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
21/06/2017 W1380 Arthroscopic femoro-acetabular surgery for hip impingement syndrome N/A Coding Principles Submitted Add W1800 as an unacceptable combination with W1380. The trimming of the bone and cartilage is ‘part and parcel’ of the Femoro-acetabular procedure and should not be added on as an extra.
13/06/2017 A5730 Facet or sacroiliac joint (RF) radiofrequency thermocoagulation (including rhizolysis under X-ray control) - 4 to 6 joints Facet or sacroiliac joint (RF) radiofrequency thermocoagulation, cryoprobe or phenol (including rhizolysis under X-ray control) - 4 to 6 joints. Narrative Change Submitted To reflect updated clinical practicehttps://www.nice.org.uk/guidance/ng59/documents/draft-guideline-2 This is because cryoprobe or phenol denervation are in common use procedures in the NHS and at least as effective as RF denervation.
13/06/2017 A5720 Facet or sacroiliac joint (RF) radiofrequency thermocoagulation (including rhizolysis under X-ray control) - up to 3 joints Facet or sacroiliac joint (RF) radiofrequency thermocoagulation, cryoprobe or phenol (including rhizolysis under X-ray control) - up to 3 joints Narrative Change Submitted To reflect updated clinical practiceThe rationale is that cryoprobe or phenol denervation are in common use and at least as effective as RF denervation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684948/
13/06/2017 W4244 Tibial liner exchange in total knee replacement N/A Coding Principles Submitted We haven't yet decided on coding principles for this new code, so I've looked at what we've agreed for other knee replacement codes and tried to mirror them. Please feel free to add further codes or disagree with my suggestions!
13/06/2017 N/A N/A Peroral endoscopic myotomy (POEM) for achalasia. New Code Submitted Brand new procedure/test
12/06/2017 N/A N/A Transpupillary thermotherapy for ocular melanoma New Code Submitted Brand new procedure/test
12/06/2017 N/A N/A 3D saline infusion sonohysterography New Code Submitted Brand new procedure/test
12/06/2017 N/A N/A Platelet rich plasma injections for knee Osteoarthritis. New Code Submitted Improves coding structure and adds clarityImproves coding structure and adds clarity
07/06/2017 N/A N/A Patella resurfacing (as sole procedure) New Code Submitted Improves coding structure and adds clarity
06/06/2017 X6580 Proton Beam Therapy (PBT) complete course of treatment PROTON BEAM THERAPY (PBT) COMPLETE COURSE OF TREATMENT FOR OCULAR TUMOURS Narrative Change Submitted To reflect updated clinical practiceCurrently the only provision we have in the UK for this treatment is for Ocular Tumours amending the narrative aligns this to the discrete clinical activity taking place.
06/06/2017 W5503 N/A Insertion of biodegradable sub acromial spacer New Code Submitted Brand new procedure/testBrand new procedure/test
06/06/2017 V2562 Decompression for central spinal stenosis (3 or more levels) N/A Coding Principles Submitted V2660 Revision of decompression for central spinal stenosis is listed as unacceptable with V2560 Decompression for central spinal stenosis (1 or 2 levels) but not with V2562 Decompression for central spinal stenosis (3 or more levels). I suggest this should be added as well.
01/06/2017 K2613 Revision replacement of aortic valve Revision of aortic valve replacement Narrative Change Submitted Improves coding structure and adds clarityWe feel that the current narrative could be interpreted as "Revision or replacement" but by slightly altering the narrative it makes it clear that this is a revision of an aortic valve replacement.
30/05/2017 H4685 Insertion of biodegradable perirectal spacer under image guidance Insertion of biodegradable perirectal spacer under image guidance (as sole procedure) Narrative Change Submitted Improves coding structure and adds clarityOur board rep feels that this procedure would not be performed in conjunction with any other procedure.
23/05/2017 N/A N/A Percutaneous release of constriction of sheath of tendon (e.g. trigger finger) New Code Submitted Improves coding structure and adds clarityAlthough we do have a code for an open release of tendon: T7230 "Release of constriction of sheath of tendon (e.g. trigger finger)" the percutaneous approach is a completely different procedure which doesn't involve making an incision.
23/05/2017 V4280 Correction of degenerative scoliosis including decompression +/- fusion (including spinal cord monitoring) Correction of adult degenerative or idiopathic scoliosis including decompression +/- fusion (including spinal cord monitoring) Narrative Change Submitted To align current codes and consistencyWe have several codes for the correction of juvenile scoliosis and I believe this code was intended to be used for adult scoliosis. However the narrative doesn't mention "adult". There are also 2 types of adult scoliosis: Adult idiopathic and Adult degenerative scoliosis. As surgery isn’t done that often on adults I don’t think we need two separate codes just the addition of idiopathic to the narrative.
23/05/2017 N/A N/A Arthroscopic labral reconstruction of the hip (including graft) New Code Submitted Although we have a similar code: W7761 "Repair of hip labral tear" I think a new code might be more appropriate than a narrattive change as this procedure is performed on patients who have had previous hip surgery in which a large portion or the entire labrum was removed or if the labrum is torn beyond repair.
19/05/2017 W5821 N/A Robotic assisted unicompartmental knee replacement - Bilateral New Code Submitted Technical adjunct to W5201 and the bilateral version of W5820
19/05/2017 N/A N/A Insertion of Leadless (wireless) Pacemaker New Code Submitted Brand new procedure/testWe have become aware that a few NHS centers have now performed insertion of leadless pacemakers.
16/05/2017 V3345 Mobilisation of the lumbar/thoracic vessels to provide spinal surgical access (by vascular surgeon) N/A Coding Principles Published Code L5100 'Aorto-iliac, aorto-femoral, ilio-femoral bypass' is being added on when V3345 is being billed, when in fact only V3345 should be billed by the vascular surgeon as only one procedure is being performed. As well as adding this as unbundled should we add 'as sole procedure' to this code?
09/05/2017 N/A N/A Diphencyprone Topical Immunotherapy for warts and verucca. New Code Rejected Brand new procedure/testBrand new procedure/test
08/05/2017 AU027 N/A N/A Reinstatement Published Code still requiredRequest received from Ben Mann: You reviewed a request to add CERA as a new code but suggested that 22011 should be used. I have contacted the relevant insurer who believes that CERA is different to 22011. Evoked Potential is too broad. A CERA is an evoked potential that measures up to the cortex an ABR (which has its own code) is an EP that measures up to the brainstem. 22011 measures whether there has been a response – the evoked potential. CERA measures the degree of response which is the audiometry part. This takes longer as you use a range of frequencies and amplitudes to build up a picture. This is why we believe the 22011 is not appropriate for the CERA - it is only part of the picture.
08/05/2017 N/A N/A POINT SHEAR WAVE ELASTOGRAPHY (PSWE) New Code Published Brand new procedure/testNon-invasive assessment of liver disease is a fairly new clinical approach for the interpretation and diagnosis of liver pathology. It is based on the integration of ultrasound imaging and biomechanical measurements such as tissue stiffness of the liver and spleen. Further integration with blood tests results and scoring systems completes the available information which leads to the development of a rapid focused and often problem solving diagnostic approach.
08/05/2017 W3715c N/A Ceramic on ceramic hip resurfacing arthroplasty New Code Rejected Improves coding structure and adds clarity. This is a novel implant for hip resurfacing arthroplasty. This is a hip resurfacing arthroplasty with a ceramic on ceramic bearing surface. The implant is all ceramic and contains no metal. We are proposing W3715c (for ceramic) W3715 is listed as hip resurfacing arthroplasty metal-on-metal. W3718 is listed as minimally invasive hip resurfacing arthroplasty
06/05/2017 5012B N/A Globin panel New Code Published
06/05/2017 5011T N/A CISH or chromogenic in situ hybridization New Code Published Brand new procedure/test
06/05/2017 5010T N/A CMV-CISH New Code Published
06/05/2017 5009B N/A Mitotane level New Code Published Brand new procedure/test
06/05/2017 5008B N/A Residual leukaemic testing New Code Published
06/05/2017 5007T N/A DNA RET protein gene test New Code Published
06/05/2017 5006B N/A Mycoplasma genus PCR New Code Published
06/05/2017 5005B N/A PD-L1 marker New Code Published Brand new procedure/test
06/05/2017 V3345 Mobilisation of the lumbar/thoracic vessels to provide spinal surgical access (by vascular surgeon) Mobilisation of the lumbar/thoracic vessels to provide spinal surgical access (by vascular surgeon) as sole procedure Narrative Change Published
06/05/2017 A5770 Medial Branch Block (under x-ray control) - 5 to 6 levels N/A Inactivate Published Current code replaced by a new code
06/05/2017 A5760 Medial Branch Block (under x-ray control) - 3 to 4 levels N/A Inactivate Published Current code replaced by a new code
06/05/2017 A5750 Medial Branch Block (under x-ray control) - 1 to 2 levels N/A Inactivate Published Current code replaced by a new code
06/05/2017 A5772 N/A Medial Branch Block (under x-ray control) – 5 to 6 levels New Code Published
06/05/2017 A5762 N/A Medial Branch Block (under x-ray control) – 3 to 4 levels New Code Published
06/05/2017 A5752 N/A Medial Branch Block (under x-ray control) – 1 to 2 levels New Code Published
05/05/2017 T6800 Delayed or secondary repair of tendon (including graft, transfer and/or prosthesis) (not otherwise specified) Secondary repair of tendon (including graft, transfer and/or prosthesis) (not otherwise specified) Narrative Change Rejected Improves coding structure and adds clarity When we receive fees for this code we do not know if this is a delayed primary or a secondary procedure and so have to contact the specialist to ascertain this. Our CMO feels the delayed primary procedure is different to a secondary element and that the delayed aspect should be included within the relevant primary code.
04/05/2017 J0781 Chemosaturation therapy for primary or metastatic cancer of the liver N/A Coding Principles Published Our CMO feels this should so be included in the unacceptable combinations with J0781 as they integral to the procedure.
03/05/2017 T6822 Delayed or secondary repair of Achilles tendon with tendon or fascial graft Secondary repair of Achilles tendon with tendon or fascial graft Narrative Change Rejected Improves coding structure and adds clarity When we receive fees for this code we do not know if this is a delayed primary or a secondary procedure and so have to contact the specialist to ascertain this. Our CMO feels the delayed primary procedure is different to a secondary element and that the delayed aspect should be included within the relevant primary code.
03/05/2017 XR962 Percutaneous chemical ablation of tumour - Ultrasound guided N/A Inactivate Rejected Current code replaced by a new codeFollowing the introduction of J0781 Chemosaturation therapy for primary or metastatic cancer of the liver our CMO believes XR962 is now superseded by J0781.
03/05/2017 C7982 Pars plana vitrectomy with internal tamponade, scleral buckling and retinopexy (including dissection or excision of epiretinal membrane/macular surgery) Pars plana vitrectomy with internal tamponade, scleral buckling and retinopexy (with dissection or excision of epiretinal membrane/macular surgery) Narrative Change Under Review Improves coding structure and adds clarityOur CMO believes that the word including should be replaced by with to add greater clarity.
02/05/2017 N/A N/A We have had various requests from providers for these diagnostic codes. New Code Submitted Brand new procedure/test
20/04/2017 N/A N/A Irreversible electroporation of prostate cancer New Code Published Brand new procedure/testBrand 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 Published Brand new procedure/testBrand new procedure/test
19/04/2017 N/A N/A One-step nucleic acid amplification (ONSA) New Code Published 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 IHS Multi Gene panel (BRAF, EGFR,KRAS and NRAS) New Code Published Improves coding structure and adds clarityImproves coding structure and adds clarity
18/04/2017 E2500 Diagnostic nasolaryngopharyngoscopy (including biopsy) as sole procedure endoscopic nasolaryngopharyngoscopy (as sole procedure) Narrative Change Published 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.
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