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Table 1 ICD-10-AM codes used to identify Ambulatory Care Sensitive Conditions (ACSCs) and exclusions made based on procedure fields

From: Patient characteristics associated with hospitalisations for ambulatory care sensitive conditions in Victoria, Australia

Category

ICD10 codes

Notes (ICD10)

Influenza and pneumonia

J10 J11 J13 J14 J153 J154 J157 J159 J168 J181 J188

In any diagnosis field, excludes cases with secondary diagnosis of D57, and people under 2 months

Other vaccine preventable

A35 A36 A37 A80 B05 B06 B161 B169 B180 B181 B26 G000 M014

In any diagnosis field

Asthma

J45 J46

Principal diagnosis only

Congestive heart failure*

I50 I110 J81

Principal diagnosis only, exclude cases with procedure codes according to attached list

Diabetes complications

E101 E102 E103 E104 E105 E106 E107 E108 E110 E111 E112 E113 E114 E115 E116 E117 E118 E130 E131 E132 E133 E134 E135 E136 E137 E138 E140 E141 E142 E143 E144 E145 E146 E147 E148

In any diagnosis field

Chronic obstructive pulmonary disease

J20 J41 J42 J43 J44 J47

Principal diagnosis only, J20 only with diag2 of J41 J42 J43 J47 J44

Angina

I20 I240 I248 I249

Principal diagnosis only, exclude cases with procedure codes NOT in blocks 1820 to 2140

Iron deficiency anaemia

D501 D508 D509

Principal diagnosis only

Hypertension*

I10 I119

Principal diagnosis only, exclude cases with procedure codes according to attached list

Nutritional deficiencies

E40 E41 E42 E43 E550 E643

Principal diagnosis only

Dehydration and gastroenteritis

E86 K522 K528 K529

Principal diagnosis only

Pyelonephritis

N390 N10 N12 N11 N136

Principal diagnosis only

Perforated/bleeding ulcer

K250 K251 K252 K254 K255 K256 K260 K261 K262 K264 K265 K266 K270 K271 K272 K274 K275 K276 K280 K281 K282 K284 K285 K286

Principal diagnosis only

Cellulitis

L03 L04 L08 L980 L88 L983

Principal diagnosis only, exclude cases with any procedure except those in blocks 1820 to 2016 or if procedure is 30216-02 30676-00 30223-02 30064-00 34527-01 34527-00 90661-00 and this is the only listed procedure

Pelvic inflammatory disease

N70 N73 N74

Principal diagnosis only

Ear, nose and throat infections

H66 H67 J02 J03 J06 J312

Principal diagnosis only

Dental conditions

K02 K03 K04 K05 K06 K08 K098 K099 K12 K13

Principal diagnosis only

Convulsions and epilepsy

O15 G40 G41 R56

Principal diagnosis only

Gangrene

R02

In any diagnosis field

  1. *Procedure codes to use for exclusions for congestive heart failure and hypertension:
  2. 33172-00, 35304-00, 35305-00, 35310-02, 35310-00, 38281-11, 38281-07, 38278-01.
  3. 38278-00, 38281-02, 38281-01, 38281-00, 38256-00, 38278-03, 38284-00, 38284-02.
  4. 38521-09, 38270-01, 38456-19, 38456-15, 38456-12, 38456-11, 38456-10, 38456-07.
  5. 38456-01, 38470-00, 38475-00, 38480-02, 38480-01, 38480-00, 38488-06, 38488-04.
  6. 38489-04, 38488-02, 38489-03, 38487-00, 38489-02, 38488-00, 38489-00, 38490-00.
  7. 38493-00, 38497-04, 38497-03, 38497-02, 38497-01, 38497-00, 38500-00, 38503-00.
  8. 38505-00, 38521-04, 38606-00, 38612-00, 38615-00, 38653-00, 38700-02, 38700-00.
  9. 38739-00, 38742-02, 38742-00, 38745-00, 38751-02, 38751-00, 38757-02, 38757-01.
  10. 38757-00, 90204-00, 90205-00, 90219-00, 90224-00.