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
20/09/2017 M1130 Therapeutic ureterorenoscopy (+/- cystoscopy and insertion/removal of stent) N/A Coding Principles Submitted Medical director feels that these procedures should unbundle
20/09/2017 M1120 Diagnostic ureterorenoscopy (+/- cystoscopy) N/A Coding Principles Submitted Medical director feels that these procedures should unbundle
20/09/2017 M1120 Diagnostic ureterorenoscopy (+/- cystoscopy) N/A Coding Principles Submitted Bupa medical director feels that these procedures should unbundle
19/09/2017 N/A N/A PSMA Pet scan New Code Submitted Brand new procedure/test
19/09/2017 M1120 Diagnostic ureterorenoscopy (+/- cystoscopy) N/A Coding Principles Submitted Bupa medical director feels that these procedures should unbundle
18/09/2017 N/A N/A Inclusive charges for upright MRI scan of one spinal area in flexion and extension (2 part) New Code Submitted Improves coding structure and adds clarityUpright MRI we would like to propose the following updated policy • The customer must have a diagnostic MR of the spinal area in question on an MR scanner that is at least 1.5T • This means that the units offering upright MRI cannot preauthorise a diagnostic scan with immediate proceed to dynamic (eg flexion and extension) • The customer must have on-going objective symptoms Indications Ongoing objective symptoms despite a normal mri‎ indicating a potential dynamic issue that may not be apparent on a supine film i.e. exacerbated by standing. Potential subtle instability that requires flexion/extension imaging‎ of a specific region
18/09/2017 M1120 Diagnostic ureterorenoscopy (+/- cystoscopy) N/A Coding Principles Submitted Our medical director feels that these codes should unbundle
18/09/2017 K4100 Bypass for coronary artery(ies) (including harvesting of grafts and endarterectomy) N/A Coding Principles Submitted
14/09/2017 K4100 Bypass for coronary artery(ies) (including harvesting of grafts and endarterectomy) N/A Coding Principles Submitted Our CMO feels these two codes should unbundle.
13/09/2017 N/A N/A Stress ECG with pharmaceutical agent (with reporting) New Code Submitted Brand new procedure/testNo code for a stress ECG using drugs to induce / influence heart rate and assess conductivity e.g. ajmaline challenge for
12/09/2017 N/A N/A Lutetium 177 therapy for neuroendocrine tumours. New Code Submitted Brand new procedure/test
11/09/2017 N/A N/A Seton placement for treatment of anal fistula New Code Submitted Improves coding structure and adds clarityImproves coding structure and adds clarity.... We currently do not have a code for Seton placement alone – the seton stitch is +/- in H5520 Laying open of high anal fistula (fistulotomy) +/- insertion of stitch (including sigmoidoscopy) and H5510 Laying open of low anal fistula (fistulotomy) +/- insertion of stitch (including sigmoidoscopy)
11/09/2017 N/A N/A Injection of therapeutic substance into keloid scar New Code Submitted Improves coding structure and adds clarityImproves coding structure and adds clarity
11/09/2017 IM064 PET/CT Scan Cardiac stress N/A Inactivate Submitted Current code replaced by a new codeSee Request 3953
11/09/2017 IM063 PET/CT Scan Cardiac rest PET/CT scan with Rubidium (including stress & rest) test Narrative Change Submitted Improves coding structure and adds clarityWe currently have two codes available for PET/CT Scan Cardiac – one for stress test (IM064) and one for rest test (IM063). We will be using one of these codes for PET/CT Scan Cardiac using Rubidium and the CMOs have advised this test should include both the rest and stress stages – therefore we do not need a separate code for each. We propose to retain the IM063 code and retire the IM064 code REF: http://jnm.snmjournals.org/content/48/5/783.full https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3650901/
06/09/2017 P2120 Total removal of vaginal mesh/tape with reconstruction of vagina and/or urethra, including cystoscopy and/or proctoscopy N/A Coding Principles Submitted These codes are part and parcel, as the P2120 will include the M7360.
05/09/2017 N/A N/A Implantation of artificial iris for congenital or traumatic aniridia New Code Submitted Brand new procedure/testAbsence or loss of the iris tissue of the eye can occur as a result of a congenital defect or as result of trauma or previous surgery. Individuals who lack an iris or who have an iris that cannot constrict properly often suffer from severe light sensitivity or photophobia. They may have significant glare at night time and often have impaired vision.A new procedure is now being performed to implant an artificial iris to remedy this condition.
21/08/2017 xxxT N/A Mismatch Repair Protein MMR New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A Abelson Murine Leukemia Oncogene Testing New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A HYDROCORTISONE TEST New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A G6PD GENE DEFICIENCY GENE TEST New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A CYP21A2 GENE SEQUENCING New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxM N/A C-MYC FISH New Code Published Brand new procedure/testrequest from Bupa
21/08/2017 xxxT N/A Beta D Glucan New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxM N/A T CELL CLONALITY New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A Serum Free Light Chains New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A MPL Mutation New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A ANTI-AMPA 1/2 Antibodies New Code Published Brand new procedure/testTesting for ANTI-AMPA 1/2 Antibodies in diseases such as Autoimmune Encephalitis
21/08/2017 xxxB N/A Measles, Mumps and Rubella Antibodies New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A SKAB: SKIN ANTIBODIES New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxS N/A Staphylococcus PVL testing New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxF N/A Faecal multiplex PCR New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxF N/A C. difficile PCR New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxF N/A C. difficile Ribotyping New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A Neurone Specific Enolase (NSE) New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A SMA autoantibodies New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A AMA autoantibodies New Code Published AMA - test is requested to help diagnose primary biliary cirrhosis
21/08/2017 xxxB N/A PROP profile New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A Otoblot-inner Ear Antigen New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 xxxB N/A Calcium corrected New Code Published Brand new procedure/testRequest from Bupa
21/08/2017 N/A N/A RH5 New Code Published Brand new procedure/testRequest from Bupa
18/08/2017 xxxB N/A Zinc Transport 8 New Code Published Brand new procedure/testSubmitted on behalf of Bupa
16/08/2017 N/A N/A Transforaminal epidural (cervical) New Code Published Improves coding structure and adds claritysee previous...
16/08/2017 N/A N/A Transforaminal epidural (thoracic) New Code Published
16/08/2017 N/A N/A Transforminal epidural (caudal) New Code Published See previous..
16/08/2017 N/A N/A Transforminal epidural - lumbar New Code Published Improves coding structure and adds claritysee 3914
16/08/2017 A5290 Transforaminal epidural N/A Inactivate Published Improves coding structure and adds clarityWe feel that A5290 “Transforminal epidural” should be separated out into 4 codes in the same way that the A5200/10/11/20 codes for epidural injections are split into areas of the spine: lumbar caudal thoracic and cervical. This clarifies which area of the spine is being treated.
14/08/2017 S5240 N/A N/A Reinstatement Rejected Code still requiredSince the inactivation of this code (plus S5210) confusion has been caused at many of our hospitals. This has been looked into and guidance given to those using it incorrectly i.e. for trigger point injections etc. However we have hospitals wanting to assign this code for legitimate procedures such as steroid injections into scars and steroid injections for alopecia.
14/08/2017 S5210 N/A N/A Reinstatement Rejected Code still requiredSince the inactivation of this code (plus S5240) confusion has been caused at many of our hospitals. This has been looked into and guidance given to those using it incorrectly i.e. for trigger point injections etc. However we have hospitals wanting to assign this code for legitimate procedures such as steroid injections into scars and steroid injections for alopecia.
14/08/2017 N/A N/A Mole Mapping New Code Published Brand new procedure/testBrand new procedure/test
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