P31 KE-P31 · outpatient visit

One row per condition family: what the record supports under the published definition, what the note states, the visit's diagnosis entries, and an assessment. Codes are coded from the signed documentation; the software never assigns one.

Note: unsigned draft

Side-panel conditions check FRUN-00031 · front-engine 1.2 · replay 267b3fa9b41f8651…

Library check LRUN-00031 · library_default_set@1.1 · library-engine 1.1 · replay a4ba8a28b7386b3e… · Data (JSON)

Core definitions 2

Core definitions: condition families for this encounter (2)
Condition family	What the record supports	What the note states	Visit diagnosis entries	Assessment
Heart failure type (ejection fraction) judgement tier · side-panel condition	`front_hf_ef_type@1.0` Draft · pending review Record meets: Heart failure with reduced ejection fraction (HFrEF) Ejection fraction 32% · echocardiogram 2026-09-12 (transthoracic, biplane): Left ventricular ejection fraction 32% by biplane method. (Dr. Leopold Nairn (cardiology)) · ECHO-P31-2 Ejection fraction 28% · echocardiogram 2025-10-07 (transthoracic, biplane): Left ventricular ejection fraction 28% by biplane method. (Dr. Leopold Nairn (cardiology)) · ECHO-P31-1 Acuity indicators (1): evidence only Acuity words in the note: chronic Options and what the record shows Heart failure with reduced ejection fraction (HFrEF) · needs latest ejection fraction 40% or lower · record: latest 32% on 2026-09-12 · met Heart failure with mildly reduced ejection fraction (HFmrEF) · needs latest ejection fraction 41% to 49% · record: latest 32% on 2026-09-12 · not met Heart failure with preserved ejection fraction (HFpEF) · needs latest ejection fraction 50% or higher · record: latest 32% on 2026-09-12 · not met Heart failure with improved ejection fraction (HFimpEF) · needs an earlier ejection fraction of 40% or lower, the latest above 40%, and a rise of at least 10 points · record: earlier 28% on 2025-10-07, latest 32% on 2026-09-12 (change +4 points) · not met Citation Heart failure type by ejection fraction (four categories, 2021 universal definition as restated in 2022) front_hf_ef_type@1.0 In our words: Reduced ejection fraction: 40% or lower. Mildly reduced: 41% to 49%. Preserved: 50% or higher. Improved: an earlier ejection fraction of 40% or lower, a later one above 40%, and a rise of at least 10 points. (2021 edition, as restated in an openly licensed 2022 paper.) HFrEF, LVEF ≤ 40% Chandramouli C, Stewart S, Almahmeed W, Lam CSP (Clinical Cardiology), Clinical implications of the universal definition for the prevention and treatment of heart failure (2022) · Section 1.3 'New universal definition' (classification by left ventricular ejection fraction) · source Licence: open licence: CC BY 4.0, attribution: Chandramouli C, Stewart S, Almahmeed W, Lam CSP. Clinical implications of the universal definition for the prevention and treatment of heart failure. Clin Cardiol 2022;45(Suppl 1):S2-S12. doi:10.1002/clc.23842. Licensed under CC BY 4.0.. Source checked: opened. No endorsement by the cited bodies is implied. To confirm with a clinician: the boundary wording at exactly 40%. This file reads reduced as 40% or lower (the openly licensed source); the federal cross-check says below 40%. A reported 40% is shown as reduced. To confirm with a clinician: the improved-category baseline rule. The baseline is the first earlier ejection fraction of 40% or lower on file and the comparison value is the latest; another reading (lowest earlier value, or the value just before the latest) can give a different answer. To confirm with a clinician: whether the 2021 categories should stay the shown edition now that a 2026 edition reportedly drops fixed cut-offs between reduced and preserved.	heart failure with reduced ejection fraction	None entered	Supported and specific The note says “heart failure with reduced ejection fraction” and the latest ejection fraction, 32% on 2026-09-12, fits the type written. Clinician's response to the side-panel card: No response yet · offer OF-000027
Whole code category, for reference (no code is selected, ranked or suggested): Heart failure type (ejection fraction) Coders only reference for coders — the clinician's documented statement governs; the software does not assign codes `I50` Heart failure (23 codes in the category). `I50.1` Left ventricular failure, unspecified `I50.20` Unspecified systolic (congestive) heart failure `I50.21` Acute systolic (congestive) heart failure `I50.22` Chronic systolic (congestive) heart failure `I50.23` Acute on chronic systolic (congestive) heart failure `I50.30` Unspecified diastolic (congestive) heart failure `I50.31` Acute diastolic (congestive) heart failure `I50.32` Chronic diastolic (congestive) heart failure `I50.33` Acute on chronic diastolic (congestive) heart failure `I50.40` Unspecified combined systolic (congestive) and diastolic (congestive) heart failure `I50.41` Acute combined systolic (congestive) and diastolic (congestive) heart failure `I50.42` Chronic combined systolic (congestive) and diastolic (congestive) heart failure `I50.43` Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure `I50.810` Right heart failure, unspecified `I50.811` Acute right heart failure `I50.812` Chronic right heart failure `I50.813` Acute on chronic right heart failure `I50.814` Right heart failure due to left heart failure `I50.82` Biventricular heart failure `I50.83` High output heart failure `I50.84` End stage heart failure `I50.89` Other heart failure `I50.9` Heart failure, unspecified Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).
Kidney disease stage (filtering rate) measured · side-panel condition	`front_kidney_stage_wording@1.0` Draft · pending review No wording's requirement is met by the record Options and what the record shows Chronic kidney disease stage 1 · needs filtering rate 90 or above with a kidney damage marker (for example albuminuria on two tests at least 90 days apart) · record: filtering rate 60 or above; needs a kidney damage marker (no persistent albuminuria on file) · not assessable Chronic kidney disease stage 2 · needs filtering rate 60-89 with a kidney damage marker (for example albuminuria on two tests at least 90 days apart) · record: filtering rate 60 or above; needs a kidney damage marker (no persistent albuminuria on file) · not assessable Chronic kidney disease stage 3a · needs filtering rate 45-59 on two results at least 90 days apart · record: results at least 90 days apart are 60 or above · not met Chronic kidney disease stage 3b · needs filtering rate 30-44 on two results at least 90 days apart · record: results at least 90 days apart are 60 or above · not met Chronic kidney disease stage 4 · needs filtering rate 15-29 on two results at least 90 days apart · record: results at least 90 days apart are 60 or above · not met Chronic kidney disease stage 5 · needs filtering rate below 15 on two results at least 90 days apart · record: results at least 90 days apart are 60 or above · not met Citation Kidney disease stage wording by filtering rate, with the albumin-to-creatinine category (options for the clinician) front_kidney_stage_wording@1.0 In our words: Kidney disease by filtering rate: below 60 on results at least 3 months apart; or urine albumin-to-creatinine ratio 30 mg/g or higher on two tests at least 3 months apart. Stage by filtering rate: G1 90 or above; G2 60-89; G3a 45-59; G3b 30-44; G4 15-29; G5 below 15 (G1 and G2 also need a marker of kidney damage). Albumin-to-creatinine category: A1 below 30, A2 30-299, A3 300 mg/g or above. The filtering rate is estimated with the 2021 race-free creatinine equation. Decreased eGFR <60 mL/min/1.73 m2 (GFR categories G3a-G5) for ≥3 months Department of Veterans Affairs and Department of Defense, VA/DoD Clinical Practice Guideline for the Primary Care Management of Chronic Kidney Disease, Provider Summary (Version 5.0) (2025) · Sidebar 6 'Criteria for CKD' (PDF page 16; printed page 13 of 37). Do not use Sidebar 9 (a reproduced third-party figure) · source Licence: U.S. government work (public domain); filtering-rate stage bands (90, 60, 45, 30, 15) and the G3a/G3b split: fact only citation; albumin-to-creatinine categories (A1 below 30, A2 30-299, A3 300 mg/g or above): fact only citation; 2021 creatinine equation: public domain. Source checked: opened. No endorsement by the cited bodies is implied. To confirm with a clinician: three months is encoded as 90 days (the VA/DoD summary says 3 months or more).	Not stated	None entered	Nothing to act on Kidney results 180 days apart are 60 or above (filtering rate 71.8 on 2026-05-15 and 71.8 on 2026-11-11) and the note doesn't mention kidney function. Clinician's response to the side-panel card: No response yet
Whole code category, for reference (no code is selected, ranked or suggested): Kidney disease stage (filtering rate) Coders only reference for coders — the clinician's documented statement governs; the software does not assign codes `N18` Chronic kidney disease (CKD) (9 codes in the category). `N18.1` Chronic kidney disease, stage 1 `N18.2` Chronic kidney disease, stage 2 (mild) `N18.30` Chronic kidney disease, stage 3 unspecified `N18.31` Chronic kidney disease, stage 3a `N18.32` Chronic kidney disease, stage 3b `N18.4` Chronic kidney disease, stage 4 (severe) `N18.5` Chronic kidney disease, stage 5 `N18.6` End stage renal disease `N18.9` Chronic kidney disease, unspecified Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).

Extended capabilities (licence required before commercial use) 0

Extended capabilities: published criteria cited by title and restated in our own words, no text reproduced; a licence or permission is needed before commercial use. Shown to coders always; on clinician screens only when the setting is on (now off).

Nothing in this section for this encounter.