#

mnemonic

QUESTION TEXT

RESPONSE

DEFINITIONS/DECISION RULES

2

lipid2

Within the past two years, was a lipid profile, to include total cholesterol, triglycerides, and HDL-C or LDL-C obtained for this patient?

1,2*

*If 2, go to postmiasa, else go to lipidt

A cholesterol level alone is not a lipid profile.  At a minimum, total cholesterol, triglycerides, and HDL-C or LDL-C have to be reported to respond “1” to this question.

3

lipidt

Enter the date of the most recent lipid profile obtained within this period.

mm/dd/yyyy

Day may be entered as 01, if exact date is unknown.  At a minimum, the month and year must be entered accurately.

4

ldlmeas

Was the LDL-C measured as part of the lipid profile?

1 = yes

2 = no

3 = triglycerides elevated and LDL-C not valid

1,2*,3*

*If 2 or 3, go to totalc, else go to ldlclvl2

Either a direct or calculated LDL-C value is acceptable.

If fasting triglycerides are over 400, and LDL-C value is noted to be invalid, answer “3.”

5

ldlclvl2

Enter the value of the LDL-C measured on this date.

_____

Normal range is usually 60 – 130 mg/dl or less than 3.36 mmol/L (although this varies depending on the way the LDL is calculated, if it is not a direct measurement.)

6

ldl2unit

Enter the LDL-C unit of measurement:

            1= mg/dL

            2 = mMol/L

1,2

This data must be taken from the lab report in order to ensure the correct unit of measurement is linked to the LDL-C value.

7

totalc

Enter the total cholesterol value obtained as part of the lipid profile.

_____

Value is generally reported as mg/dl or mmol/L and the normal range is usually less than 200mg/dl or 5.18 mmol/L.

This value cannot be zero-filled.

8

totalunt

Enter the total cholesterol unit of measurement:

            1= mg/dL

            2 = mMol/L

1,2

This data must be taken from the lab report in order to ensure the correct unit of measurement is linked to the total cholesterol value.

9

hdlval

Enter HDL cholesterol value obtained as part of the lipid profile.

_____

Value is generally reported as mg/dl or mmol/L and the normal findings are usually greater than 45 mg/dl (1.17 mmol/L) in males or 55 mg/dl (1.42 mmol/L) in females.

May zero-fill if this value was not included in the lipid profile.

#

mnemonic

QUESTION TEXT

RESPONSE

DEFINITIONS/DECISION RULES

10

hdlunit

Enter the HDL cholesterol unit of measurement:

            1= mg/dL

            2 = mMol/L

1,2

This data must be taken from the lab report in order to ensure the correct unit of measurement is linked to the HDL-C value.

11

trivalue

Enter the triglycerides value obtained as part of the lipid profile.

_____

Normal findings are usually <180 mg/dL (2.01 mmol/L) in females and <190 mg/dL (2.12 mmol/L ) in males.

This value cannot be zero-filled.

12

triunit

Enter the triglyceride unit of measurement:

            1= mg/dL

            2 = mMol/L

1,2

This data must be taken from the lab report in order to ensure the correct unit of measurement is linked to the triglyceride value.

#

mnemonic

QUESTION TEXT

RESPONSE

DEFINITIONS/DECISION RULES

17

lipdlowr

Within the past two years, was the patient taking or prescribed lipid-lowering medication?

1,2*

*If 2, go to cardvise, else go to medname 

“Taking or prescribed” = lipid-lowing medication was listed among the patient’s medications within the past two years or was prescribed at a clinic visit or inpatient admission

Question does not reference a new prescription.  The patient can have been on lipid-lowering medication for many years.

Classifications of lipid-lowering medication=HMG Co-A reductase inhibitors (statins), niacin, bile acid resins, and fibrates.

18

medname

Designate all lipid-lowering medications the patient was taking at the most recent clinic visit:

Statins:

1.      fluvastatin sodium (Lescol)

2.      atorvastatin calcium (Lipitor)

3.      lovastatin (Mevacor)

4.      pravastatin sodium (Pravachol)

5.      simvastatin (Zocor)

Niacin:

6.      niacin extended release tablets (Niaspan)

Bile Acid Resin:

7.      colestipol hydrochloride (Colestid)

8.      colesevelam hydrochloride (Welchol)

Fibrates:

9.      clofibrate (Atromid-S)

10.    gemfibrozil (Lopid)

11.    fenofibrate (Tricor)

12.    patient not taking any of these meds at most recent visit

13.    Chloride salt of basic anion exchange resin
cholestryamine (Prevalite)

1,2,3,4,5,6,7,8,
9,10,11,12,13

Note that although the previous question asks about lipid-lowering medication in the past two years, this question references the most recent visit prior to the pull list date. 

More than one lipid-lowering drug may be designated by the abstractor if the patient is on multiple medications for dyslipidemia.

#

mnemonic

QUESTION TEXT

RESPONSE

DEFINITIONS/DECISION RULES

19

cardvise

Within the past two years, was the patient advised of any of the following lifestyle changes to manage cholesterol/reduce cardiac risk factors?

Indicate all that apply:

1.      dietary/nutritional management of fat and/or cholesterol intake

2.      increase in physical activity

3.      weight control

4.      referral to a cardiac rehab program

5.      no recommendations provided to patient

1,2,3,4,5

Answer ‘1’ if patient was prescribed (or advised to follow) a low fat or low cholesterol diet.  The information used to answer “yes” to weight counseling in the Core Module cannot be used for cholesterol management unless there is specific reference to low fat or low cholesterol diet.  Information used to answer the weight control question in the Core Module may be used for option #3. 

Answer ‘2’ if patient is counseled regarding an increase in physical activity.  Specificity to lowering cholesterol is not necessary

Referral to a cardiac rehab program must have occurred in the past two years.