SOP Bulletin No. 12 — 9

Decision Support Unit

1 — st Floor Blackburn House, 199 Grenfell St, Adelaide                            12 — th Floor, 300 Latrobe St, Melbourne

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1 — st September 2008

RELEASE NOTES - CCPS VERSION 2008/08

Version 2008/08 of the Medical Knowledge Base for CCPS was released into production today.  This Bulletin provides a summary of the amended SOPs that this version of CCPS incorporates.  This Bulletin also details changes to some existing rulebases.

New SOPs incorporated into CCPS	Renal artery atherosclerotic disease
SOP amendments incorporated into CCPS	Acquired cataract Myopia, hypermetropia & astigmatism
Enhancements of CCPS rulebases and commentary	Correction of rulebase error for pulmonary thromboembolism Correction of rulebase problem when propagating to depressive disorder
Additional SOP amendments incorporated - not noteworthy	Analgesic nephropathy Cut, stab, abrasion and laceration Diverticular disease of the colon Soft tissue sarcoma

New SOPs incorporated into CCPS

Renal artery atherosclerotic disease

This SOP was initially issued in 1998 and there have been a couple of minor amendments since.  It has the usual straightforward 'atherosclerotic factors' of smoking, hypertension, diabetes mellitus and dyslipidaemia as well as a factor for treatment with oral ACE inhibitors.

For information on this SoP refer to SoP Bulletin No. 14 of 2 July 1998.

SOP amendments incorporated into CCPS

Acquired cataract

• The new 'prolonged sunlight exposure' has been incorporated and, for those cases that can't be accepted via smoking, this factor will be easier to apply than the now defunct UV ratio factor.
• A reminder that acceptance of a — cquired cataract should always be without reference to either one or both eyes.  For assessment purposes, however, the diagnostic label of any rejected condition should be side specific.

For information on this SoP refer to SoP Bulletin No. 127 of 30 June 2008.

Myopia, hypermetropia & astigmatism

• Some SOP factors only apply to myopia, some only apply to astigmatism and some only apply to hypermetropia.  The rulebase relevant to each type of refractive error will be driven by the ICD code selected when diagnosing the claim.  If more than one type of refractive error is present in an eye, ie hypermetropic astigmatism or myopic astigmatism, you should separately encode and determine each type, because of the different causal factors that apply (note that myopia and hypermetropia cannot coexist in the same eye).
• You will also need to edit the reasons where they refer to 'no appropriate clinical management for myopia or hypermetropia or astigmatism'.

For information on this SoP refer to SoP Bulletin No. 123 of 6 March 2008.

Enhancements of CCPS rulebases and commentary

Pulmonary thromboembolism

In the SOP for p — ulmonary thromboembolism the factor 'Thrombus within the right atrium or right ventricle' previously propagated directly to the non-SOP ICD code 429.79.  However, w — hen the SOP definition of i — schaemic heart disease was changed in the instruments of November 2003, this ICD code was picked up by the IHD SOP so since then this factor has propagated directly to the IHD SOP.  This wa — s incorrect as there are several causes of thrombus formation, including myocardial infarction.

The rulebase has been changed so that it is now necessary to identify, via the Condition Encoder, the injury or disease responsible for the thrombus within the right atrium or right ventricle.

Thanks to Peter Castleman from the Melbourne location for drawing this to our attention.

Propagating to depressive disorder

When the new instruments for the depressive disorder SOP were incorporated into CCPS on 3.6.08, the rulebase was structured so that relevant SOP factors were enabled/disabled according to the ICD code selected.  However, we overlooked the impact of this on 5 conditions in CCPS that had factors which propagated directly to the depressive disorder SOP.  In these cases, b — ecause no ICD code for depressive disorder was selected, the SOP factors for depressive disorder were being enabled/disabled inappropriately.  The conditions involved were:

• cerebrovascular accident
• hypertension
• ischaemic heart disease
• irritable bowel syndrome
• psoriasis

The rulebase for each condition has been changed so that when propagating it is now necessary to identify, via the Condition Encoder, the type of depressive disorder.

Thanks to Cathy Linford-Klose from the Adelaide location for recognising & reporting this problem.

Additional amendments

Amendments to the following incorporated conditions are included in this release. However, there are no noteworthy CCPS features:

Analgesic nephropathy

For information on this SoP refer to SoP Bulletin No. 125 of 28 April 2008.

Cut, stab, abrasion and laceration

For information on this SoP refer to SoP Bulletin No. 127 of 30 June 2008.

Diverticular disease of the colon

For information on this SoP refer to SoP Bulletin No. 127 of 30 June 2008.

Soft tissue sarcoma

For information on this SoP refer to SoP Bulletin No. 125 of 28 April 2008.

Remember! If you are having any problems with SOPs, or SOPs in CCPS, talk to us!