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
28/06/2016 C6111 Laser trabeculoplasty (including topical or local anaesthetic) - unilateral N/A Coding Principles Submitted This code should mirror the unbundling of C6110 as it is the bilateral version of it. When this code was agreed a few months ago it was agreed to mirror the unbundling but it does not seem to have gone through
24/06/2016 U1290 Video urodynamic studies Invasive urodynamic assessment including pressure/flow measurement using fluoroscopy Narrative Change Submitted Currently there is one CCSD code for invasive urodynamics that being M4780. Recently CCSD updated the narrative for M4780 to ‘Invasive urodynamic assessment including pressure/flow measurement’ from its previous description however not all invasive urodynamic studies include video/fluoroscopy. The video urodynamics test is an invasive procedure that involves fluoroscopy and we would like this code to be completely separated from M4780 which covers just standard invasive urodynamics tests. The reason for this is because the insurers have no way of differentiating currently between invasive fluoroscopic and invasive non fluoroscopic tests as the test name does not clearly identify the difference between the two.
21/06/2016 B0410 Transsphenoidal hypophysectomy (including total) N/A Coding Principles Submitted The suggestion is to add B0410 with A3900 The procedure B0410 is the removal of a pituitary tumour through the sphenoid sinus, during the procedure the Dura is opened to expose the tumour and pituitary gland. Therefore repair of Dura is part of the procedure as this would never be left open as it would cause a leak in CSF.
16/06/2016 64300 Echocardiography (including reporting) as sole procedure N/A Coding Principles Submitted 64300 is on both schedules, it currently unbundle with 20132 in the procedure schedule. We feel that CD015 is integral to 64300 and should unbundle
16/06/2016 xxxxx N/A Breast caner prognostic gene signature assay New Code Submitted Improves coding structure and adds clarityThe Prosigna Breast Cancer Prognostic Gene Signature Assay (formerly called the PAM50 test) made by NanoString is a genomic test that analyzes the activity of certain genes in early-stage hormone-receptor-positive breast cancer. Research suggests the test may eventually be widely used to help make treatment decisions based on the risk of distant recurrence (cancer coming back in a part of the body away from the breast) for postmenopausal women within 10 years of diagnosis of early-stage hormone-receptor positive disease with up to three positive lymph nodes after 5 years of hormonal therapy treatment. The Prosigna assay looks at the activity of 58 genes (called the PAM50 gene signature) to estimate the risk of distant recurrence of hormone-receptor-positive breast cancer from 5 to 10 years after diagnosis after 5 years of hormonal therapy treatment in postmenopausal women. Based on these activity levels Prosigna assay results are reported as a risk of recurrence (ROR) score from 0 to 100 in two ways: • node-negative cancers are classified as low (0-40) intermediate (41-60) or high (61-100) risk • node-positive cancers are classified as low (0-40) or high (41-100) risk
15/06/2016 Q0710 Radical hysterectomy and lymphadenectomy (Wertheim's) +/- ureterolysis Radical hysterectomy and lymphadenectomy (Wertheim's) to include removal of the uterus, connective tissue, Fallopian tubes, ovaries and upper part of the vagina +/- ureterolysis Narrative Change Submitted Improves coding structure and adds clarityImproves coding structure and adds clarity
15/06/2016 W0321 Osteotomy/ies (eg Scarf and Akin) for Hallux Valgus correction with or without internal fixation and soft tissue correction N/A Coding Principles Submitted I would like the W1040 code to be used with W0321. New rules class this combination as unbundling. A 2nd hammer toe often co exists with a bunion and both require correction, which are distinct procedures. When a 2nd hammer toe is corrected, an osteotomy of the proximal phalanx is performed (W1040). This is a separate procedure and unrelated to the bunion correction (W0321), so I cannot see why this is unbundling. Please could this be explained? I would be grateful if W1040 can billed with W0321. Please advise. Thanks you.
15/06/2016 TBA N/A Manipulation under local anaesthetic New Code Submitted Improves coding structure and adds clarityThis request has been submitted on behalf of Steve Kriss Consultant Podiatric Surgeon.
14/06/2016 A7012 N/A Gastroelectrical mechanical stimulation New Code Submitted Brand new procedure/testBrand new procedure/test
07/06/2016 L8880 Clarivein treatment to long or short saphenous vein Endovenous mechanochemical ablation for varicose veins Narrative Change Submitted To align current codes and consistencyThis code uses manufacturers name 'CLARIVEIN' and we feel it would be better to use the NICE narrative 'Endovenous mechanochemical ablation for varicose veins'.
07/06/2016 E3680 Endoscopic laryngo-pharyngoscopy as sole outpatient procedure +/- stroboscopy N/A Inactivate Submitted This procedure is already covered by code E2500 DIAGNOSTIC ENDOSCOPIC EXAMINATION OF PHARYNX/LARYNX (INCLUDING BIOPSY) (AS SOLE PROCEDURE). Also we are unhappy that code E3680 specifies that it must be performed as an out-patient. The code should describe the discrete clinical activity and each individual patient will determine the setting. Therefore it makes the coding structure clearer to only have one code which doesn't specify the setting.
06/06/2016 MI045 N/A Liquid Meal Challenge + Pyridostigmine (Cardiovascular autonomic testing) New Code Submitted Improves coding structure and adds claritySee MI030
06/06/2016 MI044 N/A Liquid Meal Challenge + Octreotide (Cardiovascular autonomic testing) New Code Submitted Improves coding structure and adds clarityPlease see MI030
06/06/2016 MI043 N/A Carotid Sinus Massage (Cardiovascular autonomic testing) New Code Submitted Improves coding structure and adds claritySee MI030
06/06/2016 MI042 N/A Dysreflexia Test (Cardiovascular autonomic testing) New Code Submitted Improves coding structure and adds claritySee change - MI030
06/06/2016 20141 Continuous ambulatory ECG for up to 72 hours (including reporting) Continuous ambulatory ECG for up to 7 days (including reporting) Narrative Change Submitted To reflect updated clinical practiceWe have been advised that Holter monitoring can be carried out for up to 7 days and that there is no code to reflect monitoring over 72 hours. http://www.rbht.nhs.uk/patients/condition/ecg/
06/06/2016 MI041 N/A 48 hour BP & HR Monitoring (Cardiovascular autonomic testing) New Code Submitted Improves coding structure and adds clarityNarratives agreed with Bupa - see MI030
06/06/2016 MI040 N/A 24hr BP & HR profile (Cardiovascular autonomic testing) New Code Submitted Improves coding structure and adds clarityCode narratives agreed with Bupa's Medical Director Tom Woodman for clarity
06/06/2016 MI039 N/A Arm movements (Cardiovascular autonomic testing) New Code Submitted Improves coding structure and adds clarityCode narratives agreed for clarity with Tim Woodman Bupa's Medical Director
06/06/2016 MI038 N/A Cervical head movements (Cardiovascular autonomic testing) New Code Submitted Improves coding structure and adds clarityCode narratives agreed for clarity with Tim Woodman Bupa's Medical Director
06/06/2016 MI037 N/A Modified Exercise Test (Cardiovascular autonomic testing) New Code Submitted New code narrative format agreed with Tim Woodman Bupa's Medical Director
06/06/2016 MI036 N/A Liquid Meal Challenge (Cardiovascular autonomic testing) New Code Submitted Improves coding structure and adds clarityNew code narrative format agreed with Tim Woodman Bupa's Medical Director
06/06/2016 MI035 N/A Tilt Table Test (Cardiovascular autonomic testing) New Code Submitted Improves coding structure and adds clarityNew code narrative format agreed with Tim Woodman Bupa's Medical Director
06/06/2016 MI030 Assessment for autonomic dysfunction Cardiovascular autonomic function assessment Narrative Change Submitted Improves coding structure and adds clarityNew narrative format agreed with Bupa's Medical Director Tim Woodman for clarity This is one of a number of different tests and is the initial assessment. For consistency and to allow users to identify the group of codes all now have 'cardiovascular autonomic' in the narrative.
01/06/2016 N/A N/A Intracardiac Echocardiogram using St Jude Viewflex Catheter New Code Submitted A new code is required for the use of a new diagnostic /assisting equipment used within the procedure.
26/05/2016 F2620 Frenotomy /frenectomy of tongue Frenotomy /frenectomy of tongue under general anaesthetic Narrative Change Submitted Improves coding structure and adds clarityThis improves clarity as the procedure will now be split into performed under GA or the new code under LA.
26/05/2016 F2621 N/A Frenotomy /frenectomy of tongue under local anaesthetic New Code Submitted Improves coding structure and adds clarityIn small babies the procedure is very minor does not require general anaesthetic or theatre and is mostly treated at the initial consultation under local anaesthetic.
20/05/2016 W7420 Autograft anterior cruciate ligament reconstruction (including arthroscopic and meniscectomy) N/A Coding Principles Published
20/05/2016 XR124 N/A Bilateral image-guided vacuum assisted two breast lesions (with biopsy) New Code Submitted Improves coding structure and adds clarityImproves coding structure and adds clarity for insurers to set fees. These are interventional radiology procedures and the hospital (HJE) will agree a radiologists fee for each code. Separate codes makes the clinical difference clear i.e. unilateral or bilateral and number of excisions or biopsies. HJE will pay the radiologist and agree an all-inclusive price with insurers. Separate codes makes fee payments easier for the hospital to manage and also the prices reflect different time and consumables costs. All codes to be proposed XR121 (narrative change) XR122 XR123 XR124.
20/05/2016 XR123 N/A Bilateral image-guided vacuum assisted one breast lesion (with biopsy) New Code Submitted Improves coding structure and adds clarity for insurers to set fees. These are interventional radiology procedures and the hospital (HJE) will agree a radiologists fee for each code. Separate codes makes the clinical difference clear i.e. unilateral or bilateral and number of excisions or biopsies. HJE will pay the radiologist and agree an all-inclusive price with insurers. Separate codes makes fee payments easier for the hospital to manage and also the prices reflect different time and consumables costs. All codes to be proposed XR121 (narrative change) XR122 XR123 XR124.
20/05/2016 XR122 N/A Unilateral image-guided vacuum assisted two breast lesions (with biopsy) New Code Submitted Improves coding structure and adds clarityImproves coding structure and adds clarity for insurers to set fees. These are interventional radiology procedures and the hospital (HJE) will agree a radiologists fee for each code. Separate codes makes the clinical difference clear i.e. unilateral or bilateral and number of excisions or biopsies. HJE will pay the radiologist and agree an all-inclusive price with insurers. Separate codes makes fee payments easier for the hospital to manage and also the prices reflect different time and consumables costs. All codes to be proposed XR121 (narrative change) XR122 XR123 XR124.
20/05/2016 XR121 Image-guided vacuum assisted excision biopsy of breast lesions Unilateral Image-guided vacuum assisted excision one breast lesion (with biopsy) Narrative Change Submitted Improves coding structure and adds clarity for insurers to set fees for single and multiple procedures and to reflect difference in hospital costs for single and multiple procedures. These are interventional radiology procedures and we pay radiologists a fee for each code. We agree an inclusive hospital and radiologist price with insurers. Separate codes makes fee payments easier and also the price reflects different time and consumables costs. Other codes to be proposed XR122 XR123 XR124. Consumables costs are: 1 of these: Specimen casettes cell store pot Scalpel Blade with blue handle No.11 10ml Luer lock syringe Universal Basic Pack Steristrip 6 x 3.8cm Clinell Skin Swabs Streile Gauze 5ml 2% Lidocaine Atec Canister. 1 of these: 25g Luer lock orange needle 23g Lucer lock blue needle 21g Luer lock green needle 5ml Luer lock syringe Eviva needle guide Eviva Secur Marker (cork shaped) Eviva needle (Standard) Opsite 6.5 x 5cm 5ml 2% Lidocaine 10ml Lidocaine 2% and Adrenaline (1:200000) 250ml Saline Skin prep Chlorohexidine = £360 Time taken 60 mins
18/05/2016 N/A N/A Peripherally inserted central venous catheters (PICCs) (without X-ray guidance) New Code Submitted Improves coding structure and adds clarity - One of our providers who offer homecare for cancer patients have explained that they do not use the x-ray guidance when inserting PICC lines as they use this new system and so we feel there should be a code to reflect when the procedure is done without this element as is the case with other codes (eg: 25010 & 25011)
17/05/2016 S4213 Debridement and primary suture of wound without involvement of deeper tissue (skin & subcutaneous fat only) - Trunk & Limbs Debridement and primary suture of wound without involvement of deeper tissue (skin & subcutaneous fat only) - Trunk & Limbs (as a sole procedure) Narrative Change Rejected Our medical adviser feels this should be a standalone procedure
17/05/2016 S4213 Debridement and primary suture of wound without involvement of deeper tissue (skin & subcutaneous fat only) - Trunk & Limbs N/A Coding Principles Published Our medical advisor feels that S4740 is a minor addition to S4213 and that evacuation hematoma and/or drainage of abscess is an integral part of the debridement of a wound
12/05/2016 W9030 Injection(s) +/- aspiration, into joint, cyst, bursa or soft tissue, with image guidance N/A Coding Principles Published W9240 Examination/ manipulation of joint under general anaesthetic +/- injection +/- arthrogram (as sole procedure) is listed as unacceptable with W9040 Injection(s) +/- aspiration, into joint, cyst, bursa or soft tissue but not with W9030 Injection(s) +/- aspiration, into joint, cyst, bursa or soft tissue, with image guidance. Should it not be applied to W9030 as well?
11/05/2016 B2990 Reconstruction of breast using deep inferior epigastric perforator flap (DIEP) with vascularised lymph node transfer (including delayed reconstruction) N/A Coding Principles Published As per the discussion at the last Working Group meeting, these are the suggestions from AXA-PPP to add against the DIEP code
11/05/2016 B2989 Mastectomy followed by immediate Deep Inferior Epigastric Flap (DIEP) reconstruction - unilateral N/A Coding Principles Published As per the discussion at the last Working Group meeting, these are the suggestions from AXA-PPP to add against the DIEP code
11/05/2016 B2918 Mastectomy and immediate reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) N/A Coding Principles Published As per the discussion at the last Working Group meeting - these are the suggests from AXA-PPP to add against the ADM code
11/05/2016 B2917 Reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) (including delayed reconstruction) N/A Coding Principles Published As discussed at the last Working Group meeting - these codes should be added against the ADM codes. These suggestions have been put forward by AXA-PPP.
05/05/2016 n/a N/A Metabolic Testing New Code Rejected Improves coding structure and adds clarityImproves coding structure and adds clarity
28/04/2016 G5020 Robotic laparoscopic switch of duodenum with vertical gastrectomy and biliary pancreatic diversion Robot assisted laparoscopic switch of duodenum with vertical gastrectomy and biliary pancreatic diversion Narrative Change Published To align current codes and consistencyAll codes would then start with 'Robot Assisted' rather than this one code using the term 'Robotic'.
26/04/2016 N/A N/A Placement of tined lead neurostimulator (as sole procedure) not at time of permanent implant. New Code Published Improves coding structure and adds clarityExisting code A7011 (Peripheral Nerve Evaluation PNE) for trial sacral nerve stimulation is no longer sufficient to represent the evaluation phases of sacral nerve stimulation (SNS). Although PNE remains a suitable test procedure for many patients it sometimes fails or produces inconclusive results. Patients in whom PNE has not been successful or for whom the clinician deems PNE to be inappropriate can benefit from a newer 2-stage technique of Advanced Evaluation using placement of a tined lead under general anaesthetic. This evaluation technique is becoming widely-used; recent NICE guidance IPG 536 (2015) states that 'there has been a move from using a 1-stage to a 2-stage technique for the evaluation phase of the procedure. It was noted that the latter is associated with better outcomes'. Although an application for CCSD coding for tined lead placement has recently been rejected we believe that this should be reconsidered in light of changing practice.
22/04/2016 K6111 Insertion of combined biventricular pacemaker and cardioverter defibrillator (CRT-D) N/A Coding Principles Rejected Our medical adviser has said that L9510 is an integral part of the main procedure.
20/04/2016 N/A N/A Renal Denervation New Code Published Brand new procedure/testBrand new procedure/test
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