DM012 - Diabetic foot risk classification
The information contained within this article is from version 49 of the Business Rules for Quality and Outcomes Framework (QOF).
Indicator definition
Indicator ID | Description |
What do the business rules mean?
What makes a patient eligible?
How to achieve the indicator?
To meet the criteria for DM012, eligible patients must have had:
- A foot risk classification in the contract year
What will remove patients from eligibility?
- Patients have both of the following:
- Right foot amputation or congenital absence of right foot codes
- Left foot amputation or congenital absence of left foot codes
- Patients for whom neuropathy assessment is not suitable in the contract year
- Patients for whom foot examination is not suitable in the contract year
- Patients for whom diabetes quality indicator care was unsuitable in the contract year
- Patients who chose not to have a neuropathy assessment in the contract year
- Patients who chose not to have a foot examination in the contract year
- Patients who have chosen not to receive diabetes quality indicator care in the contract year
- Patients who have been invited twice (at least 7 days apart) for review
- Patient who were diagnosed with diabetes in the last 3 months of the contract year
- Patients who were newly registered with the practice in the last 3 months of the contract year
If a patient achieves the
indicator at any point during the year, any exclusions that have also been
added are ignored.
SNOMED codes used in this indicator
The codes referenced in this article are taken from the NHS Technology Reference Update Distribution (TRUD). Not all of these may be present or selectable in all clinical systems.Foot risk classification codes (FRC_COD)
SNOMED code | SNOMED code description |
394671009 | On examination - Right diabetic foot at low risk |
| 394682001 | On examination - Right diabetic foot at moderate risk |
| 394672002 | On examination - Right diabetic foot at high risk |
| 756391000000103 | On examination - Right diabetic foot at increased risk |
| 394673007 | On examination - Right diabetic foot - ulcerated |
| 394675000 | On examination - Left diabetic foot at low risk |
| 394681008 | On examination - Left diabetic foot at moderate risk |
| 394676004 | On examination - Left diabetic foot at high risk |
| 756381000000100 | On examination - Left diabetic foot at increased risk |
| 394674001 | On examination - Left diabetic foot - ulcerated |
| 980411000000102 | Young Townson FootSkin Scale for Diabetic Neuropathy risk level 1 |
| 980431000000105 | Young Townson FootSkin Scale for Diabetic Neuropathy risk level 2 |
| 980451000000103 | Young Townson FootSkin Scale for Diabetic Neuropathy risk level 3 high risk |
| 980471000000107 | Young Townson FootSkin Scale for Diabetic Neuropathy risk level 4 high risk |
Right foot amputation codes (AMPR_COD)
SNOMED code | SNOMED code description |
1010211003 | Traumatic amputation of right lower limb (disorder) |
1010227005 | Traumatic amputation of right foot (disorder) |
1010312007 | Traumatic amputation of right lower limb at level between knee and ankle (disorder) |
1010684009 | Traumatic amputation of right lower limb through thigh (disorder) |
1055306001 | Traumatic amputation of right lower limb through knee (disorder) |
10996691000119108 | History of disarticulation of right knee (situation) |
11007531000119105 | History of amputation through right ankle joint (situation) |
11007571000119108 | History of amputation of right foot (situation) |
11007691000119108 | History of disarticulation of bilateral knee joints (situation) |
119751000119105 | History of bilateral lower limb amputation (situation) |
11995441000119103 | Contracture of amputation stump of right lower limb (disorder) |
11995601000119103 | Dehiscence of amputation stump wound of right lower limb (disorder) |
11995791000119103 | Edema of amputation stump of right lower limb (disorder) |
11995991000119101 | Hematoma of amputation stump of right lower limb (disorder) |
11996161000119100 | Infection of amputation stump of right lower limb (disorder) |
11996641000119105 | Pain of amputation stump of right lower limb (finding) |
13093003 | Bilateral traumatic amputation of legs at any level with complication (disorder) |
144691000119104 | History of amputation of left and right leg through tibia and fibula (situation) |
15636891000119105 | History of amputation of bilateral feet (situation) |
15669321000119104 | Congenital absence of right lower limb (disorder) |
16087851000119103 | History of amputation of bilateral ankle joints (situation) |
16207081000119105 | Pain of amputation stump of bilateral lower limbs (finding) |
16207521000119100 | History of amputation of right midfoot (situation) |
16207601000119105 | History of amputation of right forefoot (situation) |
210767003 | Traumatic bilateral amputation of leg with complication (disorder) |
213378007 | Traumatic amputation of both feet (disorder) |
286541000119108 | History of bilateral above knee amputation of lower limbs (situation) |
308093009 | On examination - Amputated right leg (finding) |
308095002 | On examination - Amputated right above knee (finding) |
308097005 | On examination - Amputated right below knee (finding) |
36211009 | Bilateral traumatic amputation of feet without complication (disorder) |
445498009 | Bilateral traumatic amputation of lower limbs (disorder) |
723312009 | Amputation of right foot (procedure) |
723689001 | Amputation of left and right leg through tibia and fibula (procedure) |
723840008 | Amputation of bilateral lower limbs above knee (procedure) |
732212008 | Amputation of bilateral lower limbs (procedure) |
733287003 | Traumatic amputation at right hip joint (disorder) |
735668000 | Traumatic amputation of bilateral legs through hip joints (disorder) |
73600009 | Bilateral traumatic amputation of legs at any level without complication (disorder) |
772058008 | Amputation of entire right lower limb and ipsilateral hemipelvis (procedure) |
773819005 | Amputation of right forefoot (procedure) |
787161009 | Amputation of right midfoot (procedure) |
787399008 | Amputation of bilateral feet (procedure) |
816963007 | Amputated right lower limb (finding) |
816964001 | Amputated right lower limb below knee (finding) |
816965000 | Amputated right lower limb above knee (finding) |
817015003 | Amputated right forefoot (finding) |
89824004 | Bilateral traumatic amputation of feet with complication (disorder) |
Congenital absence of right foot codes (CONABR_COD)
SNOMED code | SNOMED code description |
1003644007 | Agenesis of bilateral feet |
1201776003 | Congenital complete absence of right lower limb |
15669321000119104 | Congenital absence of right lower limb |
177504007 | Acheiropodia |
304971000119107 | Congenital absence of right lower leg and foot |
371191006 | Bilateral congenital absence of feet |
45420007 | Acheiropodia |
702313004 | Tetra-amelia syndrome |
716249009 | Tetraamelia with multiple malformation syndrome |
767000001 | Congenital absence of right foot |
890222006 | Congenital complete absence of bilateral lower limbs |
890401002 | Congenital absence of bilateral lower legs and feet |
92504008 | Bilateral congenital absence of feet |
Left foot amputation codes (AMPL_COD)
SNOMED code | SNOMED code description |
1010210002 | Traumatic amputation of left lower limb (disorder) |
1010228000 | Traumatic amputation of left foot (disorder) |
1010309009 | Traumatic amputation of left lower limb at level between knee and ankle (disorder) |
1010683003 | Traumatic amputation of left lower limb through thigh (disorder) |
1055305002 | Traumatic amputation of left lower limb through knee (disorder) |
10996571000119108 | History of amputation of left foot (situation) |
10996731000119101 | History of amputation through left ankle joint (situation) |
10996771000119103 | History of disarticulation of left knee (situation) |
11007691000119108 | History of disarticulation of bilateral knee joints (situation) |
119751000119105 | History of bilateral lower limb amputation (situation) |
11995361000119109 | Contracture of amputation stump of left lower limb (disorder) |
11995521000119108 | Dehiscence of amputation stump wound of left lower limb (disorder) |
11995691000119109 | Edema of amputation stump of left lower limb (disorder) |
11995891000119108 | Hematoma of amputation stump of left lower limb (disorder) |
11996081000119108 | Infection of amputation stump of left lower limb (disorder) |
11996561000119108 | Pain of amputation stump of left lower limb (finding) |
13093003 | Bilateral traumatic amputation of legs at any level with complication (disorder) |
144691000119104 | History of amputation of left and right leg through tibia and fibula (situation) |
15636891000119105 | History of amputation of bilateral feet (situation) |
15669241000119104 | Congenital absence of left lower limb (disorder) |
16087851000119103 | History of amputation of bilateral ankle joints (situation) |
16207081000119105 | Pain of amputation stump of bilateral lower limbs (finding) |
16207561000119105 | History of amputation of left midfoot (situation) |
16207681000119102 | History of amputation of left forefoot (situation) |
210767003 | Traumatic bilateral amputation of leg with complication (disorder) |
213378007 | Traumatic amputation of both feet (disorder) |
286541000119108 | History of bilateral above knee amputation of lower limbs (situation) |
308094003 | On examination - Amputated left leg (finding) |
308096001 | On examination - Amputated left above knee (finding) |
308098000 | On examination - Amputated left below knee (finding) |
36211009 | Bilateral traumatic amputation of feet without complication (disorder) |
445498009 | Bilateral traumatic amputation of lower limbs (disorder) |
723311002 | Amputation of left foot (procedure) |
723689001 | Amputation of left and right leg through tibia and fibula (procedure) |
723840008 | Amputation of bilateral lower limbs above knee (procedure) |
732212008 | Amputation of bilateral lower limbs (procedure) |
733288008 | Traumatic amputation at left hip joint (disorder) |
735668000 | Traumatic amputation of bilateral legs through hip joints (disorder) |
73600009 | Bilateral traumatic amputation of legs at any level without complication (disorder) |
772057003 | Amputation of entire left lower limb and ipsilateral hemipelvis (procedure) |
773821000 | Amputation of left forefoot (procedure) |
787159000 | Amputation of left midfoot (procedure) |
787399008 | Amputation of bilateral feet (procedure) |
816113001 | Amputated left lower limb (finding) |
816114007 | Amputated left lower limb above knee (finding) |
816116009 | Amputated left lower limb below knee (finding) |
817014004 | Amputated left forefoot (finding) |
89824004 | Bilateral traumatic amputation of feet with complication (disorder) |
Congenital absence of left foot codes (CONABL_COD)
SNOMED code | SNOMED code description |
1003644007 | Agenesis of bilateral feet |
1201777007 | Congenital complete absence of left lower limb |
15669241000119104 | Congenital absence of left lower limb |
177504007 | Acheiropodia |
304961000119101 | Congenital absence of left lower leg and foot |
371191006 | Bilateral congenital absence of feet |
45420007 | Acheiropodia |
702313004 | Tetra-amelia syndrome |
716249009 | Tetraamelia with multiple malformation syndrome |
766999004 | Congenital absence of left foot |
890222006 | Congenital complete absence of bilateral lower limbs |
890401002 | Congenital absence of bilateral lower legs and feet |
92504008 | Bilateral congenital absence of feet |
Codes for neuropathy assessment unsuitable for patient (NPTPU_COD)
SNOMED code | SNOMED code description |
408397002 | Diabetic foot examination not indicated |
729221000000103 | Patient unsuitable for neuropathy assessment |
Codes for foot examination unsuitable for patient (FEPU_COD)
SNOMED code | SNOMED code description |
408397002 | Diabetic foot examination not indicated |
729241000000105 | Patient unsuitable for foot pulse check |
Codes for diabetes quality indicator care unsuitable for patient (DMPCAPU_COD)
SNOMED code | SNOMED code description |
717421000000100 | Excepted from diabetes quality indicators - patient unsuitable |
Codes indicating the patient has chosen not to have a neuropathy assessment (NPTDEC_COD)
SNOMED code | SNOMED code description |
412752009 | Diabetic foot examination declined |
729181000000108 | Neuropathy assessment declined |
Codes indicating the patient has chosen not to have a foot examination (FEDEC_COD)
SNOMED code | SNOMED code description |
412752009 | Diabetic foot examination declined |
699053009 | Foot pulse check declined |
Codes indicating the patient has chosen not to receive diabetes quality indicator care (DMPCADEC_COD)
SNOMED code | SNOMED code description |
716031000000106 | Excepted from diabetes quality indicators - informed dissent |
Invite for diabetes care review codes (DMINVITE_COD)
| SNOMED code | SNOMED code description |
| 1109921000000106 | Quality and Outcomes Framework quality indicator-related care invitation |
| 1110921000000100 | Quality and Outcomes Framework diabetes mellitus quality indicator-related care invitation |
| 143401000000102 | Quality and Outcomes Framework diabetes mellitus quality indicator-related care invitation using preferred method of communication |
| 705072004 | Diabetes monitoring invitation by short message service text messaging |
1066911000000100 | Diabetes monitoring short message service text message first invitation |
1066921000000106 | Diabetes monitoring short message service text message second invitation |
1066931000000108 | Diabetes monitoring short message service text message third invitation |
1083111000000108 | Diabetes monitoring invitation email |
185756006 | Diabetes monitoring first letter |
185757002 | Diabetes monitoring second letter |
185758007 | Diabetes monitoring third letter |
185759004 | Diabetes monitoring verbal invite |
185760009 | Diabetes monitoring telephone invite |
310425007 | Diabetes monitoring invitation |
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