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
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 Submitted 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 Submitted Brand new procedure/test
08/05/2017 N/A N/A POINT SHEAR WAVE ELASTOGRAPHY (PSWE) New Code Submitted 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 Submitted 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
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 Submitted 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 Submitted 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 Submitted 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 Submitted 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 Submitted Improves coding structure and adds clarityOur CMO believes that the word including should be replaced by with to add greater clarity.
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
18/04/2017 N/A N/A endoscopic nasolaryngopharyngoscopy (as sole procedure) New Code Under Review 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 Published 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 Published 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.
08/04/2017 Q2230 Oophorectomy and salpingectomy, +/- biopsy eg. omentum, peritoneum, lymph node (as sole procedure) (including bilateral) Oophorectomy and salpingectomy, +/- biopsy eg. omentum, peritoneum, lymph node (as sole procedure) - bilateral Narrative Change Published To align current codes and consistency
07/04/2017 N/A N/A Intralesional injections for immunotherapy with image guidance (nodal lesions) New Code Published 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 Published 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 Published 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 Published 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 Published 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 Rejected 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.
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
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