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.

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Request
Number
Date Code Current
Narrative
Proposed
Narrative
Type Current
Status
Reasons for
change
10/12/2014 W3111 N/A ACIC (Autologous Collagen Induced Chondrogenesis) or AMIC (Autologous Matrix Induced Chondrogenesis) New Code Submitted Brand new procedure/testAreas of articular damage identified in knees should be treated before they progress to osteo-arthritis. This will prevent or delay knee replacement surgery.
08/12/2014 X3800 Ophthalmic local anaesthetic injection administered by operator N/A Coding Principles Submitted I received an external coding query from CS Healthcare about the codes we recently changed to include 'topical or local anaesthetic'. Should these now be added as unacceptable combinations with X3800 as they should not be coded separately.
08/12/2014 C7950 N/A Intravitreal injection with implantation of a slow release steroid New Code Submitted Improves coding structure and adds clarityRequest for discussion from Carol Bush: Aware that the WG wanted this code NOT to be specific to either the condition and/or the agent being used which I entirely agree with. However understand that when this code was first published etc that these injections were given as a course of injections over a period of up to 3/4 years. Recently a new Intravitreal injection has been used using a steroid (fluocinolone acetonide) implant namely Iluvein The difference with this implant unlike other steroid and anti-VEGF injections is that the implant is a slow release steroid which lasts up to 3 years. Whilst appreciate the actual procedure for this type of implant may not vary in those other Intravitreal injection using other agents wonder if the WG would like to consider publishing a new code to differentiate these slow release implants?
08/12/2014 C7550 N/A Implantation of intra ocular miniature lens system (telescopic lens) for visual impairment New Code Submitted Brand new procedure/testWe have become aware of a number of hospitals now offering this surgery and it does appear that this treatment is now established (although perhaps not readily available on the NHS) using a form of telescopic lens called Centrasight. We would like to see a separate code for this procedure so that we are able to identify and manage these correctly.
08/12/2014 E1350 Closure of oro-antral fistula Closure of oro-antral fistula with local flap Narrative Change Submitted Improves coding structure and adds clarityRefer to new code requests 2799/2800
08/12/2014 E1354 N/A Closure of oro-antral fistula with distant flap and bone graft New Code Submitted Improves coding structure and adds clarityWe have a single code for closure of oro-antral fistula without mention of any form of grafting. This is usually included and the type of flap depends in the size of the fistula. We suggest that further coding is required to recognise the different levels of complexity. E1350 Closure of oro-antral fistula with local flap (Narrative change) E1352 Closure of oro-antral fistula with distant flap (New code) - refer 2799 E1354 Closure of oro-antral fistula with distant flap and bone graft (New code)
08/12/2014 E1352 N/A Closure of oro-antral fistula with distant flap New Code Submitted Improves coding structure and adds clarityWe have a single code for closure of oro-antral fistula without mention of any form of grafting. This is usually included and the type of flap depends in the size of the fistula. We suggest that further coding is required to recognise the different levels of complexity. E1350 Closure of oro-antral fistula with local flap (Narrative change) E1352 Closure of oro-antral fistula with distant flap (New code) E1354 Closure of oro-antral fistula with distant flap and bone graft (New code)
05/12/2014 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 The suggestion is to add W2830 with W0300. We feel that the removal of internal fixation from bone / joint should be part & parcel of W0300 "Multiple procedures on forefoot" and in the occasional situation where the fixation is being removed from a different part of the body, we will assess on a case by case basis.
05/12/2014 M4510 Diagnostic endoscopic examination of bladder (cystoscopy) including any biopsy Diagnostic endoscopic examination of bladder (flexible cystoscopy) including any biopsy Narrative Change Submitted See new code request for rigid cystoscopy.................
05/12/2014 M4514 N/A Endoscopic examination of bladder (rigid cystoscopy) including any biopsy New Code Submitted A flexible cystoscopy is done under LA mainly for diagnostic purposes whereas a rigid is done under a general or spinal anaesthetic and allows various minor procedures to be performed at the same time. Maybe we need two different codes for flexible and rigid cystoscopies like we have for sigmoidoscopy? H2502 Diagnostic flexible sigmoidoscopy (including forceps biopsy and proctoscopy) H2510 Rigid sigmoidoscopy (including proctoscopy and biopsy)
03/12/2014 B3013 Mastectomy and immediate reconstruction of breast using fixed prosthesis N/A Coding Principles Submitted The suggestion is to add B3013 with B3015 Reconstruction of breast using fixed prosthesis (including delayed reconstruction) Both codes include reconstruction of breast and so our CMO feels they should not be used together on the same breast
03/12/2014 Q1701 Laparoscopic excision of endometriosis, +/-ureterolysis Laparoscopic excision of endometriosis Narrative Change Submitted Improves coding structure and adds clarityRefer to new code request 2733 in association with this code request: Correspondence received from Mr Robert Richardson regarding Q1701 and the addition of '+/- ureterolysis': To perform extensive excision of endometriosis outside of the recto-vaginal septum is technically difficult and the technicality of the procedure and risk of the procedure together with the surgical time increases with ureterolysis. He has requested that we consider having two levels of coding for this rather than including the ureterolysis in the single code as it is not always necessary but where it is the extra time and effort should be reflected in the coding.
03/12/2014 Q1702 N/A Laparoscopic excision of endometriosis +/- ureterolysis New Code Submitted Improves coding structure and adds clarityRefer to narrative change for Q1701 in association with this code request: Correspondence received from Mr Robert Richardson regarding Q1701 and the addition of '+/- ureterolysis': To perform extensive excision of endometriosis outside of the recto-vaginal septum is technically difficult and the technicality of the procedure and risk of the procedure together with the surgical time increases with ureterolysis. He has requested that we consider having two levels of coding for this rather than including the ureterolysis in the single code as it is not always necessary but where it is the extra time and effort should be reflected in the coding.
01/12/2014 A7085 Sacral nerve stimulation for faecal/urinary incontinence or constipation Implantation or removal of sacral nerve stimulation for faecal/urinary incontinence Narrative Change Submitted Improves coding structure and adds clarityA patient would have a neurostimulator (coded under A7011 "Trial of neurostimulator to peripheral nerve (as sole procedure) not at time of permanent implant") and if this is successful is then brought in for a procedure for a permanent implant (under A7085) at a later stage. There are currently no codes that reflects re-programming and removal. There are no changes to the equipment etc being used therefore we propose to change the narrative to include "Implantation or removal" to make it clear this procedure includes implantation and removal. Please note as we have not defined the principles for grammar of new narratives I have left as "or" to discuss at the next meeting what this should be.
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 Published 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 Published 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 Published 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 Published 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 Published 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 Combined discectomy, insertion of cage device or similar, decompression and fusion (at single or multiple levels) through single posterior approach with extended anterior access without the need for laparotomy New Code Submitted Spinal surgeons placing a cage device need greater access than that required for an ordinary posterior spinal decompression and fusion but there is currently no code which encompasses this necessary additional anterior approach without resorting to a laparotomy. As a result the spinal surgeons use code V3350 "Combined anterior approach discectomy decompression and fusion and posterior fusion (lumbar region) which would normally involve a laparotomy. It would clearly be to everyone's advantage for a code to be issued which allows anterior and posterior exploration for cage placement without the need for laparotomy; hence the request for a new code.
19/11/2014 N/A N/A Endoscopic balloon dilatation tof the eustachian tube New Code Rejected 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 Published Brand new procedure/testBrand new procedure/test
14/11/2014 XR160 Percutaneous image guided fine needle aspiration (FNA) Percutaneous ultrasound guided cyst aspiration Narrative Change Rejected 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 Rejected 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 Rejected 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.
01/11/2014 B2820 Wide local excision of breast +/- local mobilisation of glandular breast tissue to fill surgical cavity N/A Coding Principles Published
01/11/2014 IM330 XR Mastoids XR Mastoids (2 or more views, including bilateral) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM324 XR Tomogram XR Tomogram (multiple views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM318 XR Sacrum spine XR Sacrum spine (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM311 XR Mammogram XR Mammogram (2 or more views each side, including bilateral) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM309 XR Lumbar spine XR Lumbar sacral spine (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM307 XR Knee with additional views XR Knee (3 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM306 XR Knee XR Knee (2 views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM336 XR Facial Bones XR Facial Bones (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM335 XR Forearm XR Forearm (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM332 XR Finger XR Finger (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM331 XR Nasal Bones XR Nasal Bones (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM329 XR Paranasal Sinuses XR Paranasal Sinuses (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM328 XR Toe XR Toe (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM325 XR Wrist XR Wrist (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM323 XR Tibia and fibula XR Tibia and fibula (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM322 XR Thoracic spine XR Thoracic spine (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM319 XR Shoulder XR Shoulder (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM317 XR Radius and ulna XR Radius and ulna (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM314 XR Patella XR Patella (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
01/11/2014 IM312 XR Orbit foreign body demonstration Both XR Orbit foreign body demonstration Both (2 or more views) Narrative Change Published Improves coding structure and adds clarityImproves coding structure and adds clarity
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