122 CHAPTER 2.3 Table 4.Continued. Criterion Original criterion text Additional (excluding) condition Justification C6 Stop antiplatelet agents with vitamin K antagonist, direct thrombin inhibitor or factor Xa inhibitors in patients with stable coronary, cerebrovascular or peripheral arterial disease. ICD-10 code Z95.5 ‘Presence of coronary angioplasty implant and graft’ is encoded as additional condition, excluding this rule AND with a duration shorter than 12 months. Stable coronary, cerebrovascular or peripheral arterial disease’ not codable. The exception to this rule is the presence of a coronary stent for less than 12 months. C8, C9 Stop vitamin K antagonist, direct thrombin inhibitor or factor Xa inhibitors for first pulmonary embolus or first deep venous thrombosis without continuing provoking risk factors (e.g. thrombophilia) for > 12 months or > 6 months respectively. ICD-10 code I48* ‘atrial fibrillation’ is encoded as additional condition, excluding this rule. A history of first pulmonary embolus > 12 months ago or first deep venous thrombosis > 6 months ago AND presence of atrial fibrillation, anticoagulant most likely prescribed for atrial fibrillation D9 Stop neuroleptic antipsychotic in patients with behavioral and psychological symptoms of dementia (BPSD) unless symptoms are severe and other non-pharmacological treatments have failed. ICD-10 code F20*, F25* and F29 ‘Schizophrenic disorders/psychotic disorder NOS’ AND coexistent ICD-10 code F51.0 or G47.0 ‘sleeping disorder’ encoded as additional condition, excluding this rule. ‘unless symptoms are.... have failed’ not codable. Sleeping disorders due to psychosis coded as additional excluding condition as mentioned in STOPP D10. D13 Stop levodopa or dopamine agonists for benign essential tremor. ICD-10 code G20, G21*, G23.1, G23.2, G31.8, G90.3 ‘Parkinson/ parkinsonism’ added as additional excluding condition. In patients with a history of Parkinson/ parkinsonism, levodopa or dopamine agonists most likely prescribed for this H4 Stop long-term corticosteroids (>3 months) as monotherapy for rheumatoid arthritis. Additional excluding condition is concurrent use of a DMARD. If DMARDs are used, corticosteroids are not used as monotherapy (monotherapy not codable otherwise) *The asterisk indicates that all subcategories starting with the letter/number combinations prior to the asterisk are included.
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