Recent Requests

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Recent Requests shows all amendment requests that have a submitted, under review, approved, published or rejected status.
Approved, published and rejected requests will remain on this page for 75 days. 

The codes and narrative listed are those proposed, view the Schedule to see actual approved codes and narratives.

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Request
Number
Date Code Current
Narrative
Proposed
Narrative
Type Current
Status
Reasons for
change
20/04/2017 N/A N/A Irreversible electroporation of prostate cancer New Code Submitted Brand new procedure/test
20/04/2017 N/A N/A Minimally invasive sacroiliac joint stabilisation surgery for chronic sacroiliac pain (includes image guidance) (NICE use the narrative “fusion” however in committee comments it was stated '6.3 The committee noted that, while this procedure achieves stabilisation of the joint, there was evidence that fusion of the joint does not occur in many patients.' New Code Submitted Brand new procedure/test
19/04/2017 N/A N/A One-step nucleic acid amplification (ONSA) New Code Submitted Improves coding structure and adds clarityAs discussed at last months meeting this is for the histopathology aspect of the OSNA test. This is a request we have had from a provider.
19/04/2017 N/A N/A We have had a variety of new code requests for pathology tests from providers to be added to the diagnostic schedule. New Code Submitted Improves coding structure and adds clarity
18/04/2017 N/A N/A endoscopic nasolaryngopharyngoscopy (as sole procedure) New Code Submitted Improves coding structure and adds clarityOur CMO feel that we still need a code for examination without biopsy or stroboscopy. This is to allow for greeter clarity in coding.
18/04/2017 M4780 Invasive urodynamic assessment including cystoscopy and pressure/flow measurements N/A Coding Principles Submitted We suggest that M4510 is listed as unacceptable with M4780 as it is part & parcel of that procedure "Invasive urodynamic assessment including cystoscopy".................
13/04/2017 T3920 N/A Multivisceral resection of retroperitoneal sarcoma New Code Submitted The overall goal in surgery for a retroperitoneal sarcoma (RPS) is complete resection of tumour with en bloc removal of closely associated/involved viscera and surrounding musculature. The role of more extended surgical resection has been advocated by several specialist sarcoma centres and is now performed safely in expert sarcoma centres. The anatomic constraints of the retroperitoneum render margin-negative excisions more technically challenging than for other sarcomas. The best chance of a curative outcome is at the primary resection; thus detailed surgical planning and expertise is required to perform multivisceral resections with reconstruction while minimizing microscopically positive margins. Viscera/organs/structures commonly resected in RPS include colon kidney pancreas spleen diaphragm small bowel duodenum liver bladder with resection of psoas iliacus musculature and/or abdominal wall. Select cases require resection and reconstruction of major vascular structures (interior vena cava aorta and/or iliac vessels) and less commonly include vertebral or pelvic bony resection. The adoption of a policy of liberal multivisceral en bloc resection over in the past 5 years was paralleled by greater local control and better outcome in RPS. This is often performed as a two-surgeon procedure. Currently no code exist for multivisceral resection for retroperitoneal sarcoma. It creates difficulty finding appropriate codes since surgery can involve many different combination of organs and structures which is not currently covered in the CCSD. The preoperative authorisation and intra-operative findings may also change which creates extra administration to change authorisation codes. This code with encompass all retroperitoneal sarcoma resection including any viscera resected. Individual organs will no longer have to be authorised as separate procedure codes.
07/04/2017 N/A N/A Intralesional injections for immunotherapy with image guidance (nodal lesions) New Code Submitted Improves coding structure and adds clarityImproves coding structure and adds clarity
06/04/2017 V3300 Minimally invasive intradiscal surgery (including laser/instrumentation) (lumbar region) Percutaneous intradiscal laser ablation (lumbar region) Narrative Change Submitted Improves coding structure and adds clarity Firstly we feel that the narrative should match NICE Guidance IPG357 and secondly "instrumentation" in the current narrative could not be considered minimally invasive.
04/04/2017 25120 Dorsal root ganglion block (local anaesthetic or neurolytic) Dorsal root ganglion block (local anaesthetic or neurolytic) (as sole procedure) Narrative Change Submitted This code is being used in addition with other procedure codes for the purposes of post operative pain relief. If this was made 'sole procedure' then it would clarify that it can be used on it's own but cannot be added to any other combination of codes.
03/04/2017 N/A N/A Flexible pouchoscopy +/- biopsy and/or removal of polyp(s) New Code Submitted This procedure is routinely performed to examine an ileo-anal pouch if the sigmoid has been removed.
23/03/2017 Q2231 N/A Oophorectomy and salpingectomy, +/- biopsy eg. omentum, peritoneum, lymph node (as sole procedure) (unilateral) New Code Submitted Improves coding structure and adds clarity Q2230 includes the wording "(including bilateral)" and so we propose this is also changed to be just "(bilateral)". We find when Q2230 is used for a unilateral procedure it is difficult to ascertain what was done which means we have to request operation notes/medical updates so having 2 codes would be helpful for us and the surgeons.
23/03/2017 T4130 Freeing of adhesions of peritoneum Relief of intestinal obstruction for adhesions, acute or chronic Narrative Change Submitted Improves coding structure and adds clarity Our CMO is concerned that this code is grossly and inappropriately overused when part of another procedure. He therefore proposes the narrative change to allow the procedure to be applied to the pathology for which it is intended and feels this change to the narrative will support this.
22/03/2017 A7012 Gastroelectrical mechanical stimulation Implantation of gastroelectrical stimulation (GES) for gastroparesis Narrative Change Published To reflect updated clinical practiceSuggest we change the narrative to match NICE guidance. https://www.nice.org.uk/guidance/ipg103/documents/gastroelectrical-stimulation-for-gastroparesis-consultation-document
21/03/2017 W4244 N/A Tibial liner exchange in total knee replacement New Code Published Improves coding structure and adds clarity Exchanging the liner in a total knee replacement is performed on a fairly regular basis but there is no code for the procedure. We do have a code for hip replacements: W3944 Acetabular liner and head changes so I propose we do the same for knees.
20/03/2017 H2503 Therapeutic sigmoidoscopy with snare loop biopsy or excision of lesion Therapeutic sigmoidoscopy/pouchoscopy with snare loop biopsy or excision of lesion Narrative Change Under Review To reflect updated clinical practiceI understand that a pouchoscopy is performed to examine an ileo-anal pouch if the sigmoid has been removed. Would it be a good idea to include this in the narrative of both sigmoidoscopy codes?
20/03/2017 H2502 Diagnostic flexible sigmoidoscopy (including forceps biopsy and proctoscopy) Diagnostic flexible sigmoidoscopy/pouchoscopy (including forceps biopsy and proctoscopy) Narrative Change Under Review To reflect updated clinical practiceI understand that a pouchoscopy is performed to examine an ileo-anal pouch if the sigmoid has been removed. Would it be a good idea to include this in the narrative of both sigmoidoscopy codes?
17/03/2017 Q1802 Hysteroscopy with resection of fibroids +/- insertion of Mirena coil N/A Coding Principles Published I suggest we list new code Q1281 - Removal and/or replacement of an embedded / migrated Mirena coil as unacceptable with Q1802 - Hysteroscopy with resection of fibroids +/- insertion of Mirena coil as it's included in the narrative.
17/03/2017 Q1800 Hysteroscopy (including biopsy, dilatation, curettage and resection of polyp(s) +/- Mirena coil insertion) N/A Coding Principles Published I suggest we list new code Q1281 - Removal and/or replacement of an embedded / migrated Mirena coil as unacceptable with Q1800 - Hysteroscopy (including biopsy, dilatation, curettage and resection of polyp(s) +/- Mirena coil insertion) as it's included in the narrative.
17/03/2017 N/A N/A Omental biopsy +/- an ascitic drain under image guidance New Code Published There is no code for this procedure & specialists are using the omentectomy code instead which isn't really appropriate.
16/03/2017 T7982 Arthroscopic subacromial decompression and rotator cuff repair (including arthroscopic procedures in glenohumeral joint) N/A Coding Principles Published Our CMO feels this is included within the T7982 procedure and should not be billed as an additional procedure. We note that W8193 (Arthroscopic subacromial decompression) is already listed as an unacceptable combination.
16/03/2017 W8194 Arthroscopic subacromial decompression and excision of distal clavicle (including arthroscopic procedures in glenohumeral joint) N/A Coding Principles Published Our CMO feels this is included within the W8194 procedure and should not be billed as an additional procedure. We note that W8193 (Arthroscopic subacromial decompression) is already listed as an unacceptable combination.
14/03/2017 A5781 N/A Selective Dorsal Rhizotomy (SDR) New Code Published Brand new procedure/testBrand new procedure/test
13/03/2017 N/A N/A CT of the coronary arteries (CTCA) with Fractional Flow Reserve (FFR) calculation New Code Published Improves coding structure and adds clarityCTCA with FFR is now NICE-approved and we would like to encourage providers to use this as it is less invasive than traditional angiography with FFR. We need a new code in order to capture new activity. Links to narrative change #3725
13/03/2017 IM017 CT of the coronary arteries (CTCA) CT of the coronary arteries (CTCA) as sole procedure Narrative Change Published Improves coding structure and adds clarityCTCA with FFR is now NICE-approved and we would like to encourage providers to use this as it is less invasive than traditional angiography with FFR. We need a new code in order to capture new activity.
09/03/2017 A3200 Decompression of cranial nerve (craniotomy) N/A Coding Principles Published Our view is that reconstruction of the cranium, V0110 is integral to the main procedure A3200 - Decompression of cranial nerve (craniotomy) and should be added to the list of unacceptable combinations.
09/03/2017 M6584 Transrectal MRI – US fusion targeted prostate biopsy N/A Coding Principles Published We don't seem to have identified any unacceptable code combinations for M6584, so I propose adding the above codes in line with what we have listed for M6582 "Transperineal template-guided biopsies of the prostate under image guidance"...............
09/03/2017 M6583 Transperineal MRI – US fusion targeted prostate biopsy N/A Coding Principles Published We don't seem to have identified any unacceptable code combinations for M6583, so I propose adding the above codes in line with what we have listed for M6582 "Transperineal template-guided biopsies of the prostate under image guidance"...............
09/03/2017 B0410 Transsphenoidal hypophysectomy (including total) N/A Coding Principles Published Given that E1260 - Image guided endoscopic frontal, sphenoid and/or ethmoid sinus surgery (FESS) is listed as unacceptable with B0410, should we not also add E1432 - FESS: excision uncinate process and anterior ethmoid bulla....?
06/03/2017 K6310 N/A CT Coronary angiogram New Code Published
03/03/2017 V3362 Primary posterior fusion with instrumentation +/- decompression +/- discectomy (including graf stabilisation and all fusion approaches) (lumbar region) Primary posterior fusion with instrumentation +/- decompression +/- discectomy (including graft stabilisation and all fusion approaches) (lumbar region) Narrative Change Published Appears to be missing T on the end of "graf"? Our CMO asked for this to be amended.
03/03/2017 A5771 Facet joint injection (under x-ray control) - 5 or more joints N/A Coding Principles Published Request from Bupa: We accepted the requests from 3681 / 3682 / 3683 for the split of facet and medial injections. The unbundling needs to mirror the existing codes.
03/03/2017 A5761 Facet joint injection (under x-ray control) - 3 to 4 joints N/A Coding Principles Published Request from Bupa: We accepted the requests from 3681 / 3682 / 3683 for the split of facet and medial injections. The unbundling needs to mirror the existing codes.
03/03/2017 A5751 Facet joint injection (under x-ray control) - 1 to 2 joints N/A Coding Principles Published Request from Bupa: We accepted the requests from 3681 / 3682 / 3683 for the split of facet and medial injections. The unbundling needs to mirror the existing codes.
01/03/2017 17180 Professional attendance on (initiation of care of) patient requiring intensive care in an emergency up to 3 hours Professional attendance on (initiation of care of) patient requiring intensive care in an emergency 2-3 hours Narrative Change Published This relates to 2 codes - 17170 and 17180. If patient was seen for any time from 0-3 hours then a consultant can bill either code as technically both are correct. I think if we can change 17170 to 0-2 hours and then change 17180 2-3 hours - I think this would add clarity.
01/03/2017 17170 Professional attendance on (initiation of care of) patient requiring intensive care in an emergency up to 2 hours 17170 - Professional attendance on (initiation of care of) patient requiring intensive care in an emergency 0-2 hours Narrative Change Rejected Improves coding structure and adds clarityThis relates to 2 codes - 17170 and 17180. If patient was seen for any time from 0-3 hours then a consultant can bill either code as technically both are correct. I think if we can change 17170 to 0-2 hours and then change 17180 2-3 hours - I think this would add clarity.
20/02/2017 N2782 Intralesional injection of pharmacologic agent for Peyronie’s disease (including post injection manipulation) Intravavernosal injection of plaque into penis Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
13/02/2017 20110 ECG (including reporting) N/A Coding Principles Rejected We should expect to have an ECG first before we decide or not to have a Holter ECG, therefore these two codes should not unbundle.
10/02/2017 B2990 Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) with vascularised lymph node transfer (including delayed reconstruction) Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) with vascularised lymph node transfer (including delayed reconstruction) - unilateral Narrative Change Published Improves coding structure and adds clarityNeeds the word unilateral as per all the other breast codes that have a bilateral version.
10/02/2017 B2986 Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) (including delayed reconstruction) - unilateral Narrative Change Published Improves coding structure and adds clarityNeeds the word unilateral as per all the other breast codes that have a bilateral version.
10/02/2017 W9282 Joint fluid examination (e.g. polarising microscopy) performed by consultant (including aspiration of fluid) N/A Coding Principles Published This is part and parcel of the main procedure.
10/02/2017 S5240 Two or more injections into subcutaneous tissue/painful trigger point under local anaesthetic N/A Inactivate Approved This code is not needed if it is an injection into subcutaneous tissue then this would be a local anaesthetic and code AC100 should be used if this is a multiple trigger point injection then use code T7292.
10/02/2017 S5210 Injection into subcutaneous tissue/painful trigger point under local anaesthetic N/A Inactivate Approved This code is not needed as an injection into subcutaneous tissue would be a Local Anaesthetic in which case use code AC100 if it is a trigger point injection use code T7290.
09/02/2017 N/A N/A Laser treatment for glaucoma eg.Cyclodiode New Code Published Brand new procedure/testThis is widely available on the NHS but there is no specific code for Cyclodiode laser treatment for glaucoma. Probably best to have a generic code in case other types of laser become common practice.
08/02/2017 L8880 Endovenous mechanochemical ablation for varicose veins Endovenous mechanochemical ablation for varicose veins - unilateral Narrative Change Published To align current codes and consistencyWe now have a code for when this procedure is performed bilaterally. For consistency with other varicose vein codes should L8880 be updated to unilateral?
08/02/2017 A5750 Medial Branch Block or Facet joint injection (under x-ray control) Medial Branch Block or Facet joint injection (under x-ray control) – 1 – 2 joints Narrative Change Published To align current codes and consistencyBy adding 1-2 joints to the narrative it makes it clearer alongside the other codes A5760 Medial Branch Block or Facet joint injection (under x-ray control) - 3 to 4 joints and A5770 Medial Branch Block or Facet joint injection (under x-ray control) - 5 to 6 joints
07/02/2017 T7983 Open subacromial decompression and rotator cuff repair N/A Inactivate Published I've received an external query which states that T7983 (above) is similar to T7910 (Open sub acromial decompression and rotator cuff repair +/- excision of distal clavicle). The clinical advice we received on the shoulder codes suggested we remove 'greater/less than 2cm tear' from the narratives but it does also look like T7983 should've been inactivated to avoid a duplication in codes.
07/02/2017 M6192 Robotic assisted laparoscopic prostatectomy (including cystoscopy) Robotic assisted laparoscopic radical prostatectomy, reconstruction of bladder neck including bilateral pelvic lymphadenectomy (including cystoscopy) Narrative Change Published To align current codes and consistencyBrings this narrative in line with non-robotic code for the same procedure (M6182)
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