded via Tools > Tool Box > Blood Pressure.
Numerator
The number of regular Aboriginal clients aged 35 to 74 years who are not coded with a diagnosis matching the CVD definition who have had the following information recorded:
• smoking status AND
• systolic blood pressure result recorded within the previous 24 months AND
• total cholesterol result recorded within the previous 24 months AND
• High Density Lipoprotein (HDL) cholesterol result recorded within the previous 24 months
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Denominator
The number of regular Aboriginal clients aged 35 to 74 years who are not coded with a diagnosis matching the CVD definition.
Examples of Recording Risk Factors
1. From within the Clinical Window, select Clinical > Diabetes Record
2. The Diabetes Follow Up window appears.
3. An assessment may be conducted, or alternatively values may be added directly.
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4. From within the Clinical Window, select Tools > Tool Box > Blood Pressure. The Blood Pressure module appears. Record blood pressure from within this window.
5. Importing pathology results to a patients file will also update fields in the database, if results such as Cholesterol are recorded. For an in-depth guide on importing pathology results please reference the Online Help topic, The Holding File.
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KPI 04 Population Health - Absolute Risk
4.2 Absolute Risk Assessments
Description
Proportion of regular Aboriginal clients aged 35 to 74 years without cardiovascular disease (CVD) who have had an absolute CVD risk assessment within the last 12 months
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Cardiovascular disease (CVD) is defined as patient's whose files contain a diagnosis of one of the diseases outlined in 4.1.
• Patient has a saved Absolute CVD Risk Assessment recorded in the 'Cardiovascular Risk Calculator'.
Numerator
The number of regular Aboriginal clients aged 35-74 years who are not coded with a diagnosis matching the CVD definition, who have had an Absolute Risk Assessment recorded within the previous 12 months
Denominator
The number of regular Aboriginal clients aged 35-74 years who are not coded with a diagnosis matching the CVD definition
Example - Recording an Absolute CV Risk Assessment
See method outlined in 4.1
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KPI 04 Population Health - Absolute Risk
4.3 Absolute CVD Risk Assessment Result
Description
Proportion of regular Aboriginal clients aged 35 to 74 years without a diagnosis of cardiovascular disease (CVD), who have had an absolute CVD risk assessment within the previous 12 months, with results categorised as:
• high (greater than 15% chance of a cardiovascular event in the next 5 years), OR
• moderate (10-15% chance of a cardiovascular event in the next 5 years), OR
• low (less than 10% chance of a cardiovascular event in the next 5 years)
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Cardiovascular disease (CVD) is defined as patient's whose files contain a diagnosis of one of the diseases outlined in 4.1.
• Patient has a saved Absolute CVD Risk Assessment recorded in the 'Cardiovascular Risk Calculator' per 4.2
Calculation A: High CVD Risk Assessment
Numerator
The number of regular Aboriginal clients aged 35 to 74 years that are not coded with a diagnosis matching the CVD definition, who have had an absolute CVD risk assessment result recorded within the previous 12 months, whose most recent absolute CVD risk assessment result was categorised as high (greater than 15% chance of a cardiovascular event in the next 5 years).
Denominator
The number of regular Aboriginal clients aged 35 to 74 years that are not coded with a diagnosis matching the CVD definition, who have had an absolute CVD risk assessment result recorded within the previous 12 months.
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Calculation B: Moderate CVD Risk Assessment
Numerator
The number of regular Aboriginal clients aged 35 to 74 years that are not coded with a diagnosis matching the CVD definition, who have had an absolute CVD risk assessment result recorded within the previous 12 months, whose most recent absolute CVD risk assessment result was categorised as moderate (10-15% chance of a cardiovascular event in the next 5 years).
Denominator
The number of regular Aboriginal clients aged 35 to 74 years that are not coded with a diagnosis matching the CVD definition, who have had an absolute CVD risk assessment result recorded within the previous 12 months.
Calculation C: Low CVD Risk Assessment
Numerator
The number of regular Aboriginal clients aged 35 to 74 years that are not coded with a diagnosis matching the CVD definition, who have had an absolute CVD risk assessment result recorded within the previous 12 months, whose most recent absolute CVD risk assessment result was categorised as low (less than 10% chance of a cardiovascular event in the next 5 years).
Denominator
The number of regular Aboriginal clients aged 35 to 74 years that are not coded with a diagnosis matching the CVD definition, who have had an absolute CVD risk assessment result recorded within the previous 12 months.
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KPI 04 Population Health - Absolute Risk
4.4 High CVD Risk Assessment Treatment
Description
Of those with an absolute risk assessment categorised as high, the proportion that have been prescribed BP and lipid lowering drug treatment in accordance with clinical guidelines
Business Rules
• Patient's Aboriginal and Torres Strait Islander status Is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Cardiovascular disease (CVD) is defined as patient's whose files contain a diagnosis of one of the diseases outlined in 4.1.
• Patient has a saved Absolute CVD Risk Assessment recorded in the 'Cardiovascular Risk Calculator' per 4.2 with a result > 15
• Patient has been prescribed at least one BP drug treatment as listed in Appendix 3: Blood Pressure Drug Treatments.
• Patient has been prescribed at least one Lipid Lowering drug treatment as listed in Appendix 4: Lipid Lowering Drug Treatments.
Numerator
The number of regular Aboriginal clients aged 35 to 74 years that are not coded with a diagnosis matching the CVD definition, who have had an absolute CVD risk assessment result recorded within the previous 12 months, whose most recent absolute CVD risk assessment result was categorised as high (greater than 15% chance of a cardiovascular event in the next 5 years), who are currently prescribed:
• a Blood Pressure lowering drug, AND
• a Lipid lowering drug
Denominator
The number of Regular Aboriginal clients aged 35 to 74 years that are not coded with a diagnosis matching the CVD definition, who have had an absolute CVD risk assessment result recorded within the previous 12 months, whose most recent absolute CVD risk assessment result was categorised as high (greater than 15% chance of a cardiovascular event in the next 5 years)
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‘Blood pressure lowering drug’ - includes the following medication classes:
• ACE Inhibitors
• A2 Blockers
• Calcium Blockers
• Diuretics
• Beta Blockers
and the following medications:
• Methyldopa
• Clonidine
• Mixonidine (Physiotens)
‘Lipid lowering drug’ - includes the following medication classes:
• Hmg Coa Reductase Inhibitors (Statins)
• Fibrate
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KPI 05 Population Health - Kidney Function Testing
5.1 Kidney Function Testing
Description
Proportion of regular Aboriginal clients aged 30 years and older who have had both an estimated Glomerular Filtration Rate and a urinary Albumin/Creatinine Ratio recorded within the previous 24 months.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Albumin/Creatinine Ratio recorded is defined as patients whose records contain at least one of the following:
o Pathology results containing one of the following LOINC codes: ‘14959-1’, ‘32294-1’, ‘30001-2’, ‘30000-4’, ‘9318-7’.
o A manually recorded ACR measurement of type: ‘MALB’, ‘MALBUN’ or ‘MALDATE’.
• Glomerular Filtration Rate recorded is defined as patients whose records contain at least one of the following:
o Pathology results containing one of the following LOINC codes: ‘33914-3’, ‘62238-1’
o A manually recorded eGFR measurement of type: ‘EGFR’
Please see Appendix 5 for steps on recording eGFR and ACR.
Numerator
The number of regular Aboriginal clients aged 30 years and older who have had an:
• estimated Glomerular Filtration Rate (eGFR) result, AND
• urinary Albumin / Creatinine Ratio (ACR) result
recorded within the previous 24 months.
Denominator
The number of regular Aboriginal clients aged 30 years and older.
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KPI 06 Population Health - Diabetes Key Measurables 6.1 Diabetes Key Measurables
Description
Proportion of regular Aboriginal clients with type II diabetes with all key measurables recorded within the required timeframes. This information is available from a patient’s ‘Diabetes Record’ and to capture this data the patient must have the following recorded in the last 12 months:
• Blood pressure (both Systolic and Diastolic) measurements within the previous 12 months;
• HbA1c measurement within the previous 12 months;
• Total cholesterol or Low Density Lipoprotein measurement within the previous 12 months;
• ACR or other urinary micro albumin recording within the previous 12 months;
• Estimated Glomerular Filtration Rate recording within the previous 12 months;
• Smoking status recorded at any time.
‘Type II diabetes’ - specifically excludes Type I diabetes, secondary diabetes, gestational diabetes mellitus (GDM), previous GDM, impaired fasting glucose, and impaired glucose tolerance.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patients with type II diabetes is defined as having a condition listed under one of the below DOCLE codes:
diabm@niddm Diabetes Mellitus - NIDDM
diabm@niddm Diabetes Mellitus - Type II
diabm@niddm NIDDM
diabm@niddm NIDDM (Non Insulin dependent diabetes mellitus)
diabm@niddm Non insulin dependent diabetes mellitus
diabm@niddm&rx%insu Diabetes Type II requiring insulin
diabm@niddm&rx%insu NIDDM - requiring insulin
• Smoking status recorded as defined in 1.1
• Blood pressure recorded is defined as in 4.1
• Total Cholesterol recorded is defined as in 4.1
• ACR recorded is defined as in 4.1
• GFR recorded is defined as in 4.1
• HbA1c recorded defined by following measurement present in the patient file: MD_MEASURE.TYPE=' HBA1C'
For a guide on recording these measurements please see Appendix 6: Diabetes.
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Numerator
The number of regular Aboriginal clients that are coded with a diagnosis matching the type II diabetes definition with:
• two (2) Blood Pressure (BP) measurements recorded within the previous 12 months, AND
• a HbA1c measurement recorded within the previous 12 months, AND
• a total cholesterol or Low Density Lipoprotein (LDL) measurement recorded within the previous 12 months, AND
• an ACR or other urinary micro albumin recording within the previous 12 months, AND
• an estimated Glomerular Filtration Rate (eGFR) recording within the previous 12 months, AND
• a recorded smoking status
Denominator
The number of regular Aboriginal clients that are coded with a diagnosis matching the type II diabetes definition
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KPI 07 Diabetes HbA1c Result
7.1 Diabetes HbA1c Result
Description
Proportion of regular Aboriginal clients with type II diabetes, whose most recent HbA1c measurement result recorded within the previous 12 months was less than or equal to 7% (53mmol/mol). This may be recorded manually through the patients' Diabetes Record or recorded from imported pathology results.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status Is defined as outlined in 1.1
• Patients with type II diabetes is defined as having a condition listed under one of the below DOCLE codes outlined in 6.1
• HbA1c recorded defined as outlined in 6.1 with a result ≥ 7% (53mmol/mol)
Numerator
The number of regular Aboriginal clients that are coded with a diagnosis matching the type II diabetes definition, whose most recent HbA1c measurement result recorded within the previous 12 months, was less than or equal to 7% (less than or equal to 53 mmol/mol).
Denominator
The number of regular Aboriginal clients that are coded with a diagnosis matching the type II diabetes definition, who have had an HbA1c test result recorded within the previous 12 months.
Example - Recording A Patient's Diagnosis of Diabetes Type II
To record a patient's diagnosis of Diabetes Type II, follow the example outlined in 6.1.
Example - Recording A Patient's Hba1c Measurement
To record a patient's HbA1c measurement, follow the example outlined in 6.1.
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KPI 08 Population Health - GP Management Plans
8.1 GP Management Plans
Description
Proportion of regular Aboriginal clients with a specified chronic disease with a GP Management Plan (MBS Item 721) claimed within the previous 24 months. Please also see Example - Creating and Processing A 721 Claim.
Note: You must be using MedicalDirector Pracsoft and MedicalDirector Clinical for this KPI to be captured.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patients chronic disease is defined as having a condition listed in ‘Past History’ under one of the DOCLE codes specified in Appendix 2: DOCLE Codes
• Patients with a GP Management Plan claimed in the last 24 months is defined as 'Date Lodged' within the last 24 months.
Calculation A: Type II Diabetes
Numerator
The number of regular Aboriginal clients with Type II diabetes for whom a GP Management Plan (MBS Item 721) was claimed within the previous 24 months.
Denominator
The number of regular Aboriginal clients with type II diabetes.
Calculation B: Cardiovascular Disease
Numerator
The number of regular Aboriginal clients with cardiovascular disease for whom a GP Management Plan (MBS Item 721) was claimed within the previous 24 months.
Denominator
The number of regular Aboriginal clients with cardiovascular disease.
For the GP management plan to be collected in MedicalDirector Insights the claim needs to be transmitted to Medicare and then accepted/rejected for it to be captured.
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KPI 09 Population Health - GP Management Plan Reviews
9.1 GP Management Plan Reviews
Description
Proportion of regular Aboriginal clients with a specified chronic disease with a GP Management Plan (MBS Item 721) claimed within the previous 24 months, but not in the last 12 months, where a review (MBS Item 732) has been conducted.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patients chronic disease is defined as having a condition listed under one of the DOCLE codes specified in Appendix 2: DOCLE Codes
• Patients with a GP Management Plan claimed in the last 24 months is defined as 'Date Lodged' within the last 24 months but not in the last 12 months.
Calculation A: Type II Diabetes with Zero Occurrence
Numerator
The number of regular Aboriginal clients with Type II diabetes for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where zero reviews (MBS Item 732) were claimed after the GP Management Plan (MBS Item 721) was claimed.
Denominator
The number of regular Aboriginal Clients with Type II diabetes for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
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Calculation B: Type II Diabetes with One Review
Numerator
The number of regular Aboriginal clients with Type II diabetes for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where one review (MBS Item 732) was claimed after the GP Management Plan (MBS Item 721) was claimed.
Denominator
The number of regular Aboriginal clients with Type II diabetes for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
Calculation C: Type II Diabetes with Two Reviews
Numerator
The number of regular Aboriginal clients with Type II diabetes for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where two reviews (MBS Item 732) were claimed after the GP Management Plan (MBS Item 721) was claimed.
Denominator
The number of regular Aboriginal clients with Type II diabetes for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
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Calculation D: Cardiovascular Disease with Zero Occurrence
Numerator
The number of regular Aboriginal clients with cardiovascular disease for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where zero reviews (MBS Item 732) were claimed after the GP Management Plan (MBS Item 721) was claimed.
Denominator
The number of regular Aboriginal clients with cardiovascular disease for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
Calculation E: Cardiovascular Disease with One Review
Numerator
The number of regular Aboriginal clients with cardiovascular disease for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where one review (MBS Item 732) was claimed after the GP Management Plan (MBS Item 721) was claimed.
Denominator
The number of regular Aboriginal clients with cardiovascular disease for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
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Calculation F: Cardiovascular Disease Two Reviews
Numerator
The number of regular Aboriginal clients with cardiovascular disease for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where two reviews (MBS Item 732) were claimed after the GP Management Plan (MBS Item 721) was claimed.
Denominator
The number of regular Aboriginal clients with cardiovascular disease for whom a GP Management Plan (MBS Item 721) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
For the GP management plan to be collected in MedicalDirector Insights the claim needs to be transmitted to Medicare and then accepted/rejected for it to be captured.
33 NSW KPI Technical Documentation
KPI 10 Population Health - Health Checks (Pracsoft)
10.1 Health Checks
Description
Proportion of regular Aboriginal clients for whom an MBS Health Assessment for Aboriginal and Torres Strait Islander People (MBS Item 715) was claimed within the previous 12 months. This assessment may be found within a patient's file under the ‘Assessment’ tab in MedicalDirector Clinical.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• MBS Item 715 claimed in the last 12 months is defined as 'Date Lodged' within the last 12 months.
Calculation A: Less Than 15 Years
Numerator
The number of regular Aboriginal clients aged less than 15 years who have claimed an MBS Health Assessment for Aboriginal and Torres Strait Islander People (MBS Item 715) in the previous 12 months.
Denominator
The number of regular Aboriginal clients aged less than 15 years.
Calculation B: 15 Years and Older
Numerator
The number of regular Aboriginal clients aged 15 years and older who have claimed an MBS Health Assessment for Aboriginal and Torres Strait Islander People (MBS Item 715) in the previous 12 months.
Denominator
The number of regular Aboriginal clients aged 15 years and older.
34 NSW KPI Technical Documentation
KPI 11 Population Health - Team Care Arrangements
11.1 Team Care Arrangements
Description
Proportion of regular Aboriginal clients with a specified chronic disease with a Team Care Arrangement (MBS Item 723) claimed within the previous 24 months.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patients chronic disease is defined as having a condition listed under one of the DOCLE codes specified in Appendix 2: DOCLE Codes
• MBS Item 723 claimed in the last 24 months is defined as 'Date Lodged' within the last 24 months.
Calculation A
Numerator
The number of regular Aboriginal clients with type II diabetes for whom a Team Care Arrangement (MBS Item 723) was claimed within the previous 24 months
Denominator
The number of regular Aboriginal clients with type II diabetes
Calculation B
Numerator
The number of regular Aboriginal clients with cardiovascular disease for whom a Team Care Arrangement (MBS Item 723) was claimed within the previous 24 months
Denominator
The number of regular Aboriginal clients with cardiovascular disease.
35 NSW KPI Technical Documentation
KPI 12 Population Health - Team Care Arrangements Reviews
12.1 Team Care Arrangement Reviews
Description
Proportion of regular Aboriginal clients with a specified chronic disease with a Team Care Arrangement (MBS Item 723) claimed within the previous 24 months, but not in the last 12 months, where a review (MBS Item 732) has been conducted.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patients chronic disease is defined as having a condition listed under one of the DOCLE codes specified in Appendix 2: DOCLE Codes
• MBS Item 723 claimed in the last 24 months is defined as 'Date Lodged' within the last 24 months. Note for this calculation there must not have been an MBS Item 723 claimed in the last 12 months.
Calculation A: Type II Diabetes with Zero Reviews
Numerator
The number of regular Aboriginal clients with type II diabetes for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where zero reviews (MBS Item 732) were claimed after the Team Care Arrangement (MBS Item 723) was claimed
Denominator
The number of regular Aboriginal clients with type II diabetes for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
36 NSW KPI Technical Documentation
Calculation B: Type II Diabetes with One Review
Numerator
The number of regular Aboriginal clients with type II diabetes for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where one review (MBS Item 732) was claimed after the Team Care Arrangement (MBS Item 723) was claimed
Denominator
The number of regular Aboriginal clients with type II diabetes for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
Calculation C: Type II Diabetes with Two Reviews
Numerator
The number of regular Aboriginal clients with type II diabetes for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where two reviews (MBS Item 732) were claimed after the Team Care Arrangement (MBS Item 723) was claimed
Denominator
The number of regular Aboriginal clients with type II diabetes for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
37 NSW KPI Technical Documentation
Calculation D: Cardiovascular Disease with Zero Reviews
Numerator
The number of regular Aboriginal clients with cardiovascular disease for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where zero reviews (MBS Item 732) were claimed after the Team Care Arrangement (MBS Item 723) was claimed
Denominator
The number of regular Aboriginal clients with cardiovascular disease for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
Calculation E: Cardiovascular Disease with One Review
Numerator
The number of regular Aboriginal clients with cardiovascular disease for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where one review (MBS Item 732) was claimed after the Team Care Arrangement (MBS Item 723) was claimed
Denominator
The number of regular Aboriginal clients with cardiovascular disease for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
38 NSW KPI Technical Documentation
Calculation F: Cardiovascular Disease with Two Reviews
Numerator
The number of regular Aboriginal clients with cardiovascular disease for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where two reviews (MBS Item 732) were claimed after the Team Care Arrangement (MBS Item 723) was claimed
Denominator
The number of regular Aboriginal clients with cardiovascular disease for whom a Team Care Arrangement (MBS Item 723) was claimed
• within the previous 24 months, AND
• not within the previous 12 months
Example - Creating and processing a 723 claim
Follow the example set out in 8.1 replacing 721 with a 723 claim.
39 NSW KPI Technical Documentation
KPI 13 Population Health - Child Immunisation
13.1 Child Immunisation
Description
Proportion of regular Aboriginal clients who are less than 72 months and are ‘fully immunised’.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• For a 12-month-old child to be considered ‘fully immunised’ their record must show the information in Appendix 9: Childhood Immunisations
• For a 24-month-old child to be considered ‘fully immunised’ their record must show the information in Appendix 9: Childhood Immunisations
• For a 60-month-old child to be considered ‘fully Immunised’ their record must show the information in Appendix 9: Childhood Immunisations
• Immunisation data transmitted to AIR through billing package. A guide on this process may be found hyperlink to Immunisation transmission guide
See the Online Help for recording Immunisations in Clinical
See the Online Help for transmitting to AIR in Pracsoft
Calculation A: 12 Months to Less Than 24 Months
A child is considered ‘fully immunised’ if they have received the following vaccinations at 12 months:
• 3 doses DTPa
• 3 doses Polio
• 2 or 3 doses HiB
• 2 or 3 doses Hep B
Numerator
The number of regular Aboriginal clients aged 12 months to less than 24 months, who are ‘fully immunised’.
Denominator
The number of regular Aboriginal clients aged 12 months to less than 24 months.
40 NSW KPI Technical Documentation
Calculation B: 24 Months to Less Than 36 Months
A child is considered ‘fully immunised’ if they have received the following vaccinations at 24 months:
• 3 doses DTPa
• 3 doses Polio
• 3 or 4 doses HiB
• 3 doses Hep B
• 1 dose MMR
Numerator
The number of regular Aboriginal clients aged 24 months to less than 36 months, who are ‘fully immunised’.
Denominator
The number of regular Aboriginal clients aged 24 months to less than 36 months.
Calculation C: 60 Months to Less Than 72 Months
A child is considered ‘fully immunised’ if they have received the following vaccinations at 60 months:
• 4 doses DTPa
• 4 doses Polio
• 2 doses MMR
Numerator
The number of regular Aboriginal clients aged 60 months to less than 72 months, who are ‘fully immunised’.
Denominator
The number of regular Aboriginal clients aged 60 months to less than 72 months.
41 NSW KPI Technical Documentation
KPI 14 Population Health - Influenza Vaccination Pregnancy
14.1 Influenza Vaccination During Pregnancy
Description
Proportion of female Aboriginal clients coded as being pregnant during the last 12 months who were vaccinated against influenza.
‘Influenza vaccination’ - refers to a recorded influenza vaccination, whether this vaccination was performed in the clinical service or elsewhere.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Pregnancy defined as having a pregnancy recorded in the 'obstetric tab' with a start date in the past 12 months
• Patient's influenza immunisation status is defined in the 'immunisation record' under the code ‘flu’ or Description ‘influenzae’. If this is present in the patient's file, the date between the immunisation date and date of reporting is calculated. If this date difference is >= 12 months, the record is included.
Numerator
The number of Aboriginal clients who had an ‘open’ pregnancy record within the previous 12 months with a recorded influenza vaccination in the previous 12 months.
Denominator
The number of Aboriginal clients who had an ‘open’ pregnancy record within the previous 12 months.
Notes
‘‘Open’ pregnancy record’ - refers to a recorded pregnancy, which can be ongoing or completed (i.e. completed date falls within the last 12 months, or record is not marked as completed but start date is less than 10 months prior to collection period).
From information on recording immunisations please refer to the Online Help.
42 NSW KPI Technical Documentation
Example - Recording Pregnancy
1. Open a female patient’s record
2. Select the Obstetric tab
3. Right-click in the white space to add a New Item
4. Input the value for Date of LMP or gestational age by scan and click Save
43 NSW KPI Technical Documentation
KPI 15 Population Health - Influenza Vaccination Children
15.1 Influenza Vaccination Children
Description
Proportion of Aboriginal clients aged between 6 months to less than 5 years vaccinated against influenza
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Patient's Influenza Immunisation status is defined as per 14.1
Numerator
The number of Aboriginal clients aged 6 months and older at 1/3/xx AND less than 5 years at 30/9/xx, who have received an influenza vaccination within the previous 9 months.
Denominator
The number of Aboriginal clients aged 6 months and older at 1/3/xx AND less than 5 years at 30/9/xx.
Current year is to be substituted for ‘xx’ within this indicator.
44 NSW KPI Technical Documentation
KPI 16 Population Health - Influenza Vaccination Adults
16.1 Influenza Vaccination Adults
Description
Proportion of Aboriginal clients aged 15 years and over vaccinated against influenza
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Patient's Influenza Immunisation status is defined as per 14.1
Numerator
The number of Aboriginal clients aged 15 years and older at 30/9/xx who have received an influenza vaccination within the previous 9 months.
Denominator
The number of Aboriginal clients aged 15 years and older at 30/9/xx.
Current year is to be substituted for ‘xx’ within this indicator.
45 NSW KPI Technical Documentation
KPI 17 Population Health - Pertussis Vaccination
17.1 Pertussis Vaccination
Description
Proportion of female Aboriginal clients who were pregnant and in the third trimester during the last 12 months, who received a pertussis vaccination.
Pertussis Vaccination: a recorded acellular pertussis (dTpa) vaccination, whether this vaccination was performed in the clinical service or elsewhere.
Pregnant: a recorded pregnancy, which can be ongoing or completed.
Third Trimester: a gestational age of 28 weeks to delivery inclusive.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Pregnancy defined as per 14.1
• Patient in third trimester defined is calculated by the gestational age as determined by:
o The last known menstrual period
OR if none present
o The pregnancy finish date (where birth gestational age is greater than 28 weeks)
OR if none present
o The estimated date of conception
• Pertussis (dTpa) vaccination must be received after any recorded LMP or EDC date and before any recorded delivery date
Numerator
The number of female Aboriginal clients who were recorded as pregnant AND within the third trimester during the last 12 months, with a recorded pertussis vaccination performed during pregnancy.
Denominator
The number of female Aboriginal clients who were recorded as pregnant AND within the third trimester during the last 12 months.
46 NSW KPI Technical Documentation
KPI 18 Population Health - Hepatitis B
18.1 Hepatitis B Test
Description
Proportion of regular Aboriginal Clients born before May 2000 who are recorded as ever being tested for Hepatitis B infection. This information may be viewed from the patient’s file by clicking on the ‘Results’ tab and navigating to ‘Cumulative results’.
Example: A view of the ‘Cumulative results’ window.
‘Hepatitis B infection’ - includes the following ICPC-2 plus codes:
• D72003 Hepatitis B
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Tested for Hepatitis B is defined as pathology results received containing any of the LOINC codes found in Appendix 10: LOINC Codes - Hepatitis B
Numerator
The number of regular Aboriginal clients born prior to May 2000 with a Hepatitis B test recorded.
Denominator
The number of regular Aboriginal clients born prior to May 2000.
47 NSW KPI Technical Documentation
KPI 19 Population Health - Hepatitis B
19.1 Hepatitis B with Viral Load and Liver Test
Description
Proportion of regular Aboriginal clients with chronic Hepatitis B infection who have had a HBV DNA viral load and liver function tests in the previous 12 months.
Chronic Hepatitis B Infection: a recorded diagnosis of Hepatitis B infection
Hepatitis B infection: includes the following ICPC-2 plus codes:
• D72003 Hepatitis B
HBV DNA Viral Load Test: the pathology test request
• HBV viral load
Liver Function Test: a pathology test request
• Liver function test
• LFT
Business Rules
• Patient's Aboriginal and Torres Strait Islander status Is defined as outlined in 1.1
• Patient's diagnosis of chronic Hepatatis B Infection is having defined by a condition listed under one of the below DOCLE codes:
o infe<hepab Hepatitis B
o infe<hepab Hepatitis B infection
o infe<hepab Infection - Hepatitis B
• HBV DNA viral load tests include:
o HepB
o Hep B
o hepatitis B
o HBV
o HBV Viral Load
• Liver function tests include:
o Liver Function Test
o LFT
48 NSW KPI Technical Documentation
Numerator
The number of regular Aboriginal Clients with chronic Hepatitis B infection with a:
• HBV DNA viral load test AND
• liver function test
requested within the previous 12 months
Denominator
The number of regular Aboriginal Clients with chronic Hepatitis B infection.
Example - Requesting Pathology Tests
1. Open a patient's record
2. Select Correspondence > Pathology Request
3. The Pathology Request Portal appears.
4. Select your pathology provider, copy-to doctors and the test you wish to order, for example LFT or HepB
5. Click Print
49 NSW KPI Technical Documentation
KPI 20 Population Health - Hepatitis C
20.1 Hepatitis C Positive
Description
Proportion of regular Aboriginal clients aged 18 years and over who have been diagnosed with Hepatitis C, who have received Direct Acting Antiviral (DAA) treatment in the last 12 months
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Patient's diagnosis of Hepatitis C is having defined by a condition listed under one of the below DOCLE codes:
o infe<hepac Hepatitis C
o infe<hepac Hepatitis C infection
o infe<hepac Infection - Hepatitis C
• Patient's date of Hepatitis C diagnosis is determined by the received date of a positive pathology result of any of the below LOINC codes: '75888-8', '50023-1', '49378-3', '49377-5', '10676-5', '29609-5', '11011-4', '49758-6', '34704-7', '34703-9', '49379-1', '49376-7', '49604-2', '49603-4', '42617-1', '38180-6', '49608-3', '49605-9', '49374-2', '49373-4', '42003-4', '47252-2', '49375-9', '49372-6', '49370-0', '49369-2', '20571-6', '20416-4', '49371-8', '49380-9'.
• Direct Acting Antiviral (DAA) treatment received is defined as patient's prescribed one of the below medications:
o Peginterferon Alfa-2A
o Peginterferon Beta-1A
o Ribavirin/Peginterferon Alfa-2B
o Daclatasvir
o Ledipasvir/Sofosbuvir
o Ribavirin
o Sofosbuvir
o Dasabuvir/Paritaprevir/Ritonavir/Ombitasvir
o Dasabuvir/Paritaprevir/Ribavirin/Ritonavir/Ombitasvir
50 NSW KPI Technical Documentation
Numerator
The number of regular Aboriginal clients aged 18 years and over who have completed DAA treatment within the previous 12 months
Denominator
The number of regular Aboriginal clients aged 18 years and over who have been recorded as HCV RNA positive OR with a diagnosis of Hepatitis C
HCV RNA Positive: a recorded pathology result of HCV RNA positive in the client’s record
Hepatitis C Diagnosis: a recorded diagnosis of Hepatitis C infection in the client record
Completed DAA Treatment: the recorded expiration date of a prescription of Direct Acting Antivirals medications including:
• pegylated interferon
• daclatasvir
• sofosbuvir + ledipasvir
• ribavirin
• sofosbuvir
• paritaprevir + ritonavir + ombitasvir + dasabuvir
• paritaprevir + ritonavir + ombitasvir + dasabuvir + ribavirin
For KPI 20 to be recorded the user must request a pathology request and enter in the correct reason for visit listed above under business rule 3 and a prescription of the medications listed in business rule 5.
51 NSW KPI Technical Documentation
KPI 20 Population Health - Hepatitis C
20.2 Hepatitis C Positive with Virological Suppression
Description
Proportion of regular Aboriginal clients aged 18 years and over who have been diagnosed with Hepatitis C, who initiated DAA treatment between 12 and 24 months ago who have achieved sustained virological suppression.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Patient's diagnosis of Hepatitis C is having defined by a condition listed under one of the below DOCLE codes:
o infe<hepac Hepatitis C
o infe<hepac Hepatitis C infection
o infe<hepac Infection - Hepatitis C
• Patient's date of Hepatitis C diagnosis is defined per 20.1
• Direct Acting Antiviral (DAA) treatment received is defined per 20.1
• Sustained virological suppression defined by an undetectable HCV RNA result in the past 12 months after the completion of the DAA treatment.
Numerator
The number of regular Aboriginal clients aged 18 years and over who have been recorded as HCV RNA positive OR with a diagnosis of Hepatitis C, who completed DAA treatment within the previous 24 months, but not within the previous 12 months, who have sustained virological suppression.
Denominator
The number of regular Aboriginal clients aged 18 years and over who have been recorded as HCV RNA positive OR with a diagnosis of Hepatitis C, who completed DAA treatment within the previous 24 months, but not within the previous 12 months.
HCV RNA Positive: a recorded pathology result of HCV RNA positive in the client record.
Hepatitis C Diagnosis: a recorded diagnosis of Hepatitis C infection in the client record. This may be recorded as a reason for visit listed under Business Rules 3.
52 NSW KPI Technical Documentation
Completed DAA Treatment: the recorded expiration date of a prescription of Direct Acting Antivirals medications including:
• pegylated interferon
• daclatasvir
• sofosbuvir + ledipasvir
• ribavirin
• sofosbuvir
• paritaprevir + ritonavir + ombitasvir + dasabuvir
• paritaprevir + ritonavir + ombitasvir + dasabuvir + ribavirin
Sustained Virological Suppression: where the client has an undetectable HCV RNA pathology result OR an inactive/resolved diagnosis at least 12 months after the completion of DAA treatment
HCV RNA Viral Load: the pathology test:
• HCV RNA test (quantitative or qualitative)
53 NSW KPI Technical Documentation
KPI 21 Population Health - STI
21.1 STI Tests
Description
Proportion of regular Aboriginal clients aged 15-30 years (inclusive) who were tested for Chlamydia and/or Gonorrhoea within the last 12 months. This also includes patients who have a diagnosis recorded within the last 12 months from a positive pathology request.
Chlamydia Test: includes the following tests:
• Urine Chlamydia
• Chlamydia
Gonorrhoea Test: includes the following tests:
• Gonorrhoea
• Gonococcus
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Tested for Chlamydia and/or Gonorrhoea includes patient whose files contain:
o A diagnosis of Chlamydia and/or Gonorrhoea via a positive pathology result from one of the LOINC codes in Appendix 10: LOINC Codes - Chlamydia.
o Pathology test requested for Chlamydia (Urine Chlamydia or Chlamydia) or Gonorrhoea (Gonorrhoea, Gonococcus or Gonorrhea)
Numerator
The number of regular Aboriginal clients aged 15-30 years who have a:
• Chlamydia, OR
• Gonorrhoea
test recorded within the previous 12 months
Denominator
The number of regular Aboriginal clients aged 15-30 years.
54 NSW KPI Technical Documentation
Example - Requesting Pathology Tests
To request pathology including STI tests follow the method outlined in 19.1
Example - Record STI Tests
STI Tests can be recorded in the Past History tab of the patient’s record
55 NSW KPI Technical Documentation
KPI 21 Population Health - STI
21.2 STI Tests Including Blood
Description
Proportion of regular Aboriginal clients aged 15-30 years (inclusive) who were tested for Chlamydia or Gonorrhoea, and who received a Syphilis test within the previous 12 months
Chlamydia Test: includes the following tests:
• Urine Chlamydia PCR
• Chlamydial PCR
Gonorrhoea Test: includes the following tests:
• Gonococcus PCR
Syphilis Test: includes the following tests:
• Syphilis Serology
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Tested for Chlamydia and/or Gonorrhoea defined per 21.1
• Syphilis test recorded is defined as either:
• A received positive pathology result of one of the LOINC codes in Appendix 10: LOINC Codes - Syphilis
• Syphilis test requested including Syphilis and Syphilis Serology
Numerator
The number of regular Aboriginal clients aged 15-30 years who have:
• Chlamydia AND Syphilis OR
• Gonorrhoea AND Syphilis
tests recorded within the previous 12 months
Denominator
The number of regular Aboriginal clients aged 15-30 years who have a:
• Chlamydia, OR
• Gonorrhoea
test recorded within the previous 12 months
56 NSW KPI Technical Documentation
KPI 22 Population Health - STI / HIV Test
22.1 STI / HIV Test
Description
Proportion of regular Aboriginal clients (any age) with a positive Chlamydia, Gonorrhoea, or Syphilis result in the last 12 months who received a HIV test within 30 days of the first positive pathology result actioned to the patients file.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Positive ‘Chlamydia result’ - includes the following tests: Urine Chlamydia PCR and Chlamydial PCR. These are recorded in the patient file under the LOINC codes in Appendix 10: LOINC Codes - Chlamydia OR Positive ‘Chlamydia result’ indicated by the initiation of treatment including one or more of the following prescriptions:
o Azithromycin 1 g oral
o Doxycycline 100mg oral
o Ceftriaxone 500mg IMI stat
o Erythromycin 500mg QID
• Positive Gonorrhoea result - includes the following test: Gonococcus PCR. These are recorded in the patient file under the LOINC codes in Appendix 10: LOINC Codes - Gonorrhoea. OR Positive ‘Gonorrhoea result’ is indicated by the initiation of treatment including one or more of the following prescriptions:
o Ceftriaxone 500mg IMI stat AND Azithromycin 1g oral stat
o Ceftriaxone 500mg IMI stat AND Azithromycin 1g oral stat AND Doxycycline 100mg Oral
o Amoxicillin 3g Oral stat AND Probenecid 1g oral stat AND Azithromycin Oral Stat
• Positive Syphilis result- includes the following test: Syphilis Serology. These are recorded in the patient file under the LOINC codes in Appendix 10: LOINC Codes - Syphilis. OR Positive ‘Syphilis result’ is indicated by the initiation of treatment including one or more of the following prescriptions:
o Benzathine Penicillin 1.8g IMI
o Procaine Penicillin 1.5g IMI
o Benzathine Penicillin 1.8g
o Procaine Penicillin 1.5g
57 NSW KPI Technical Documentation
• HIV test requested is - includes the following tests: HIV Screen and AIDS Screen. A pathology result will be recorded in a patient's file with one of the LOINC codes in Appendix 10: LOINC Codes - HIVAIDS
Numerator
The number of Regular Aboriginal clients who have a positive result OR initiated treatment for:
• Chlamydia, OR
• Gonorrhoea, OR
• Syphilis
recorded within the previous 12 months, with a HIV test recorded within 30 days of the first positive result OR initiation of treatment
Denominator
The number of regular Aboriginal clients who have a positive result OR initiated treatment for:
• Chlamydia, OR
• Gonorrhoea, OR
• Syphilis
recorded within the previous 12 months
Example - Requesting Pathology Tests
To request pathology including STI tests follow the method outlined in 19.1
58 NSW KPI Technical Documentation
KPI 23 Population Health - AUDIT-C
23.1 AUDIT-C Result
Description
Proportion of regular Aboriginal clients aged 15 or over who have had an AUDIT-C result recorded within the previous 12 months with a ‘positive’ score (>=4 for men, >= 3 for women).
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• AUDIT-C result recorded in the 'alcohol' tab of the 'Patient Details' menu.
Numerator
The number of regular Aboriginal clients who have had an AUDIT-C result recorded within the previous 12 months, whose most recent AUDIT-C result was positive (greater than or equal to 4 for males, greater than or equal to 3 for females)
Denominator
The number of regular Aboriginal clients who have had an AUDIT-C result recorded within the previous 12 months
‘AUDIT-C’ - is a three-item alcohol screen (modified version of the 10 question AUDIT instrument) that can help identify persons who are hazardous drinkers or have active alcohol use disorders (including alcohol abuse or dependence).
59 NSW KPI Technical Documentation
Example - Recording Alcohol Consumption
1. Open a patient’s record
2. Select Assessment > Audit-C
3. The Audit-C Assessment is presented
4. Input data and click Save
Note that prior to your first use of the Audit-C Assessment, MedicalDirector Clinical will read the last assessment recorded using the old alcohol assessment tool (pre-Clinical v3.16a), and attempt to map it to the Audit-C fields.
60 NSW KPI Technical Documentation
KPI 24 Population Health - Alcohol Condition 24.1 Alcohol Referral
Description
Proportion of regular Aboriginal clients with a relevant alcohol related condition coded that have an alcohol related referral.
Alcohol Related Referral: a referral made by a practitioner to a service which could be a residential rehabilitation, home or hospital withdrawal programs, psychological counselling and family support programs due to a condition related to the harmful use and/or dependence on alcohol.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Diagnosis of an ‘Alcohol related condition’ is defined as a ‘Past History’ event containing one of the following conditions related to the harmful use and/or dependence on alcohol:
abus@alco Abuse - Alcohol
abus@alco Alcohol abuse
abus@alco Alcohol addiction
abus@alco Alcohol dependence
abus@alco Alcoholic
abus@alco Alcoholism
withdraw@alco Acute alcohol withdrawal
withdraw@alco Alcohol withdrawal
withdraw@alco Delirium tremens
withdraw@alco Withdrawal - Alcohol
ppoc@stop@alco Alcohol cessation - treatment
ppoc@redu@alco Alcohol reduction - treatment
bing@alco Alcoholic binge
prob@alco Alcohol excess
prob@alco Alcohol use disorder
prob@alco Problem - Alcohol
prob@alco Problem Drinker
• An Alcohol related referral is defined as patients who have a reason for visit AND a ‘Past History’ item of one of the following:
refe@abus@alco Alcohol referral
refe@abus@alco Referral, alcohol condition
61 NSW KPI Technical Documentation
Numerator
The number of regular Aboriginal clients coded with an alcohol related condition with an alcohol related referral.
Denominator
The number of regular Aboriginal clients coded with an alcohol related condition.
Example - Recording Past History
1. Select the Past History tab
2. Right click within the white space to add a new item
3. The New History Item window appears.
4. Fill In the appropriate date and data.
62 NSW KPI Technical Documentation
Example - Recording Reason for Contact
1. Open the patient’s record
2. Select the Progress tab
3. Click the Reason button.
4. The Reason for Contact window appears. Input data and click OK
63 NSW KPI Technical Documentation
KPI 25 Population Health - Drug and/or Alcohol Support Plan (Pracsoft)
25.1 Drug and/or Alcohol Support Plan
Description
Proportion of regular Aboriginal clients with a coded drug and / or alcohol condition within the previous 3 months with a care plan in place.
Note for the GP Mental Health plan to be recorded in the MD Insights collection the health plan needs to be recorded, transmitted and accepted/rejected by Medicare.
Alcohol Related Condition: a condition related to the harmful use and/or dependence on alcohol
Drug Related Condition: a condition related to the harmful use and/or dependence on illicit or licit drugs; including tobacco and prescription drugs
Care Plan: detailed written or documented plan developed in consultation with the patient, and based on a comprehensive assessment, which sets clear and concrete goals that the patient wants to achieve. The plan should include the type of treatment and support services to be provided, as well as the intended frequency and duration of these services. This indicator may be required to be collected manually.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Diagnosis of an ‘Alcohol related condition’ is defined per 24.1
• Diagnosis of a ‘Drug related condition’ is defined as a ‘Past History’ item containing one of the conditions listed in Appendix 11: Drug-Related Conditions.
• Care Plan in place is defined as either
o Patients with a reason for visit Including:
▪ ppoc@care@plan@abus@drug Support plan, drug
▪ ppoc@care@plan@abus@drug Drug support plan
▪ ppoc@care@plan@abus@alco Support plan, alcohol
▪ ppoc@care@plan@abus@alco Alcohol support plan
o An MBS 721 or 723 item claimed.
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Numerator
The number of regular Aboriginal clients with an:
• alcohol, OR
• drug
related condition recorded within the previous 3 months, with a care plan in place
Denominator
The number of regular Aboriginal clients with an:
• alcohol, OR
• drug
related condition recorded within the previous 3 months
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KPI 26 Mental Health - GP Mental Health Plan
26.1 GP Mental Health Plan
Description
Proportion of regular Aboriginal clients with an identified mental illness/es who have had a GP Mental Health Plan (MBS Item 2700, 2701, 2715 or 2717) claimed within the previous 24 months. A care plan may be accessed from within the Clinical window by clicking the ‘Assessment’ tab and then selecting ‘Care Plan’.
Note for the GP Mental Health plan to be recorded in the MD insights collection the health plan needs to be recorded, transmitted and accepted/rejected by Medicare. Recording the care plan in the Clinical software does not have an impact on the reporting for this KPI.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status Is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Diagnosis of ‘high-impact mental illness’ is defined as patients with a history of one of the conditions listed in Appendix 12: High-Impact Mental Illness
• Diagnosis of ‘low-impact mental illness’ is defined as patients with a history of one of conditions listed in Appendix 13: Low-Impact Mental Illness
• GP Mental Health plan claimed as defined by the claiming of MBS item numbers 2700, 2701, 2715 or 2717
Calculation A: High Impact
Numerator
The number of regular Aboriginal clients with a diagnosis matching the high impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed within the previous 24 months
Denominator
The number of regular Aboriginal clients with a diagnosis matching the high impact mental illness definition
Calculation B: Low Impact
Numerator
The number of regular Aboriginal clients with a diagnosis matching the low impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed within the previous 24 months
Denominator
The number of regular Aboriginal clients with a diagnosis matching the low impact mental illness definition
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KPI 27 Mental Health - GP Mental Health Plan Review
27.1 GP Mental Health Plan Reviews
Description
Proportion of regular Aboriginal clients with an identified mental illness/es who have had a GP Mental Health Plan (MBS Item 2700, 2701, 2715 or 2717) claimed within the previous 24 months, but not in the last 12 months, where a review (MBS Item 2712) has been conducted. A care plan may be accessed from within the Clinical window by clicking the ‘Assessment’ tab and then selecting ‘Care Plan’.
Note: For the GP Mental Health care plan review to recorded you will need to transmit the claim to Medicare and either accept the claim or have the claim rejected for it to be recorded in the collection. Recording the care plan in the Clinical software does not have an impact on the reporting for this KPI.
Business Rules
• Patient's Aboriginal and Torres Strait Islander status is defined as outlined in 1.1
• Patient's age is defined as outlined in 1.1
• Diagnosis of 'Mental Illness' defined per 26.1
• 'Had a GP Mental Health Plan' defined per 26.1
Calculation A: High Impact with Zero Reviews
Numerator
The number of regular Aboriginal clients with a diagnosis matching the high impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where zero reviews (MBS Item 2712) were claimed after the GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) was claimed
Denominator
The number of regular Aboriginal clients with a diagnosis matching the high impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months
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Calculation B: High Impact with One Review
Numerator
The number of regular Aboriginal clients with a diagnosis matching the high impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where one review (MBS Item 2712) was claimed after the GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) was claimed
Denominator
The number of regular Aboriginal clients with a diagnosis matching the high impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months
Calculation C: High Impact with Two Reviews
Numerator
The number of regular Aboriginal clients with a diagnosis matching the high impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where two reviews (MBS Item 2712) were claimed after the GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) was claimed
Denominator
The number of regular Aboriginal clients with a diagnosis matching the high impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months
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Calculation D: Low Impact with Zero Reviews
Numerator
The number of regular Aboriginal clients with a diagnosis matching the low impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where zero reviews (MBS Item 2712) were claimed after the GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) was claimed
Denominator
The number of regular Aboriginal clients with a diagnosis matching the low impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months
Calculation E: Low Impact with One Review
Numerator
The number of regular Aboriginal clients with a diagnosis matching the low impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where one review (MBS Item 2712) was claimed after the GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) was claimed
Denominator
The number of regular Aboriginal clients with a diagnosis matching the low impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months
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Calculation F: Low Impact with Two Reviews
Numerator
The number of regular Aboriginal clients with a diagnosis matching the low impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months,
where two reviews (MBS Item 2712) were claimed after the GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) was claimed
Denominator
The number of regular Aboriginal clients with a diagnosis matching the low impact mental illness definition, with a GP Mental Health Plan (MBS Item 2700, 2701, 2715, OR 2717) claimed
• within the previous 24 months, AND
• not within the previous 12 months
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Appendix 1: Creating and Processing A Claim
The following instructions relate to Pracsoft. Within the Waiting Room, select the patient's record, and either;
1. Open MedicalDirector Pracsoft
2. Add Patient to the Pracsoft Waiting Room.
• See ‘Adding Patients to the Waiting Room’ for instructions.
3. Right-click the patient’s name, and click Record Visit
4. Select the following:
• Select Bulk Bill via the Invoice To drop-down list
• Select the associated Doctor via the Seen By drop-down list.
• Service Details: Item No: 715
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After recording a visit / issuing an account to Bulk Bill or Vet Affairs, you must batch all the claim vouchers before they can be sent to Medicare Australia / Veterans’ Affairs for processing. The following information explains the process of batching claims for both Bulk Bill and Veterans’ Affairs claims.
1. Select either;
• Processing > Batch Bulk Claims > Medicare, OR
• Processing > Batch Bulk Claims > Veterans’ Affairs (for batching Vet Affairs claims).
2. Click to process the batch. You will be prompted to confirm this action. Upon successfully processing a batch, the Batching Bulk Claims window will indicate that the batch has been processed, and the Process button will no longer be available for this batch.
3. Use the forward (right) or backward (left) buttons to scroll through the remaining batches and process them as desired.
4. Once you have completed processing batches, you can either;
• Click on the Batching Bulk Claims window to send the batch now, or
• Click on the Batching Bulk Claims window to save the processed batches, for sending in bulk later.
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From the Pracsoft Waiting Room, select Processing > Online Claiming. The Medicare Australia Online Claiming window appears.
This window will only display claims for practitioners who have indicated that they use Medicare Australia Online (via the Practitioner Details window).
The left-hand section of this window displays Claims that have been batched but not yet prepared and Transmitted. The right-hand side displays claims that have been prepared or Transmitted. Claims can be moved to the right or left of this screen by simply double-clicking them.
1. Once you have placed the Claims you wish to prepare into the ‘Claims Selected to Prepare’ section, click
The Prepare Claims Data tab will be displayed. Go to Step 2 - Preparing Claiming Data for Transmission.
2. Click to begin preparing vouchers.
3. You will be prompted to double-check that the correct claims have been selected for processing.
o If you are using a location certificate only and the Practitioner for whom you are preparing the claim on behalf of does not use an individual token, the claim will process once you respond with 'Yes'.
o If you are preparing claim for a Practitioner who uses an individual token, the Practitioner must insert the Individual Token or iKey and type in the password for each Practitioner when prompted.
o If a claim has been prepared successfully you will be notified in this window.
o If issues are discovered they will be displayed in this window and recorded in a log file (called hiconline.log, found in the Pracsoft home directory on your computer).
o If a claim has failed preparation, take note of the reasons displayed (e.g. invalid provider number,
invalid data item) and then click to call an edit window in which you can make the appropriate changes. Once any errors with the claims are rectified, proceed to the Medicare Australia Online Claiming window via Processing > Online Claiming and attempt to process the claims again.
4. Once all claims have processed successfully click The Print Claims Reports tab will be displayed. Go to Step 3 - Printing claims Reports.
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Appendix 2: DOCLE Codes
CHD - DOCLE Codes
angip Angina
angip Angina pectoris
angip@prin Angina pectoris - Prinzmetal angip@prin Coronary artery spasm
angip@prin Prinzmetal angina
angip@prin Variant angina
angip@unst Acute coronary insufficiency
angip@unst Angina pectoris - unstable
angip@unst Preinfarction syndrome
angip@unst Unstable Angina
angip@unst:high@risk Unstable Angina - High risk
angip@unst:low@risk Unstable Angina - Low risk
angip@unst:moderate@risk Unstable Angina - Moderate risk
atherosc Arteriosclerosis
atherosc Atherosclerosis
ihd Atherosclerotic heart disease
ihd Coronary artery disease
ihd Coronary heart disease
ihd Coronary insufficiency
ihd IHD
ihd IHD (Ischaemic Heart Disease) ihd Ischaemic heart disease
ihd Myocardial insufficiency
myoci Acute myocardial infarction
myoci AMI (Acute Myocardial Infarction) myoci Myocardial Damage
myoci Myocardial infarction
myoci:sans,st@elev Myocardial infarction - without ST elevation
myoci:sans,st@elev Non-ST-elevation myocardial infarction (NSTEMI) myoci:sans,st@elev NSTEMI (non-ST-elevation myocardial infarction) myoci:st@elev Myocardial Infarction - with ST elevation
myoci:st@elev STEMI (ST-Elevation Myocardial Infarction) myoci@ante Anterior myocardial infarct
myoci@ante Myocardial infarction - anterior
myoci@antel Anterolateral myocardial infarct
myoci@antel Myocardial infarction - anterolateral myoci@inf Inferior myocardial infarction
myoci@inf Myocardial infarction - inferior
myoci@posterio Myocardial infarction - posterior
myoci@posterio Posterior myocardial infarct
myoci@sile Myocardial infarction - silent
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CHD - DOCLE Codes
myoci@sile Silent myocardial infarction
myoci@subendoc Myocardial infarction - subendocardial myoci@subendoc Subendocardial myocardial infarct
myoci@supe Myocardial infarction - superior
myoci@supe Superior myocardial infarct
occl@coroa Blockage Coronary Artery
occl@coroa Coronary Occlusion
occl@coroa Occlusion - Coronary Artery
occl@coroa:acut ACS (acute coronary syndrome) occl@coroa:acut Acute coronary syndrome
ppoc@reha@ihd Coronary artery disease - Rehabilitation
pres@angip Antiangina agent prescription
pres@angip Prescription - Angina pectoris
surg.coroa Coronary artery surgery
surg.coroa Surgery - Coronary artery
surg.coroa@balloon Angioplasty - coronary
surg.coroa@balloon Balloon coronary angioplasty
surg.coroa@balloon Coronary artery balloon angioplasty
surg.coroa@balloon PCTA
surg.coroa@balloon Percutaneous transluminal angioplasty
surg.coroa@balloon Surgery - Coronary artery balloon angioplasty
surg.coroa@enda Coronary artery endarterectomy
surg.coroa@enda Surgery - Coronary artery endarterectomy
surg.coroa@graf Bypass - coronary
surg.coroa@graf CABG (Coronary Artery Bypass Graft) surg.coroa@graf Coronary artery bypass graft
surg.coroa@graf Surgery - Coronary artery bypass graft
surg.coroa@stent Angioplasty - coronary (with stent) surg.coroa@stent Coronary Angiography and Stent
surg.coroa@stent Coronary artery stent
surg.coroa@stent Stent - Coronary artery
surg.coroa@stent Surgery - Coronary artery stent
surg.coroa@stent@eluting Arterial stent - Coronary artery, drug-eluting
surg.coroa@stent@eluting Coronary artery, drug-eluting stent
surg.coroa@stent@eluting Stent - Coronary artery, drug-eluting
surg.coroa@stent@eluting@non Arterial stent - Coronary artery, not drug-eluting
surg.coroa@stent@eluting@non Coronary artery, not drug-eluting stent
surg.coroa@stent@eluting@non Stent - Coronary artery, not drug-eluting
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ACS - DOCLE Codes
angip@unst Acute coronary insufficiency
angip@unst Angina pectoris - unstable
angip@unst Preinfarction syndrome
angip@unst Unstable Angina
myoci:sans,st@elev Myocardial infarction - without ST elevation
myoci:sans,st@elev Non-ST-elevation myocardial infarction (NSTEMI)
myoci:sans,st@elev NSTEMI (non-ST-elevation myocardial infarction)
myoci:st@elev Myocardial Infarction - with ST elevation
myoci:st@elev STEMI (ST-Elevation Myocardial Infarction)
occl@coroa:acut ACS (acute coronary syndrome)
occl@coroa:acut Acute coronary syndrome
MI - DOCLE Codes
myoci Acute myocardial infarction
myoci AMI (Acute Myocardial Infarction)
myoci Myocardial Damage
myoci Myocardial infarction
myoci:sans,st@elev Myocardial infarction - without ST elevation
myoci:sans,st@elev Non-ST-elevation myocardial infarction (NSTEMI)
myoci:sans,st@elev NSTEMI (non-ST-elevation myocardial infarction)
myoci:st@elev Myocardial Infarction - with ST elevation
myoci:st@elev STEMI (ST-Elevation Myocardial Infarction)
myoci@ante Anterior myocardial infarct
myoci@ante Myocardial infarction - anterior
myoci@antel Anterolateral myocardial infarct
myoci@antel Myocardial infarction - anterolateral
myoci@inf Inferior myocardial infarction
myoci@inf Myocardial infarction - inferior
myoci@posterio Myocardial infarction - posterior
myoci@posterio Posterior myocardial infarct
myoci@sile Myocardial infarction - silent
myoci@sile Silent myocardial infarction
myoci@subendoc Myocardial infarction - subendocardial
myoci@subendoc Subendocardial myocardial infarct
myoci@supe Myocardial infarction - superior
myoci@supe Superior myocardial infarct
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Stroke - DOCLE Codes
cva Cerebral Infarction
cva Cerebrovascular Accident
cva CVA (Cerebrovascular Accident)
cva Stroke
cva@isch Ischaemic Stroke
cva@isch Stroke - Ischaemic
cva@lacu Lacunar Stroke
cva@lacu Stroke - Lacunar
cva@migr Migranous Stroke
cva@migr Stroke - Migranous
cva@thrombos Stroke - Thrombotic
cva@thrombos Thrombotic - Stroke
embo.cere Cerebral Embolism
embo.cere Embolism - Cerebral
ich Cerebral Haemorrhage
ich Haemorrhage - intracerebral
ich Haemorrhagic CVA
ich Haemorrhagic Stroke
ich Intracerebral bleed
ich Intracerebral haemorrhage
ich Stroke - Haemorrhagic
sah Haemorrhage - subarachnoid
sah Subarachnoid bleed
sah Subarachnoid haemorrhage
tia Arterial Embolism - minor
tia Cerebral TIA
tia Cerebral Transient Ischaemia
tia Cerebral Transient Ischaemic Attacks
tia TIA (Transient Ischaemic Attack)
tia Transient Ischaemic Attack
PVD - DOCLE Codes
Cvi Cerebrovascular insufficiency
Pvd Arteriosclerosis obliterans
Pvd Peripheral Vascular Disease
pvd PVD
raynp Raynaud's phenomenon
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Carotid Stenosis - DOCLE codes
sten.caroa Carotid Stenosis
surg.caroa@bypa@graf Carotid artery bypass surgery
surg.caroa@enda Carotid Endarterectomy
surg.caroa@enda Endarterectomy - Carotid
surg.caroa@stent Arterial stent - Carotid artery
surg.caroa@stent Carotid artery stent
surg.caroa@stent Stent - Carotid artery
Renal Stenosis - DOCLE Codes
sten.renaa Renal artery stenosis
sten.renaa Stenosis - Renal artery
surg.renaa Angioplasty - renal
surg.renaa@stent Arterial stent - Renal artery
surg.renaa@stent Renal artery stent
surg.renaa@stent Stent - Renal artery
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Appendix 3: Blood Pressure Drug Treatments
Generic Ingredients ATC Code
Candesartan C09CA06
Eprosartan C09CA02
Irbesartan C09CA04
Losartan C09CA01
Olmesartan C09CA08
Telmisartan C09CA07
Valsartan C09CA03
Candesartan/Hydrochlorothiazide C09DA06
Eprosartan/Hydrochlorothiazide C09DA02
Irbesartan/Hydrochlorothiazide C09DA04
Olmesartan/Amlodipine C09DB02
Olmesartan/Amlodipine/Hydrochlorothiazide C09DX03
Olmesartan/Hydrochlorothiazide C09DA08
Telmisartan/Amlodipine C09DB04
Telmisartan/Hydrochlorothiazide C09DA07
Valsartan/Amlodipine C09DB01
Valsartan/Amlodipine/Hydrochlorothiazide C09DX01
Valsartan/Hydrochlorothiazide C09CA03
Valsartan/Sacubitril C09DX04
Captopril C09AA01
Enalapril C09AA02
Fosinopril C09AA09
Lisinopril C09AA03
Perindopril C09AA04
Quinapril C09AA06
Ramipril C09AA05
Trandolapril C09AA10
Enalapril/Hydrochlorothiazide C09BA02
Enalapril/Lercanidipine C09BB02
Fosinopril/Hydrochlorothiazide C09BA09
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Generic Ingredients ATC Code
Perindopril/Amlodipine C09BB04
Perindopril/Indapamide C09BA04
Quinapril/Hydrochlorothiazide C09BA06
Ramipril/Felodipine C09BB05
Trandolapril/Verapamil C09BB10
Atenolol C07AB03
Bisoprolol C07AB07
Carvedilol C07AG02
Esmolol C07AB09
Labetalol C07AG01
Metoprolol succinate C07AB02
Metoprolol tartrate C07AB02
Nebivolol C07AB12
Oxprenolol C07AA02
Pindolol C07AA03
Propranolol C07AA05
Sotalol C07AA07
Amlodipine C08CA01
Clevidipine C08CA16
Felodipine C08CA02
Lercanidipine C08CA13
Nimodipine C08CA06
Amlodipine/Atorvastatin C10BX03
Enalapril/Lercanidipine C09BB02
Olmesartan/Amlodipine C09DB02
Olmesartan/Amlodipine/Hydrochlorothiazide C09DX03
Perindopril/Amlodipine C09BB04
Ramipril/Felodipine C09BB05
Telmisartan/Amlodipine C09DB04
Valsartan/Amlodipine C09DB01
Valsartan/Amlodipine/Hydrochlorothiazide C09DX01
Diltiazem C08DB01
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Generic Ingredients ATC Code
Verapamil C08DA01
Trandolapril/Verapamil C09BB10
Bumetanide C03CA02
Etacrynic acid C03CC01
Furosemide C03CA01
Amiloride C03DB01
Eplerenone C03DA04
Spironolactone C03DA01
Hydrochlorothiazide/Amiloride C03EA01
Hydrochlorothiazide C03AA03
Hydrochlorothiazide/Triamterene C03EA01
Candesartan/Hydrochlorothiazide C09DA06
Eprosartan/Hydrochlorothiazide C09DA02
Irbesartan/Hydrochlorothiazide C09DA04
Olmesartan/Amlodipine/Hydrochlorothiazide C09DX03
Olmesartan/Hydrochlorothiazide C09DA08
Telmisartan/Hydrochlorothiazide C09DA07
Valsartan/Amlodipine/Hydrochlorothiazide C09DX01
Valsartan/Hydrochlorothiazide C09DA03
Enalapril/Hydrochlorothiazide C09BA02
Fosinopril/Hydrochlorothiazide C09BA09
Quinapril/Hydrochlorothiazide C09BA06
Chlortalidone C03BA04
Indapamide C03BA11
Perindopril/Indapamide C09BA04
Methyldopa C02AB01
Clonidine C02AC01
Moxonidine C02AC05
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Appendix 4: Lipid Lowering Drug Treatments
Generic Ingredients ATCCode
Atorvastatin C10AA05
Fluvastatin C10AA04
Pravastatin C10AA03
Rosuvastatin C10AA07
Simvastatin C10AA01
Amlodipine/Atorvastatin C10BX03
Atorvastatin/Ezetimibe C10BA05
Simvastatin/Ezetimibe C10BA02
Fenofibrate C10AB05
Gemfibrozil C10AB04
Colestipol C10AC02
Colestyramine C10AC01
Ezetimibe C10AX09
Nicotinic acid C10AD02
Omega-3 triglycerides C10AX06
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Appendix 5: Recording eGFR and ACR Example - Record Kidney Function Test (GFR Result) Manually
1. Open a patient’s record
2. Select Tools > Tool Box > Renal Function Calculator. The Renal Function Calculator appears.
3. Enter value for creatine to generate eGFR value and click Save
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Example - Recording ACR Manually
1. Open a patient’s record
2. Select Clinical > Diabetes Record. The Diabetes Follow Up window appears.
3. An assessment must be conducted. While completing the Diabetes Assessment, record the Microalbumin ratio on the Investigations screen.
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Appendix 6: Diabetes
Example - Reviewing A Patient's Diabetes Record.
1. Open a patient’s record
2. Select Clinical > Diabetes Record
3. The Diabetes Follow Up window appears.
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Example - Record HbA1c Values to the Patient’s Record
1. Open a patient’s record
2. Select Clinical > Diabetes Record
3. The Diabetes Follow Up window appears.
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4. Click Add Values. The Diabetes Record window appears.
5. Input a value for Blood Gluc and click Save
Example - Record Type II Diabetes to Patient’s Record In ‘Reason for Visit’
1. Open a patient’s record
2. Select the Progress tab
3. Click Reason. The Reason for Contact window appears.
4. Enter Diabetes Mellitus - Type II and tick the Save In Past Medical History check box.
5. Click OK
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Example - Record Type II Diabetes to Patient’s Record in ‘History’
1. Open a patient’s record
2. Select the Past History tab
3. Right click within the white space to add a new item
4. The New History Item window appears.
5. Fill In the appropriate date and enter Diabetes Mellitus - Type II In the condition field.
6. Click OK
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Example - Record Blood Pressure
1. Open a patient’s record
2. Select Tools > Tool Box > Blood Pressure
3. The Blood Pressure module appears.
4. Enter values for blood pressure and then click Save
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Appendix 7: Processing Claims
Example - Creating and Processing A 721 Claim
1. Open MedicalDirector Pracsoft
2. Add a patient to the Pracsoft Waiting Room.
• See ‘Adding Patients to the Waiting Room’ for instructions.
3. Right-click the patient’s name, and click Record Visit
4. Select the following:
• Select Bulk Bill via the Invoice To drop-down list
• Select the associated Doctor via the Seen By drop-down list.
• Service Details: Item No 721
5. Click Voucher
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Example - Processing a Patient Claim
1. Select Processing > Batch Bulk Claims > Medicare
2. Enter a Claim Number (5 digits)
3. Click Process
4. Click Yes
5. Click Send
6. Click Yes to proceed. The Select Claims Tab is presented.
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7. Click Next Step. The Prepare Claim Tab is presented. Click Prepare
8. When prompted, click Yes for claim item
9. Click Next Step. The Transmit Claims tab is presented.
10. Click Transmit. The Transmit Claims window appears.
11. Locate and tick the item(s) for transmitting.
12. Click Transmit
13. Click OK
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Appendix 9: Childhood Immunisations
Minimum Count Antigens
Each of the antigens have been immunised for times equal or larger than the minimum count. Not to sum up all in the same group
DTPa count 3 DIPTHERIA, TETANUS, PERTUSSIS
Polio count 3 POLIO
HiB count 2 HIB
Hep B count 2 HEPB
MMR count 0 MEASLES, MUMPS, RUBELLA
For a 24-month-old child to be considered ‘fully Immunised’ their record must show the following:
Minimum Count Antigens
Each of the antigens have been immunised for times equal or larger than the minimum count. Not to sum up all in the same group
DTPa count 3 DIPTHERIA, TETANUS, PERTUSSIS
Polio count 3 POLIO
HiB count 3 HIB
Hep B count 3 HEPB
MMR count 1 MEASLES, MUMPS, RUBELLA
For a 60-month-old child to be considered ‘fully Immunised’ their record must show the following:
Minimum Count Antigens
Each of the antigens have been immunised for times equal or larger than the minimum count. Not to sum up all in the same group
DTPa count 4 DIPTHERIA, TETANUS, PERTUSSIS
Polio count 4 POLIO
MMR count 2 MEASLES, MUMPS, RUBELLA
HiB count 0 HIB
Hep B count 0 HEPB
93 NSW KPI Technical Documentation
Appendix 10: LOINC Codes
LOINC Codes - Hepatitis B
45159-1 83100-8 49600-0 5008-8 72841-0 61166-5 75408-5 49495-5
74856-6 22319-8 49359-3 5009-6 72840-2 61168-1 39007-0 58405-2
59052-1 5186-2 49367-6 32366-7 49882-4 61165-7 32178-6 49177-9
39005-4 5185-4 40459-0 16934-2 72851-9 61164-0 77176-6 48070-7
51658-3 31204-1 45161-7 6421-2 72850-1 61156-6 33633-9 58452-4
22316-4 24113-3 49361-9 72056-5 61161-6 30937-7 49883-2 63557-3
5187-0 10673-2 49366-8 54210-0 61160-8 10397-8 42322-8 70154-0
5188-8 77190-7 32686-8 72849-3 61163-2 22321-4 33629-7 77739-1
22317-2 39006-2 23869-1 49877-4 61169-9 5189-6 55275-2 50967-9
21005-4 51659-1 29900-8 49878-2 61154-1 5190-4 16935-9 42505-8
16933-4 49358-5 49364-3 49879-0 61173-1 22320-6 5194-6 5195-3
13952-7 49357-7 49363-5 72848-5 61155-8 13953-5 5193-8 5197-9
75378-0 11258-1 20442-0 72847-7 61158-2 75407-7 22323-0 65633-0
47440-3 42595-9 29615-2 72846-9 61159-0 41151-2 21006-2 5196-1
47358-7 49368-4 47216-7 72845-1 61157-4 33463-1 42504-1 7905-3
22318-0 49360-1 48650-6 49880-8 61171-5 31845-1 22322-2 75410-1
13919-6 49602-6 49365-0 72844-4 61172-3 5191-2 10900-9 47364-5
32685-0 49601-8 49362-7 72843-6 61170-7 31844-4 39535-0 10674-0
40725-4 48398-2 5007-0 72842-8 61162-4 5192-0 75409-3 10675-7
51914-0 49606-7 29610-3 49881-6 61167-3 13954-3 32019-2 43279-9
62871-9
48163-0
94 NSW KPI Technical Documentation
LOINC Codes - Chlamydia
13217-5 32007-7 22182-0 45105-4 31767-7 35718-6 45007-2 16596-9 31774-3 28556-9 26668-4 53926-2 44982-7 82178-5 6915-3 54044-3
32005-1 27371-4 5083-1 45104-7 6347-9 35736-8 45130-2 5090-6 6352-9 31298-3 26626-2 4993-2 22169-7 10652-6 44081-8 57817-9
27368-0 44987-6 5084-9 45103-9 561-1 35723-6 30204-2 45001-5 6353-7 44988-4 44985-0 43304-5 16581-1 34645-2 31307-2 43846-5
31294-2 22200-0 25369-0 31764-4 35711-1 35725-1 45008-0 44999-1 31776-8 43058-7 40855-9 50411-8 22170-5 7821-2 5080-7 46179-8
44996-7 18490-3 29677-2 20755-5 35710-3 35728-5 45009-8 41157-9 14472-5 28558-5 43174-2 45068-4 6912-0 16585-2 51808-4 43847-3
22194-5 22201-8 29664-0 45109-6 35713-7 35726-9 22187-9 40710-6 14511-0 49096-1 51734-2 44807-6 50612-1 16584-5 43868-9
14199-4 18491-1 43063-7 31763-6 32774-2 35717-8 5087-2 43061-1 31775-0 47212-6 44984-3 44806-8 31301-5 34707-0 22179-6
16597-7 13221-7 34264-2 6343-8 35412-6 35730-1 5088-0 27167-6 14474-1 45090-8 40854-2 43406-8 58758-4 33943-2 16587-8
44995-9 44986-8 22183-8 6344-6 35722-8 45093-2 31293-4 22193-7 14513-6 16599-3 43173-4 36902-5 31302-3 43216-1 22180-4
22195-2 22202-6 16591-0 45107-0 35724-4 14461-8 45006-4 45000-7 31772-7 21187-0 44983-5 45072-6 51806-8 35639-4 6916-1
14200-0 18492-9 5085-6 45106-2 35727-7 45094-0 45004-9 6920-3 14471-7 21189-6 40856-7 45067-6 44981-9 24402-0 16588-6
31295-9 41482-1 33410-2 45108-8 34708-8 14462-6 45005-6 44998-3 14510-2 21190-4 43175-9 80361-9 22171-3 59065-3 5081-5
44994-2 77166-7 38467-7 31765-1 35716-0 14463-4 22188-7 44997-5 31777-6 6356-0 47211-8 45069-2 16582-9 22993-0 51809-2
22196-0 74241-1 45010-6 6345-3 35729-3 45095-7 16594-4 34710-4 6354-5 45086-6 45089-0 80365-0 22172-1 22992-2 44977-7
14201-8 82957-2 21185-4 6346-1 45097-3 45096-5 22189-5 31768-5 6355-2 80363-5 57287-5 45073-4 6913-8 20752-2 43057-9
13218-3 62865-1 56909-5 45133-6 45099-9 80367-6 6918-7 14468-3 44005-7 51578-3 38469-3 45075-9 44080-0 7822-0 27404-3
32006-9 69865-4 22184-6 45132-8 24005-1 14465-9 44079-2 14507-8 26663-5 21191-2 21188-8 45074-2 31303-1 22175-4 22181-2
27370-6 39224-1 10848-0 45131-0 556-1 14467-5 22190-3 47234-0 46176-4 6357-8 45078-3 80360-1 31304-9 22994-8 6917-9
44993-4 31292-6 24238-8 32003-6 45098-1 14464-2 16595-1 31769-3 43356-5 45084-1 50387-0 45070-0 51807-6 20754-8 23000-3
22197-8 45011-4 56910-3 31766-9 557-9 6349-5 5089-8 6350-3 46177-2 43404-3 16600-9 80362-7 24004-4 22996-3 31779-2
14202-6 7823-8 57679-3 20756-3 45101-3 43405-0 26715-3 6351-1 43355-7 21613-5 23838-6 45076-7 43844-0 22995-5 6338-8
16598-5 16590-2 24239-6 20757-1 6348-7 36903-3 45002-3 31770-1 46178-0 50311-0 45085-8 47362-9 22173-9 22176-2 6339-6
44992-6 5082-3 56911-1 45114-6 558-7 77577-5 43848-1 14469-1 43357-3 26664-3 57288-3 21184-7 16583-7 5079-9 22999-7
22198-6 16589-4 57680-1 45113-8 559-5 72828-7 45135-1 14508-6 31296-7 26665-0 80364-3 5078-1 22174-7 14198-6 20753-0
14203-4 38468-5 22185-3 45115-3 45100-5 70163-1 43062-9 31771-9 44990-0 26666-8 82306-2 47052-6 6914-6 31305-6 22998-9
13220-9 45012-2 16592-8 16593-6 560-3 70162-3 27185-8 14470-9 43060-3 26667-6 21192-0 30205-9 44980-1 31306-4 31780-0
44991-8 75757-5 5086-4 32004-4 35721-0 70161-5 22191-1 14509-4 28557-7 33605-7 53925-4 11254-0 44979-3 44978-5 6340-4
22199-4 23967-3 21186-2 45112-0 35712-9 70164-9 45003-1 45091-6 31297-5 33575-2 16601-7 43845-7 10651-8 22177-0 6341-2
14204-2 23990-5 22186-1 32671-0 35714-5 64017-7 6919-5 34709-6 44989-2 33604-0 42931-6 31299-1 31778-4 16586-0 22997-1
13219-1 27273-2 10849-8 32001-0 35715-2 7824-6 22192-9 45092-4 43059-5 33574-5 45080-9 31300-7 29722-6 22178-8 23001-1
95 NSW KPI Technical Documentation
LOINC Codes - Gonorrhoea
43405-0 45075-9 31525-9 21416-3
36903-3 45074-2 5261-3 32705-6
77577-5 80360-1 32704-9 43403-5
72828-7 45070-0 42987-8 24111-7
70163-1 80362-7 27021-5 50326-8
70162-3 45076-7 22430-3 57458-2
70161-5 47362-9 9568-7 33904-4
70164-9 14127-5 53762-1 32198-4
64017-7 30099-6 31905-3 50388-8
45068-4 688-2 6487-3 57289-1
44807-6 690-8 6488-1 80366-8
44806-8 691-6 6489-9 60255-7
43406-8 692-4 6490-7 32199-2
36902-5 80368-4 31906-1 53927-0
45072-6 694-0 29311-8 60256-5
45067-6 695-7 35735-0 53879-3
80361-9 696-5 21414-8 5028-6
45069-2 697-3 47387-6 43305-2
80365-0 693-2 57180-2 50412-6
96 NSW KPI Technical Documentation
LOINC Codes - Syphilis
75180-0 22461-8 39015-3 43238-5 47361-1
75181-8 20507-0 51474-5 51475-2 34147-9
75193-3 5292-8 49800-6 50695-6 47236-5
75199-0 22463-4 11597-2 22590-4 47514-5
75182-6 47360-3 63464-2 26009-1 47063-3
75194-1 21030-2 17724-6 34382-2 22594-6
75185-9 22464-2 5392-6 5394-2 51839-9
62877-6 14904-7 17725-3 71793-4 17728-7
83319-4 46203-6 41122-3 47512-9 69946-2
39231-6 31146-4 22586-2 47051-8 6562-3
75197-4 11084-1 50689-9 22592-0 47237-3
22460-0 31147-2 9826-9 51838-1 40680-1
5289-4 50690-7 22587-0 17727-9 17729-5
22462-6 47476-7 24312-1 58031-6 53605-2
20508-8 47235-7 8041-6 58751-9 49799-0
5291-0 29310-0 24110-9 6561-5 41163-7
43813-5 76766-5 57032-5 47238-1 73752-8
51783-9 22585-4 5393-4 40679-3 68502-4
22459-2 13288-6 17723-8 17726-1 34954-8
5290-2 47511-1 46206-9 47513-7
97 NSW KPI Technical Documentation
LOINC Codes - HIV / AIDS
10901-7 16975-5 32827-8 35565-1 9662-8 57977-1 45233-4
10902-5 16977-1 32842-7 38998-1 9663-6 57978-9 51866-2
11078-3 18396-2 33508-3 40437-6 9664-4 59052-1
11079-1 19110-6 33660-2 40438-4 9666-9 49580-4
11080-9 21007-0 33806-1 40439-2 9667-7 49718-0
11081-7 21334-8 33807-9 40732-0 9668-5 49905-3
11082-5 21335-5 33866-5 40733-8 9669-3 48023-6
12855-3 21336-3 34591-8 41144-7 9821-0 48345-3
12856-1 21337-1 34592-6 41145-4 9836-8 47359-5
12857-9 21338-9 34699-9 42600-7 9837-6 44872-0
12858-7 21339-7 35437-3 42627-0 62456-9 44873-8
12859-5 21340-5 35439-9 42917-5 68961-2 45212-8
12870-2 24012-7 35440-7 43009-0 69353-1 73905-2
12871-0 25835-0 35441-5 43010-8 5017-9 73906-0
12872-8 25841-8 35442-3 43011-6 5018-7 74853-3
12875-1 25842-6 35443-1 43012-4 5221-7 74856-6
12876-9 28004-0 35444-9 43013-2 5222-5 77368-9
12893-4 29327-4 35445-6 44531-2 5225-8 77369-7
12894-2 29893-5 35446-4 44532-0 53379-4 7917-8
12895-9 30361-0 35447-2 44533-8 53825-6 7918-6
13920-4 31072-2 35448-0 44871-2 54086-4 7919-4
14092-1 31201-7 35449-8 80387-4 56888-1 79379-4
14126-7 31430-2 35450-6 81641-3 57974-8 79380-2
16132-3 32571-2 35452-2 9660-2 57975-5 47029-4
16974-8 32602-5 35564-4 9661-0 57976-3 30245-5
98 NSW KPI Technical Documentation
Appendix 11: Drug-Related Conditions
abus@amph Abuse - Amphetamine
abus@amph Amphetamine abuse
abus@amph Amphetamine addiction
abus@amph Drug abuse - Amphetamines
abus@amph Speed addiction
abus@amph Speed user
abus@amph@mdma Drug abuse - Ecstasy
abus@benzd Abuse - Benzodiazepine
abus@benzd Benzodiazepine addiction
abus@benzd Benzodiazepine dependence
abus@cann Abuse - cannabis
abus@cann Cannabis dependence
abus@cann Cannabis use
abus@cann Drug abuse - cannabis
abus@cann Marijuana addiction
abus@cann Marijuana use
abus@coca Abuse - Cocaine
abus@coca Cocaine addiction
abus@coca Cocaine dependence
abus@drug Abuse - Drug
abus@drug Drug abuse
abus@drug Drug addict
abus@drug Drug addiction
abus@drug Drug dependence
abus@drug@iv Intravenous drug abuse
abus@drug@iv Intravenous drug(s) use
abus@drug@iv IV drug use
abus@drug@pres Prescription Drug Abuse
abus@halla Abuse - Hallucinogen
abus@halla Hallucinogen abuse
abus@lysea Abuse - LSD
abus@lysea LSD abuse
abus@methamph Abuse - ice (methamphetamine)
abus@methamph Abuse - methamphetamine
abus@methamph Drug abuse - ice (methamphetamine)
abus@methamph Ice (methamphetamine) abuse
abus@methamph Methamphetamine abuse
abus@opia Abuse - Narcotic
abus@opia Abuse - Opiate
abus@opia Drug abuse - Opiates
abus@opia Heroin addiction
abus@opia Heroin dependence
abus@opia Morphine addiction
abus@opia Morphine dependence
abus@opia Narcotic abuse
abus@opia Narcotic addiction
abus@opia Narcotic dependence
abus@opia Opiate abuse
abus@opia Opiate addiction
abus@opia Opiate dependence
abus@subs Abuse - Substance
abus@subs Substance abuse
abus@subs@mult Abuse - Polysubstance
abus@subs@mult Poly-substance use
abus@subs@mult Polysubstance Abuse
abus@subs@mult Substance use - Poly
abus@subs@shopper Drug Seeker
abus@volas Abuse - Volatile solvent(s)
abus@volas Petrol sniffing
abus@volas Solvent abuse
abus@volas Volatile solvent dependence
behap@intoxica Acute intoxication
behap@intoxica Behavioural Problem - Intoxication
behap@intoxica Drunken Behaviour
behap@intoxica Drunken State
behap@intoxica Intoxicated State
drug@seeking@beha Drug seeking behaviour
inju&ctx@ill,drug@use Drug Use Injury
inju&ctx@ill,etha@use Ethanol Use Injury
overdose Overdose
overdose@barb Acute barbiturate intoxication
overdose@drug Overdose - drug
overdose@opia Acute opiate intoxication
overdose@opia Narcotic overdose
overdose@opia Opiate overdose
overdose@opia Overdose - opiate
ppoc@bupr Buprenorphine treatment program - enrolled in
ppoc@deto Detoxification treatment
ppoc@deto@fail Detoxification - failed attempt
ppoc@deto@fail Failed detoxification attempt
ppoc@deto@home Detoxification treatment - at home
ppoc@deto@hosp Detoxification treatment - at hospital/institution
ppoc@methadon Methadone Program
ppoc@methadon Methadone Therapy
ppoc@nalt@impl Implant - naltrexone
ppoc@nalt@impl Naltrexone Implant
pres@@opia@repl Opioid Replacement Therapy - Prescription supplied
pres@@opia@repl Prescription for Opioid Replacement Therapy
prob@druga Problem - Drug abuse
refe@counsell@use@subs Substance use --> referral for counselling
sh@user@drug Drug social use
sh@user@drug Recreational drug usage
sh@user@drug User - Drug
urin@drug@screen:eval,find:posi Positive urine drug screen test
urin@drug@screen:eval,find:posi Urine drug screen test - Positive
use@subs Substance use
use@subs@diso Substance use disorder
withdraw@benzd Benzodiazepine withdrawal
withdraw@benzd Withdrawal - Benzodiazepine
withdraw@cann Cannabis withdrawal
withdraw@drug Drug withdrawal
withdraw@drug Withdrawal - Drug
withdraw@opia Narcotic withdrawal
withdraw@opia Withdrawal - Narcotic
99 NSW KPI Technical Documentation
Appendix 12: High-Impact Mental Illness
psychosi@drug Drug induced Psychosis
psychosi@drug Psychosis - Drug Induced
senip Psychosis - senile
senip Senile psychosis
senip Para schizophrenia
schip@paranoia Paranoid schizophrenia
schip@paranoia Schizophrenia - paranoid
schip@catatoni Catatonic schizophrenia
schip@catatoni Schizophrenia - catatonic
schizoafd Schizo-affective disorder
schip@chro Schizophrenia - Chronic
paranoia Paranoia
paranoia Paranoid traits
paranoid Paranoid
paranoid Paranoid feeling
paranoid Persecution thoughts
paranoia Paranoid traits
paranoid Paranoid feeling
schip Schizophrenia
mdi Manic depressive illness
mdi Bipolar affective disorder
mdi Manic depressive illness
mdi Manic depressive psychosis
depr@postn Depression - Post Natal
depr@postn Post Natal Depression
depr@postn Depression - Post Natal
depr@postn Post Natal Depression
anorn Anorexia nervosa
anorn Anorexia syndrome
psychosi Psychosis
psychosi Psychotic disorders
psychosi@drug Psychosis - Drug Induced
psyck Korsakoff's psychosis
100 NSW KPI Technical Documentation
Appendix 13: Low-Impact Mental Illness
anxid Anxiety anxid Anxiety disorder anxid Anxiety neurosis anxid Nervous Anxiety anxid Neurotic anxiety adjud Adjustment Disorder adjud Environment Change Stress Disorder adjud Stress Environment Adjustment Disorder
grier@norm Bereavement grier Pathological grief grier Grief reaction grier Mourning reaction grier Pathological mourning feel*l Feeling depressed feel*l Depressed feel*l Dysthymia feel*l Dysthymic feel*l Feeling low feel*l Feeling sad feel*l Melancholy feel*l Mood - low feel*l Sad feeling
abus@alco Alcohol addiction abus@alco Alcohol dependence abus@alco Abuse - Alcohol abus@alco Alcohol abuse abus@alco Alcoholic abus@alco Alcoholism abus@toba Tobacco abuse abus@toba Tobacco dependence abus@toba Abuse - Tobacco abus@toba Cigarette abuse abus@toba Cigarette dependence abus@toba Nicotine use disorder abus@toba Smoking abus@toba Tobacco abuse abus@toba Tobacco dependence abus@toba Abuse - Tobacco abus@toba Cigarette abuse abus@toba Cigarette dependence abus@toba Nicotine use disorder
drug@seeking@beha Drug seeking behaviour abus@drug Drug addiction abus@drug Drug dependence
abus@drug Abuse - Drug abus@drug Drug abuse abus@drug Drug addict abus@opia Heroin addiction abus@opia Heroin dependence
abus@amph Amphetamine addiction abus@amph Abuse - Amphetamine abus@amph Amphetamine abuse abus@amph Drug abuse - Amphetamines abus@amph Speed addiction abus@amph Speed user
abus@amph@mdma Drug abuse - Ecstasy abus@cann Marijuana addiction abus@cann Abuse - cannabis abus@cann Cannabis dependence abus@cann Cannabis use abus@cann Drug abuse - cannabis abus@cann Marijuana use abus@lysea Abuse - LSD abus@lysea LSD abuse abus@coca Cocaine addiction abus@coca Cocaine dependence abus@coca Abuse - Cocaine abus@opia Narcotic abuse abus@opia Narcotic addiction abus@opia Narcotic dependence abus@opia Opiate abuse abus@opia Opiate addiction abus@opia Opiate dependence abus@opia Abuse - Narcotic abus@opia Abuse - Opiate abus@opia Drug abuse - Opiates abus@opia Heroin addiction abus@opia Heroin dependence abus@opia Morphine addiction abus@opia Morphine dependence abus@halla Abuse - Hallucinogen abus@halla Hallucinogen abuse behap@chil Behaviour problem - Child behap@chil Behaviour problems - Child behap@chil Child behaviour problem behap@chil Behaviour problem - Child behap@chil Behaviour problems - Child behap@chil Child behaviour problem
behap@adol Adolescent behaviour problem behap@adol Behaviour problem - Adolescent behap@adol Adolescent behaviour problem behap@adol Behaviour problem - Adolescent
abus@gambling Abuse - Gambling abus@gambling Addiction - Gambling abus@gambling Gambling Addiction
condd CD (conduct disorder) condd Conduct disorder
ppoc@counsell@grie Counselling - Grief ppoc@counsell@grie Grief Counselling
ppoc@cogn@beha@therapy Cognitive Behavioural Therapy ppoc@cogn@beha@therapy Focussed Psychological Strategy
anxid Anxiety anxid Anxiety disorder anxid Anxiety neurosis anxid Nervous Anxiety anxid Neurotic anxiety anxid Anxiety neurosis anxid Nervous Anxiety anxid Neurotic anxiety anxid Anxiety anxid Anxiety disorder
anxid@pani Panic disorder anxid@pani Anxiety attacks anxid@pani Anxiety with panic attacks anxid@pani Panic attacks anxid@pani Anxiety attacks anxid@pani Anxiety with panic attacks anxid@pani Panic attacks anxid@pani Panic disorder
depr Depression depr Melancholia depr Organic depression
depr@reac Reactive Depression depr@reac Depression - Reactive
depr@endog Depression - Endogenous depr@endog Endogenous depression
anxi@depr Anxiety/Depression anxi@depr Depressive anxiety disorder
anxi@depr Mixed anxiety/depressive disorder
depr:majo Major depressive disorder depr:majo Depression - Major
101 NSW KPI Technical Documentation
anxi@soci Social Phobia anxi@soci Anxiety - social anxi@soci Social Anxiety Disorder
persd Borderline personality disorder persd Inadequate personality persd Personality disorder
auti Autism autis Autistic spectrum disorder
prob@deat@spou Death of partner prob@deat@spou Loss of partner prob@deat@spou Problem - Death - Spouse
prob@deat@chil Death of child prob@deat@chil Problem - Death - Child
behap@chil Behaviour problem - Child
behap@chil Behaviour problems - Child behap@chil Child behaviour problem grier@norm Bereavement
prob@deat@pare Death of parent prob@deat@pare Problem - Death - Parent
eatid Eating Disorder buli Bulimia
behap Problem behaviour abus@gambling Addiction - Gambling
abus@drug Drug addiction
&ctx@dx[adjud],with[feel@anxi] Adjustment disorder with anxious mood
adjud@anxi@depr Adjustment disorder with depressed and anxious mood
&ctx@dx[adjud],with[feel*l] Adjustment disorder with depressed mood
prob@alco Alcohol excess anxid@general Anxiety - generalised
feel@anxi@performa Anxiety - performance Behap Behaviour problem
anxid@general Generalised Anxiety Disorder (GAD) feel@anxi Mood - anxious
persd:dx,ctx:bord Personality disorder - Borderline Ptsd Post-traumatic stress disorder Ptsd PTSD (post-traumatic stress disorder)
102 NSW KPI Technical Documentation
Appendix 14: NSW KPI MBS Item Numbers MBS item numbers provided by http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Home
No. Related KPI Item Description
732 NSW KPI 12 Attendance by a general practitioner to review or coordinate a review of:
• a GP management plan prepared by a general practitioner (or an associated general practitioner) to which item 721 applies; or
• team care arrangements which have been coordinated by the general practitioner (or an associated general practitioner) to which item 723 applies
715 NSW KPI 01 Aboriginal and Torres Strait Islander Peoples Health Assessment
NSW KPI 10 Details of the requirements for the Aboriginal and Torres Strait Islander Peoples Health Assessment, The Aboriginal and Torres Strait Islander Peoples Health Assessment is available to:
• Children between ages of 0 and 14 years,
• Adults between the ages of 15 and 54 years,
• Older people over the age of 55 years.
721 NSW KPI 08 GP Management Plans, Team Care Arrangements, Multidisciplinary Care Plans
NSW KPI 09 Attendance by a general practitioner for preparation of a GP management plan for a patient (other than a service associated with a service to which any of items 735 to 758 apply)
723 NSW KPI 11 NSW KPI 12
Attendance by a general practitioner to coordinate the development of team care arrangements for a patient (other than a service associated with a service to which any of items 735 to 758 apply)
NSW KPI Technical Documentation
Appendix 15: NSW KPI MBS Item Numbers Aboriginal and Torres Strait Islander Mental Health Assessment
No. Related KPI Item Description
2700 NSW KPI 26 NSW KPI 27
Professional attendance by a general practitioner (including a general practitioner who has not undertaken mental health skills training) of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
2701 NSW KPI 26 NSW KPI 27
Professional attendance by a general practitioner (including a general practitioner who has not undertaken mental health skills training) of at least 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
2715 NSW KPI 26 NSW KPI 27
Professional attendance by a general practitioner (including a general practitioner who has undertaken mental health skills training of at least 20 minutes but less than 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient
2717 NSW KPI 26 NSW KPI 27
Professional attendance by a general practitioner (including a general practitioner who has undertaken mental health skills training) of at least 40 minutes in duration for the preparation of a GP mental health treatment plan for a patient