Recent Requests

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.

Page
Viewing All
Request
Number
Date Code Current
Narrative
Proposed
Narrative
Type Current
Status
Reasons for
change
28/11/2014 G2332 N/A Laporoscopic Insertion of magnetic band for gastro-oesophageal reflux disease (LINX) New Code Submitted Brand new procedure/test
23/11/2014 N/A N/A Sedation or General Anaesthesia for MRI or CT scan New Code Submitted Brand new procedure/testSome patients cannot lie still in an MRI or CT scanner unless they are sedated or anaesthetised for example smaller children demented adults or those with severe claustrophobia (mostly a problem for MRI patients because the tunnel is long and narrow).
21/11/2014 W9030 One or two injections, +/- aspiration, into joint(s), cyst, bursa or soft tissue, with image guidance W9030 - One or two injections, +/- aspiration, into joint, cyst, bursa or soft tissue, with image guidance Narrative Change Submitted Improves coding structure and adds clarityThe 's' should be removed and a bilateral code should be created. At present insurers will only pay radiologists once regardless of whether they have spent double the time on a bilateral procedure doing double the work.
20/11/2014 L8690 N/A Sclerotherapy for thread veins New Code Submitted Brand new procedure/testAlthough the treatment is generally considered cosmetic we would like to raise this as a new code request for discussion primarily to allow for greater clarity and have a more specific code with which to manage these claims.
20/11/2014 C0880 N/A Retrobulbar irradiation for thyroid eye disease New Code Submitted Brand new procedure/testThyroid eye disease (also known as dysthyroid eye disease Graves' eye disease Graves' ophthalmopathy or thyroid orbitopathy) is a disease that predominantly affects the extraocular muscles. It affects an estimated 400 000 people in the UK assuming a 37.5 % prevalence of thyroid eye disease in Graves' disease (1). It is the most common cause of unilateral or bilateral proptosis (prominent or staring eyes) in adults due to enlarged eye muscles and an increase in the fatty tissue behind the eyes.
20/11/2014 S0982 N/A Psoralen photochemotherapy (PUVA/PUVB) per session – localised New Code Submitted Brand new procedure/testWe have suggested using the term ‘per session’ rather than per course as the number of sessions in a course will be tailored to the individual patient’s needs.
20/11/2014 S0980 N/A Psoralen photochemotherapy (PUVA/PUVB) per session – whole body New Code Submitted Brand new procedure/testWe have suggested using the term ‘per session’ rather than per course as the number of sessions in a course will be tailored to the individual patient’s needs.
20/11/2014 A7350 Local anaesthetic blockade of named major nerve or plexus N/A Coding Principles Submitted The suggestion is to add A7350 with L8512. This follows on from a discussion that we had at the October Working Group and a request from Bupa to remove A7350 from the EVLT which the Working Group declined. I understand the Working Group agreed to add L8512 with A7350 to align with all the other EVLT codes. Please can the Working Group confirm this.
19/11/2014 unsure N/A Combines discectomy, insertion of cage, decompression and fusion (at single or multiple levels) through single posterior approach New Code Submitted Improves coding structure and adds clarity. Currently we find specialists use code V3350 which describes an anterior and posterior fusion which is inappropriate. Our CMO and orthopaedic advisor feel this new code will allow the procedure to be billed correctly.
19/11/2014 N/A N/A Endoscopic balloon dilatation tof the eustachian tube New Code Submitted Brand new procedure/testThe majority of middle ear disease is due to dysfunction of the eustachian tube. Current medical treatments are not effective. Balloon dilatation of the eustachian tube improves the function of the eustachian tube and is well established in mainland Europe and North America but has not been used widely adopted in the UK to date. Balloon Eustachian tuboplasty is a minimally invasive procedure that has shown promising results as a treatment for different forms of ETD in published case series. NICE published guidance on this procedure for the NHS in 2011. It was not approved for general use due to lack of convincing evidence there has been a lot of publications demonstrating efficacy since. Coding was published for this as part of the NICE guidance: OPCS4.6 Code(s) D22.2 Intubation of eustachian canal Y76.6 Endonasal endoscopic approach to other body cavity Y40.3 Balloon dilation of organ NOC
19/11/2014 AUDxxx N/A Rotational Chair Testing- Kinetics New Code Submitted Brand new procedure/test
17/11/2014 S5770 N/A Dressing of skin using vacuum assisted closure device,(vac pump) New Code Submitted Brand new procedure/test
14/11/2014 XR160 Percutaneous image guided fine needle aspiration (FNA) Percutaneous ultrasound guided cyst aspiration Narrative Change Submitted A breast clinic performing this procedure has stated that in their experience ‘fine needle aspirations’ are sent for cytology which is not needed for cysts. They have suggested an alternative narrative of “Percutaneous ultrasound guided cyst aspiration”.
14/11/2014 L8515 Endovenous laser treatment (EVLT) of more than one venous trunk +/- phlebectomies - bilateral N/A Coding Principles Submitted Varicose vein treatment should seek to tackle a specific pathology causing the varicose veins, multi same-day treatments are uncommon and in some cases unnecessary, particularly when considering treatments intended to cure the cause of the varicose veins. There is limited evidence supporting multiple simultaneous treatments to treating varicose veins. Therefore, these procedures should not be coded together.
14/11/2014 L8514 Endovenous laser treatment (EVLT) of more than one venous trunk +/- phlebectomies - unilateral N/A Coding Principles Submitted Varicose vein treatment should seek to tackle a specific pathology causing the varicose veins, multi same-day treatments are uncommon and in some cases unnecessary, particularly when considering treatments intended to cure the cause of the varicose veins. There is limited evidence supporting multiple simultaneous treatments to treating varicose veins. Therefore, these procedures should not be coded together.
31/10/2014 M6192 Robot assisted laparoscopic prostatectomy (including cystoscopy) N/A Coding Principles Submitted T4130 Freeing of adhesions of peritoneum T4300 Laparoscopic adhesiolysis (including biopsy) T4302 Open adhesiolysis (including biopsy) The above codes are all listed as unacceptable with M6180 Radical prostatectomy, reconstruction of bladder neck (including bilateral pelvic lymphadenectomy) (including cystoscopy) and M6182 Laparoscopic radical prostatectomy, reconstruction of bladder neck including bilateral pelvic lymphadenectomy (including cystoscopy) but not with M6192 Robot assisted laparoscopic prostatectomy (including cystoscopy). I suggest that we add them.
30/10/2014 7269U N/A Pre-Prostatic Massage New Code Published Brand new procedure/testBrand new procedure/test
30/10/2014 7268U N/A Post-Prostatic Massage New Code Published Brand new procedure/testBrand new procedure/test
30/10/2014 7267O N/A Seminal fluid post vasectomy New Code Published Brand new procedure/testBrand new procedure/test
30/10/2014 7179O N/A Sperm morphology New Code Published Brand new procedure/testBrand new procedure/test
30/10/2014 J5000 Percutaneous examination of bile duct N/A Coding Principles Published Remove unacceptable combination J5000 with J0900
30/10/2014 W8193 Arthroscopic subacromial decompression (as sole procedure) N/A Coding Principles Published This should have been added in March 2013
30/10/2014 W0861 Metatarso-phalangeal cheilectomy - bilateral, as sole procedure N/A Coding Principles Published This should have been added in March 2013
30/10/2014 V3362 Primary posterior fusion with instrumentation +/- decompression +/- discectomy (including graf stabilisation and all fusion approaches) (lumbar region) N/A Coding Principles Published This should have been added in March 2013
30/10/2014 J1800 Cholecystectomy (including mini-cholecystectomy) N/A Coding Principles Published This should have been added in March 2013
30/10/2014 D0702 Aural toilet (including microsuction and/or suction of exteriorised mastoid cavity) N/A Coding Principles Published This should have been added in March 2013
30/10/2014 P2120 Total removal of vaginal mesh with reconstruction of vagina and/or urethra, including cystoscopy and/or proctoscopy Total removal of vaginal mesh/tape with reconstruction of vagina and/or urethra, including cystoscopy and/or proctoscopy Narrative Change Published Narrative change to include the 'tape' because this is specifically mentioned in the communication from the DH and MRHA
30/10/2014 P2110 Partial removal of vaginal mesh with reconstruction of vagina and/or urethra, including cystoscopy and/or proctoscopy Partial removal of vaginal mesh/tape with reconstruction of vagina and/or urethra, including cystoscopy and/or proctoscopy Narrative Change Published Narrative change to include the 'tape' because this is specifically mentioned in the communication from the DH and MRHA
30/10/2014 IM994 N/A CMR for myocardial viability assessment and cardiomyopathy assessment (fibrosis assessment) and/ or myopericarditis and/ or valve disease. New Code Submitted Improves coding structure and adds clarity. We need to be able to book single package procedures as one scan on Radiology booking system for the purposes of resource allocation and clinical workflow.
29/10/2014 IM995 N/A CMR for the assessment of ischaemia. New Code Submitted Improves coding structure and adds clarity. Need to be able to book single package procedure as one scan on Radiology booking system for the purposes of resource allocation and clinical workflow
28/10/2014 IM996 N/A CMR for the assessment of the aortic valve and the thoracic aorta. New Code Submitted Improves coding structure and adds clarity. Need to be able to book single package procedure as one scan on Radiology booking system for the purposes of resource allocation and clinical workflow.
28/10/2014 IM997 N/A CMR for screening for secondary causes of HT and / or assessment of LVH. New Code Submitted Improves coding structure and adds clarityNeed to be able to book single package procedure as one scan on Radiology booking system for the purposes on resource allocation and clincal workflow.
26/10/2014 N/A N/A Mosaic Retinal Photography New Code Submitted Brand new procedure/test
24/10/2014 V2660 Revision of decompression for central spinal stenosis Revision of decompression for central spinal stenosis including X Stop Narrative Change Submitted To reflect updated clinical practicenumerous invoices received billed with X Stop alongside
24/10/2014 V2562 N/A Decompression for central spinal stenosis (3 or more levels) including X Stop Narrative Change Submitted To reflect updated clinical practicereceived numerous accounts with X stop billed alongside this procedure
24/10/2014 V2560 Decompression for central spinal stenosis (1 or 2 levels) Decompression for central spinal stenosis (1 or 2 levels) including X Stop Narrative Change Submitted To reflect updated clinical practicea number of cases where the X Stop is being used alongside this procedure
21/10/2014 W7420 Autograft anterior cruciate ligament reconstruction (including arthroscopic and meniscectomy) Autograft anterior cruciate ligament reconstruction (including arthroscopic and meniscal surgery) Narrative Change Rejected To reflect updated clinical practiceTo enable the code to cover meniscal repair as well as meniscectomy.
21/10/2014 20160 Phototesting (specialist dermatology units only) Phototesting Narrative Change Published This code is also in the Diagnostic Schedule however the narratives are different. In the diagnostic schedule the narrative is 20160 Phototesting so suggest we remove '(specialist dermatology units only)' from the narrative in the Procedure Schedule as I understand this doesn't add anything to the coding. Thanks to Bupa for spotting.
21/10/2014 B3140 Therapeutic mammoplasty for breast cancer Autograft anterior cruciate ligament reconstruction (including arthroscopic and meniscal surgery) Coding Principles Published B2820 is part & parcel of a therapeutic mammoplasty
20/10/2014 L9180 Insertion of Portacath/Port-a-cath/Vasoport Unit Insertion of Portacath/Port-a-cath/Vasoport unit under image guidance Narrative Change Published Improves coding structure and adds clarityInsertion of ports are routinely done under ultrasound guidance. The addition of 'under image guidance' has been requested to allow for more clarity in terms of what is included in the procedure.
20/10/2014 B3022 N/A Adjustment or revision of flap harvest site following mastectomy and breast reconstruction, including liposuction and excision of scar (as sole procedure) New Code Published Improves coding structure and adds clarityImproves coding structure and adds clarity
16/10/2014 B---- Reconstruction of breast using Deep Inferior Epigastric Perforator flap (DIEP) +/- vascularised lymph node transfer (including delayed reconstruction) Vascularised lymph node transfer (not in combination with breast reconstruction) New Code Rejected See request 2600 and 2688
16/10/2014 B2990 N/A Reconstruction of breast using Deep Inferior Epigastric Perforator flap (DIEP) with vascularised lymph node transfer (including delayed reconstruction) New Code Published A separate code is required for DIEP when performed with vasularised lymph node transfer. Also see request 2689 and 2600
16/10/2014 B2986 Reconstruction of breast using Deep Inferior Epigastric Perforator flap (DIEP) +/- vascularised lymph node transfer (including delayed reconstruction) Reconstruction of breast using Deep Inferior Epigastric Perforator Flap (DIEP) (including delayed reconstruction) Narrative Change Published As of September the original DIEP code has been changed to add +/- vascularised lymph node transfer. This is a specialist technique requiring considerable extra planning on top of the DIEP itself. Additional anastomosis of vessels identification of correct lymphatics and potential patient morbidity increase the complexity of the procedure considerably. Additional theatre time is in the order of an hour and this is not now reflected in the renumeration. The vascularised lymph nodes can also be used in their own right as an isolated free flap with no DIEP breast reconstruction. No code has been asigned for this.
14/10/2014 A8480 N/A Dynamic intra-compartmental pressure studies utilising a non infusion technique New Code Rejected This system used involves an invasive technique as opposed to the non evasive technique used for code A8470 where the clinician uses a handheld manometer. A brief outline of the technique is described in the box below.
08/10/2014 7331B N/A Next generations sequencing (NGS) molecular profiling - Caris New Code Published Although the narrative includes a brand name it is important to identify for these tests the methodology being used similar to how we have ""cyberknife"" and ""GammaKnife"". For patients with cancer that are not responding to conventional treatments or where there are not conventional treatments - this test can help to identify which chemotherapy agents may and may not be beneficial.
08/10/2014 7330B N/A Next generations sequencing (NGS) molecular profiling - Farotech New Code Published Brand new procedure/testAlthough the narrative includes a brand name it is important to identify for these tests the methodology being used similar to how we have ""cyberknife"" and ""GammaKnife"". As the treatment of cancer is no longer a one size for all but appropriate treatments to tailor to the individuals diagnosis and prognosis of cancer. With advances of molecular testing and next-generation-sequencing the ability to evaluate a vast number of genes provides patients the access to the most appropriate treatment. The use of a separate code to identify this treatment will avoid numerous codes for each gene being created as well as reflecting the actual technique used. For patients with cancer that are not responding to conventional treatments or where there are not conventional treatments - this test can help to identify which chemotherapy agents may and may not be beneficial.
08/10/2014 L8515 Endovenous laser treatment (EVLT) of more than one venous trunk +/- phlebectomies - bilateral N/A Coding Principles Rejected Surgeons can do this procedure without the need for an anaesthetist, and thus should be able to use A7350 ("Local anaesthetic blockade of named major nerve or plexus"). L8512 ("Endovenous laser treatment (EVLT) of single venous trunk +/- phlebectomies - unilateral") is not an unacceptable combination with A7350, therefore, L8513/L8514/L8515 should not either.
08/10/2014 L8514 Endovenous laser treatment (EVLT) of more than one venous trunk +/- phlebectomies - unilateral N/A Coding Principles Rejected Surgeons can do this procedure without the need for an anaesthetist, and thus should be able to use A7350 ("Local anaesthetic blockade of named major nerve or plexus"). L8512 ("Endovenous laser treatment (EVLT) of single venous trunk +/- phlebectomies - unilateral") is not an unacceptable combination with A7350, therefore, L8513/L8514/L8515 should not either.
08/10/2014 L8513 Endovenous laser treatment (EVLT) of single venous trunk +/- phlebectomies - bilateral N/A Coding Principles Rejected Surgeons can do this procedure without the need for an anaesthetist, and thus should be able to use A7350 ("Local anaesthetic blockade of named major nerve or plexus"). L8512 ("Endovenous laser treatment (EVLT) of single venous trunk +/- phlebectomies - unilateral") is not an unacceptable combination with A7350, therefore, L8513/L8514/L8515 should not either.
Page
Viewing All