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
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 Submitted 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 Submitted Improves coding structure and adds clarityImproves coding structure and adds clarity
16/10/2014 B2986 Reconstruction of breast using Deep Inferior Epigastric Perforator flap (DIEP) +/- vascularised lymph node transfer (including delayed reconstruction) separate code for Deep Inferior Epigastric Perforator flap (DIEP) with vascularised lymph node transfer (including delayed reconstruction) additional code for vascualrised lymph node transfer (not in combination with breast reconstruction) Narrative Change Submitted 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. Prior to this new ammendment I agreed with BUPA that we would use the DIEP CCSD code but I would be paid an additional uplift fee of £1000 for addition of the lymph nodes. BUPA agree that this should still be the case and have asked me to contact you for an ammendment.
08/10/2014 xxxxB N/A Next generations sequencing (NGS) molecular profiling - Caris New Code Submitted 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 xxxxB N/A Next generations sequencing (NGS) molecular profiling - Farotech New Code Submitted 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 Submitted 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 Submitted 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 Submitted 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.
07/10/2014 IMxxx N/A IV Cholangiogram New Code Submitted Improves coding structure and adds clarityThere are currently no codes available for this investigation. The only options being IM098 - Magnetic resonance cholangiopancreatography (MRCP) and IM262 - T-tube cholangiogram. This is an x-ray examination to show the bile ducts. In order to see the bile ducts it is necessary to be given an injection into the vein in your arm. This is given slowly over a period of approximately 20 minutes. The fluid injected passes through the liver and into the bile ducts. Xrays are then taken. The examination will take approximately 2 – 3 hours.
07/10/2014 IMxxx N/A CT Enteroclysis New Code Submitted Improves coding structure and adds clarityThere is currently a code for MRI Enteroclysis (IM054) but no code for CT Enteroclysis. CT enteroclysis has been shown to be superior to other imaging tests such as peroral small-bowel examinations conventional CT and barium enteroclysis except in the demonstration of early apthous ulcers of Crohns disease .CT enteroclysis is complementary to capsule endoscopy in the elective investigation of small-bowel disease with a specific role in the investigation of Crohn disease small-bowel obstruction and unexplained gastrointestinal bleeding.
03/10/2014 Q1802 Hysteroscopy with resection of fibroids +/- insertion of Mirena coil N/A Coding Principles Submitted Bupa proposes to add Q1802 and Q1703 as unacceptable combinations. Hysteroscopy and resection of any fibroids is always carried out prior to Bipolar radio frequency ablation. If multiple resections are carried out then the Q1703 would not be carried out as the lining of the uterus in parts would be too thin.
30/09/2014 Q0710 Radical hysterectomy and lymphadenectomy (Wertheim's) +/-ureterolysis N/A Coding Principles Submitted Bupa proposes to add the following combination: Q0710 - Your uterus, cervix, top part of the vagina, fallopian tubes, ovaries, supporting tissues and lymph nodes are removed. Leaving behind the vagina. Q0880 - your uterus, cervix, ovaries and fallopian tubes are removed. Leaving behind the vagina. These are similar procedures and should be coded together
30/09/2014 IM017 Computed tomography of the coronary arteries (CTCA) N/A Coding Principles Submitted Calcium scoring would also be included within a CTCA, therefore should not be coded together as CT calcium scoring forms part of a CTCA
25/09/2014 W9039 N/A Injections, +/- Aspiration(s), into Bilateral Joints for Pain Relief with Image Guidance New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9038 N/A Injection(s), +/- Aspiration, into Unilateral Joint for Pain Relief with Image Guidance New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9049 N/A Injections, +/- Aspiration(s), into Bilateral Joints for Pain Relief New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9048 N/A Injection(s), +/- Aspiration, into Unilateral Joint for Pain Relief New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9037 N/A Injections, +/- Aspiration(s), into Bilateral Joints for Osteoarthritis with Image Guidance New Code Submitted This adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9036 N/A Injection(s), +/- Aspiration, into Unilateral Joint for Osteoarthritis with Image Guidance New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 N/A N/A PARAMYTONIA CONGENITA SCN4 New Code Submitted not listed on current diagnostic schedule for this pathology test
25/09/2014 W9047 N/A Injections, +/- Aspiration(s), into Bilateral Joints for Osteoarthritis New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9046 N/A Injection(s), +/- Aspiration, into Unilateral Joint for Osteoarthritis New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9035 N/A Injections, +/- Aspiration(s), into Bilateral Joints for Bursitis with Image Guidance New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9034 N/A Injection(s), +/- Aspiration, into Unilateral Joint for Bursitis with Image Guidance New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9045 N/A Injections, +/- Aspiration(s), into Bilateral Joints for Bursitis New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9044 N/A Injection(s), +/- Aspiration, into Unilateral Joint for Bursitis New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9033 N/A Injections of Viscosupplementation into Bilateral Joints with Image Guidance New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9032 N/A Injection of Viscosupplementation into Unilateral Joint with Image Guidance New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9043 N/A Injections of Viscosupplementation into Bilateral Joints New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9042 N/A Injection of Viscosupplementation into Unilateral Joint New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9031 N/A Injections, +/- Aspiration(s), into Bilateral Joints, with Image Guidance, NEC (Not Elsewhere Classified) New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9041 N/A Injections, +/- Aspiration(s), into Bilateral Joints, NEC (Not Elsewhere Classified) New Code Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9030 One or two injections, +/- aspiration, into joint(s), cyst, bursa or soft tissue, with image guidance Injection(s), +/- aspiration, into unilateral joint, with Image Guidance, NEC (Not Elsewhere Classified) Narrative Change Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 W9040 Injection(s), +/- aspiration, into joint(s), cyst, bursa or soft tissue Injection(s), +/- aspiration, into unilateral joint, NEC (Not Elsewhere Classified) Narrative Change Submitted Improves coding structure and adds clarityThis adds condition specific granularity to a generic procedure code. This has been completed as a wider review of condition specific procedures. All requests should be considered in unison.
25/09/2014 IMxxx N/A Magnetic resonance study of Cardiac Anatomy Magnetic resonance study of Cardiac Function Magnetic resonance study of Cardiac Viability/Fibrosis Magnetic resonance study of Cardiac Flow Magnetic resonance study of Cardiac Stress Perfusion Magnetic resonance study of Cardiac Angiography New Code Submitted To replace code already in the ScheduleTo replace code already in the Schedule 3 codes have been proposed which are: IM049 MRI cardiac function stress IM051 MRI Cardiac morphology function stress IM052 MRI cardiac morphology function These do not reflect the activity which cardiovascular MR units perform are not mutually exclusive and will create considerable confusion. We propose 6 codes which accurately reflect activity are mutually exclusive and create transparency and clarity.
23/09/2014 XR.....new number N/A Insertion of central venous port under XRay guidance. New Code Submitted Improves coding structure and adds clarityThis procedure is already listed under vascular surgery non specific (L9180). Historically these procedures were done without real time xray imaging but this imaging is now routine. The central venous catheter insertion part of the procedure is identical to that of a tunnelled catheter XR915 with then the addition of an implanted port under the skin.
18/09/2014 64302 Transoesophageal echocardiography (including reporting) Transoesophageal echocardiography (including reporting) (as a sole procedure) Narrative Change Submitted To reflect updated clinical practiceIt is best practice in a number of cardiac procedures to perform peri intra or post operative TOES this will ensure that we can counter any challenges in relation to unbundling.
17/09/2014 V2951 Anterior discectomy, decompression and fusion (including bone grafting / multiple levels) - cervical region (3 or more levels) Anterior discectomy, decompression and fusion (including bone grafting) - cervical region (1 or 2 levels) Narrative Change Submitted Improves coding structure and adds claritycode currently advises multi level however we have since amended to state 3 or more levels
15/09/2014 Q0920 N/A Myomectomy (including laparoscopically) +/-ureterolysis Narrative Change Published To align current codes and consistencyTo align current codes and consistency
15/09/2014 Q0890 Vaginal hysterectomy including salpingo-oophorectomy (including laparoscopically assisted) Vaginal hysterectomy including salpingo-oophorectomy (including laproscopically assisted) +/-ureterolysis Narrative Change Published To align current codes and consistencyTo align current codes and consistency
15/09/2014 Q0880 Hysterectomy with excision / biopsy and/or removal of omentum and uterine adnexa for ovarian malignancy Hysterectomy with excision / biopsy and/or removal of omentum and uterine adnexa for ovarian malignancy +/-ureterolysis Narrative Change Published To align current codes and consistencyTo align current codes and consistency
15/09/2014 Q0830 Vaginal hysterectomy with laparoscopic assistance Vaginal hysterectomy with laparoscopic assistance +/-ureterolysis Narrative Change Published To align current codes and consistencyTo align current codes and consistency
15/09/2014 Q0800 Vaginal hysterectomy without laparoscopic assistance Vaginal hysterectomy without laparoscopic assistance +/-ureterolysis Narrative Change Rejected To align current codes and consistencyTo align current codes and consistency
15/09/2014 Q0790 Laparoscopic total hysterectomy (+/- oophorectomy) Laparoscopic total hysterectomy (+/- oophorectomy) +/-ureterolysis Narrative Change Published To align current codes and consistencyTo align current codes and consistency
15/09/2014 Q0751 Laparoscopic subtotal hysterectomy (+/- oophorectomy) Laparoscopic subtotal hysterectomy (+/- oophorectomy) +/-ureterolysis Narrative Change Published To align current codes and consistencyTo align current codes and consistency
15/09/2014 Q0750 Subtotal abdominal hysterectomy (+/- oophorectomy) Subtotal abdominal hysterectomy (+/- oophorectomy) +/-ureterolysis Narrative Change Published To align current codes and consistencyTo align current codes and consistency
15/09/2014 Q0740 Total abdominal hysterectomy (+/- oophorectomy) Total abdominal hysterectomy (+/- oophorectomy) +/-ureterolysis Narrative Change Published To align current codes and consistencyTo align current codes and consistency
12/09/2014 Q0712 N/A Radical trachelectomy including laparoscopic and removal of lymph nodes +/- ureterolysis Narrative Change Published To align current codes and consistencyTo align current codes and consistency
11/09/2014 Q0710 Radical hysterectomy and lymphadenectomy (Wertheim's) Radical hysterectomy and lymphadenectomy (Wertheim's) +/-ureterolysis Narrative Change Published We recently added “+/- ureterolysis” to laparoscopy codes: Q1701 Q3800 Q3900 T3910 P3190 P3191 and P3192. However ureterolysis is often part and parcel of performing a hysterectomy as well and takes very little extra time to do. We propose changing the narrative of the codes and then adding M2530 “Ureterolysis – unilateral” and M2580 “Ureterolysis – bilateral” as unacceptable code combinations.
11/09/2014 K5282 N/A N/A Inactivate Published It is unclear what “in association with other cardiac surgery” refers to. There is a code that refers directly to ablation (K5730 Ablation of atrial arrhythmia (including mapping)). Therefore Consultants can use other individual codes for example K2600/K2280/K2580/ K2780/K5730/K2700/K6010
Page
Viewing All