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
19/01/2017 Q1281 N/A Removal of a Mirena coil New Code Submitted Improves coding structure and adds clarityWe receive invoices from specialists who use the Insertion of device code (Q1280) for the removal. Our CMO feels that this is usually a less complex procedure. We would therefore hope to have a separate code to allow distinction between the two.
10/01/2017 B2918 Mastectomy and immediate reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) Mastectomy and immediate reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) - unilateral Narrative Change Submitted To align current codes and consistencySee request 3624
10/01/2017 B2919 N/A Mastectomy and immediate reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) - bilateral New Code Submitted Improves coding structure and adds clarityWe have had a request from a surgeon for the bilateral version of procedure B2918 therefore for clarity it would make sense to have a bilateral code for the instances where the procedure is performed bilaterally.
09/01/2017 C7924 N/A N/A Reinstatement Submitted Code still requiredRequest from AXA-PPP: We inactivated codes C7923 and C7924 and replaced it with a generic code (C7940) in August 2013. We would like these codes reinstated as it is causing issues with billing using a generic code due to the variation in drugs that can be used and it is hard to audit exactly what procedure is taking place when this code is pre-authorised.
09/01/2017 C7923 N/A N/A Reinstatement Submitted Code still requiredRequest from AXA-PPP: We inactivated codes C7923 and C7924 and replaced it with a generic code (C7940) in August 2013. We would like these codes reinstated as it is causing issues with billing using a generic code due to the variation in drugs that can be used and it is hard to audit exactly what procedure is taking place when this code is pre-authorised.
09/01/2017 E5480 Lung resection with resection of chest wall N/A Coding Principles Submitted We have received fees for these codes in combination and our CMO feels that the exploratory thoracotomy is an integral part of the procedure and so should be an unacceptable combination.
30/12/2016 T6822 Delayed or secondary repair of Achilles tendon with tendon or fascial graft N/A Coding Principles Submitted We believe that T6722 "Tendo Achilles lengthening primary open" should be unacceptable with T6822 "Delayed or secondary repair of Achilles tendon with tendon or fascial graft", as T6822 encompasses the lengthening if it’s required to achieve the repair.
30/12/2016 Q1800 Hysteroscopy (including biopsy, dilatation, curettage and resection of polyp(s) +/- Mirena coil insertion) N/A Coding Principles Submitted We believe that Q1800 "Therapeutic hysteroscopy" and Q0230 "Cauterisation of lesion of cervix uteri" should not be an unacceptable combination. Q1800 is a therapeutic hysteroscopy and Q0230 is a colposcopy with cauterisation - different equipment is required for both.
30/12/2016 S0520 Microscopically controlled excision of lesion of skin or subcutaneous tissue (Mohs micrographic surgery) with immediate reconstruction N/A Coding Principles Submitted We recently spoke with a specialist who said he also carries out full thickness grafts when performing “Mohs micrographic surgery with immediate reconstruction”. Shouldn't full thickness grafts also be classed as part of the reconstruction?
30/12/2016 M4780 Invasive urodynamic assessment including pressure/flow measurements Invasive urodynamic assessment including cystoscopy and pressure/flow measurements Narrative Change Submitted To align current codes and consistencyShouldn't the narrative say "including cystoscopy” as with the other bladder procedure codes?
30/12/2016 W0310 Multiple procedures on forefoot, distal to and including the tarsometatarsal joints, which involves at least two distinct procedures not intrinsic to each other - bilateral N/A Coding Principles Submitted A7352 “Image-guided local anaesthetic blockade of named major nerve or plexus” is a common peripheral nerve block. It is useful for procedures of the foot and toes, as long as a tourniquet is not required. This code is not listed as an unacceptable combination, whereas A7350 “Local anaesthetic blockade of named major nerve or plexus” is, so should this be added as well?
30/12/2016 W0300 Multiple procedures on forefoot, distal to and including the tarsometatarsal joints, which involves at least two distinct procedures not intrinsic to each other N/A Coding Principles Submitted A7352 “Image-guided local anaesthetic blockade of named major nerve or plexus” is a common peripheral nerve block. It is useful for procedures of the foot and toes, as long as a tourniquet is not required. This code is not listed as an unacceptable combination, whereas A7350 “Local anaesthetic blockade of named major nerve or plexus” is, so should this be added as well?
21/12/2016 N/A N/A Placement of Oral Implants New Code Submitted Improves coding structure and adds clarity
16/12/2016 D1710 Stapedectomy Stapedectomy and any restorative procedures. Narrative Change Submitted Improves coding structure and adds clarity When we are billed for this procedure some providers are billing separately for restorative procedures to re-establish continuity of the ossicles. Our CMO and his ENT colleagues feel that any such procedures are of necessity part and parcel of a stapedectomy and so adding "and any restorative procedure" to the narrative will make this clear for all.
16/12/2016 D1720 Revision stapedectomy Revision stapedectomy and any restorative procedure Narrative Change Submitted Improves coding structure and adds clarity When we are billed for this procedure some providers are billing separately for restorative procedures to re-establish continuity of the ossicles. Our CMO and his ENT colleagues feel that any such procedures are of necessity part and parcel of a stapedectomy and so adding "and any restorative procedure" to the narrative will make this clear for all.
15/12/2016 E2501 N/A Fibre optic examination of the pharynx +/- biopsy/removal of foreign body. New Code Submitted Improves coding structure and adds clarityThis procedure has been requested by a specialist who performs it on the NHS. It is regularly done in the USA.
13/12/2016 E1480 Endoscopic exploration frontal sinus beyond frontoethmoid recess N/A Coding Principles Submitted Our medical adviser has said that an exploration of the frontal sinus is part of the FESS procedure
07/12/2016 AU029 N/A Cortical Evoked Response Audiometry New Code Submitted Improves coding structure and adds clarity
06/12/2016 V2562 Decompression for central spinal stenosis (3 or more levels) N/A Coding Principles Submitted The code V2543 is already unbundled with the procedure V2560 which is essentially the same as the V2562 just a different number of levels. Therefore we would suggest V2543 should be unbundled with V2562.
06/12/2016 N/A N/A Bilateral Peripheral Angiogram New Code Submitted Brand new procedure/testBrand new procedure/test
01/12/2016 N/A N/A Removal of gastric band New Code Submitted Improves coding structure and adds clarityWe currently have a code G3080 "Laparoscopic gastric banding" but no code for removal.
29/11/2016 N/A N/A Fusion of first metatarso-phalangeal joint with bone grafting +/- internal fixation (as sole procedure) New Code Submitted Improves coding structure and adds clarityThis procedure is carried out within the NHS for treatment of arthritis or other deformities usually bunion. Our medical adviser feels this should be a sole procedure code as the procedure can involve a wide variety of smaller procedures intrinsic to the fusion.
29/11/2016 L8881 N/A Endovenous mechanochemical ablation for varicose veins - bilateral New Code Submitted Improves coding structure and adds clarityWe currently have a code for L8880 Endovenous mechanochemical ablation for varicose veins. By adding a bilateral code this will be consistent with other codes associated with varicose veins.
17/11/2016 K5040 Rotablation of coronary vessel(s) percutaneous transluminal rotational atherectomy (PCRS) Rotablation of coronary vessel(s) percutaneous transluminal rotational atherectomy (PCRS) +/- insertion of stent Narrative Change Published Adding a stent is an integral part of this procedure. The rotablation technique removes severe atherosclerosis in the coronary vessel in order for a stent to be inserted.
15/11/2016 XR120 CT/MRI guided biopsy(ies) CT/MRI guided biopsy(ies) of soft tissues. Narrative Change Rejected Improves coding structure and adds clarityOur CMO feels this would add clarity to the procedure and what the biopsy is performed on.
15/11/2016 V2500 Primary posterior fusion +/- decompression +/- discectomy - lumbar region (1 or 2 levels) N/A Coding Principles Published Our CMO feels this should also unbundle with V2500 as A5210 and A5211 do.
11/11/2016 N/A N/A Ultrasound guided radiofrequency ablation of benign thyroid nodule New Code Published Brand new procedure/testBrand new procedure/test
10/11/2016 W5830 N/A Robotic assisted total knee replacement New Code Published Improves coding structure and adds clarity. Last month W3720 (robotic assisted total hip replacement) and W5820 (robotic assisted unicompartmental knee replacement were approved by the group. For the sake of completeness can we add a code for total knee replacement also. UK volumes at present are nil but we anticipate performing the 1st of these either late this year or early next year.
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