NHS England QOF Reporting – Screening for malignant neoplasm of cervix

It has been brought to our attention by NHS Digital that some practices might be using Read and CTV3 code 685.. Cervical neoplasia screening' as an administrative code or problem heading to manage cervical screening recalls.

This Read/CTV3 code' 685..' was not included in the code cluster SMEAR _COD for QOFv38 (Payment QOF2017-18).

The Read and CTV3 code 685.. ‘Cervical neoplasia screening' is in the preventative procedures chapter and has been mapped to the SNOMED term 171149006 ‘Screening for malignant neoplasm of cervix' which is in the cancer screening hierarchy in SNOMED. There are some other Read and CTV3 codes that also map to SNOMED code171149006. The table below shows Read/CTV3 codes that are mapped to SNOMED code 171149006 ‘Screening for malignant neoplasm of cervix'. 

Scheme

Code

Synonym

Term

Snomed Concept

Snomed Term

CTV

ZV762

 

[V]Screening for malignant neoplasm of cervix

171149006

Screening for malignant neoplasm of cervix

CTV

685..

 

Cervical neoplasia screening

171149006

Screening for malignant neoplasm of cervix

RCT

ZV762

0

[V]Screening for malignant neoplasm of cervix

171149006

Screening for malignant neoplasm of cervix

RCT

685..

0

Cervical neoplasia screening

171149006

Screening for malignant neoplasm of cervix

RCT

685..

11

Cervical cytology screen

171149006

Screening for malignant neoplasm of cervix

RCT

685..

12

Cervical smear screen

171149006

Screening for malignant neoplasm of cervix

RCT

6859

11

Cervical cytology examination

171149006

Screening for malignant neoplasm of cervix

 

NHS Digital have consulted with their terminology team and clinical advisors and asked for the mapping to be reviewed, and it was agreed that these maps are appropriate. The methodology to undertake the mapping from Read and CTV3 to SNOMED, plus an extensive quality assurance process, has been overseen by a number of national GP clinical leads and terminology experts and validated by the Joint GP IT Committee. The mapping tables have been signed off as clinically safe for the transition of historical data. 

On this basis 171149006 ‘Screening for malignant neoplasm of cervix'' has been included in the cluster SMEAR_COD for QOF v41(Payment QOF 2018-19). The effect of this is that records with 685.. Cervical neoplasia screening' will now be reported for QOF v41. If the QOF cluster is used to support cervical smear recall then patients who have a record where 685.. has been used as an administrative code may appear to have had a smear and could be missed from smear recall. 

We would therefore request that practices check for this code in their records so that if they are using it for administrative purposes, rather than to show the smear has taken place, then they will need to update their records for the end of year. The SNOMED code 714971000000104 | Cervical smear screening administration | which is a heading' code could be used instead.

Note that this advice is only currently relevant in England. In Scotland, QOF has not been in use from 1st April 2016 and the QOF business rules in Wales and Northern Ireland are currently only specified using Read, so this issue will not affect Welsh or Northern Irish practices until such a time that audits are migrated to SNOMED CT.