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.

Viewing Procedural
Request
Number
Date Code Current
Narrative
Proposed
Narrative
Type Current
Status
Reasons for
change
19/02/2018 S0982 Psoralen photochemotherapy (PUVA/PUVB) per session – localised Phototherapy (UVB/PUVA/PUVB) per session – localised Narrative Change Submitted Improves coding structure and adds clarity We feel that this code also needs to include phototherapy which does not involve the use of other topical or systemic agents such as Psoralen (PUVA). The alternative would be to have a completely separate code for phototherapy and leave existing codes S0980/S0982 as they are.
19/02/2018 S0980 Psoralen photochemotherapy (PUVA/PUVB) per session – whole body Phototherapy (UVB/PUVA/PUVB) per session – whole body Narrative Change Submitted Improves coding structure and adds clarity We feel that this code also needs to include phototherapy which does not involve the use of other topical or systemic agents such as Psoralen (PUVA). The alternative would be to have a completely separate code for phototherapy and leave existing codes S0980/S0982 as they are.
09/02/2018 J3900 Therapeutic ERCP with insertion of biliary or pancreatic stent(s), sphincterotomy or stone extraction N/A Coding Principles Submitted This code's narrative advises that the procedure is "with insertion of biliary or pancreatic stent(s)" and so we do not feel XR575 should be allowable with it, as this would overlap with the narrative. XR570 is already listed as an unacceptable combination, so for consistency, we feel XR575 should also be an unacceptable combination.
09/02/2018 J3800 Therapeutic ERCP without insertion of stents N/A Coding Principles Submitted This code's narrative advises that the procedure is "without insertion of stents" and so we do not feel XR575 should be allowable with it - XR570 is already listed as an unacceptable combination, so for consistency, we feel XR575 should also be an unacceptable combination.
08/02/2018 E1432 FESS: excision uncinate process and anterior ethmoid bulla, antrostomy/antral puncture, simple polypectomy and attention to turbinates (bilateral) N/A Coding Principles Submitted Our understanding is that the balloon dilation codes above are stand alone procedures and would not be performed with E1432 - FESS - a specialist would do either a FESS or a balloon dilation sinuplasty.
08/02/2018 J0210 Hemihepatectomy (resection of four or more segments) N/A Coding Principles Submitted As a cholecystectomy is usually performed as part & parcel of a hepatectomy, we feel the above codes should be included in the list of unacceptable combinations.
08/02/2018 J0200 Partial hepatectomy (left hepatectomy or resection of up to three segments) N/A Coding Principles Submitted As a cholecystectomy is usually performed as part & parcel of a hepatectomy, we feel the above codes should be included in the list of unacceptable combinations.
07/02/2018 Q0750 Subtotal abdominal hysterectomy (+/- oophorectomy) +/- ureterolysis N/A Coding Principles Submitted Our CMO considers that these codes should be an unacceptable combination as there is overlap between the narratives and so it should be "either/or" rather than both codes.
07/02/2018 B2760 Skin/nipple sparing mastectomy (including axillary node biopsy) N/A Coding Principles Submitted Our CMO fees this procedure overlaps with all the listed procedure codes and so would be grateful if coding principles could be added for them as unacceptable combinations.
07/02/2018 P2380 Anterior (+/- posterior) colporrhaphy with vaginal hysterectomy (including primary repair of enterocele and cystoscopy) N/A Coding Principles Submitted Our CMO considers that these codes should be an unacceptable combination as there is overlap between the narratives and so it should be "either/or" rather than both codes.
05/02/2018 J5610 Pancreatoduodenectomy and excision of surrounding tissue (Whipple's procedure) N/A Coding Principles Submitted Reason: Part and parcel The NHS advise that these procedures are usually done as well when a Whipple's is undertaken.
05/02/2018 V4000 Combined anterior and posterior correction and instrumentation, +/-fusion of idiopathic juvenile scoliosis (including spinal monitoring) Combined anterior and posterior correction and instrumentation of idiopathic juvenile scoliosis, +/-fusion (including spinal monitoring) Narrative Change Submitted To align current codes and consistencyThis was recently misinterpreted as implying that the +/- referred to idiopathic juvenile scoliosis & could therefore be used for adults. Looking at the other idiopathic juvenile scoliosis codes the current narrative is out of sync. e.g. V4100 Posterior correction of idiopathic juvenile scoliosis with instrumentation +/-fusion (including spinal cord monitoring) & V4120 Anterior correction of idiopathic juvenile scoliosis with instrumentation +/-fusion (including spinal cord monitoring). We therefore propose the above narrative change for consistency & to avoid misinterpretation.
30/01/2018 TBA N/A MRI-guided focused ultrasound (MRgFUS) thalamotomy for essential tremor New Code Submitted Brand new procedure/testThis procedure is now being performed at Imperial College Healthcare NHS Trust.
30/01/2018 XR??? N/A Insertion of magnetic marker for non-palpable breast lesions under imaging control New Code Submitted Brand new procedure/testThis is now being performed at the Royal Marsden for small non-palpable breast lesions. While some tumours are easy to feel many – especially the ones detected through breast screening – are not palpable. We aim to remove the cancer as accurately as possible so localising it in the breast is very important. Traditionally we have used a wire as a marker which requires a procedure a few hours before the operation. However a Magseed can be placed into the breast up to 30 days in advance allowing patients to go about their daily lives in the lead-up to their operation.
30/01/2018 T2510 Laparoscopic repair of parastomal hernia requiring mesh N/A Coding Principles Submitted These are our suggestions for coding principles for this recent new code, based on existing unacceptable code combinations for other hernia repairs.
25/01/2018 M1910 Construction of ileal conduit (including ureteric implantation) N/A Coding Principles Submitted As the narrative of M1910 includes "ureteric implantation" we suggest listing M2920 as unacceptable with it.
17/01/2018 D0342 Bony meatoplasty N/A Coding Principles Published
15/01/2018 N/A N/A Subchondroplasty injection (arthroscopic), under x-ray guidance New Code Submitted Brand new procedure/test
11/01/2018 C6181 Laser suture lysis (including topical or local anaesthetic) N/A Coding Principles Submitted As the narrative for this procedure includes topical or local anaesthetic, our CMO does not feel these codes should be used together.
11/01/2018 C6180 Bleb needling +/- antimetabolites (including topical or local anaesthetic) N/A Coding Principles Submitted As the narrative for this procedure includes topical or local anaesthetic, our CMO does not feel these codes should be used together.
10/01/2018 N/A N/A Balloon dilatation of the Eustachian tube New Code Submitted Brand new procedure/testNICE advises that this procedure should only be used in the context of research. However we are receiving requests for this and we understand it is being offered in the private sector.
10/01/2018 N/A N/A Patient specific twin knee resurfacing implant New Code Submitted Brand new procedure/testSee previous request. The twin implant is a patient-specific resurfacing implant intended for larger and more elongated defects for the femoral condyles and the trochlea area
10/01/2018 N/A N/A Patient specific knee resurfacing implant New Code Submitted Brand new procedure/testwe understand that this procedure is currently part of clinical research and is being carried out at 5/6 NHS Hospitals and some private Hospitals.It may be recommended for patients where conventional surgery such as micro fracture has failed or is not appropriate and in patients too young to be considered for knee replacement
10/01/2018 H4685 Insertion of biodegradable perirectal spacer under image guidance (as sole procedure) Insertion of biodegradable perirectal spacer under image guidance Narrative Change Submitted To reflect updated clinical practiceWe have been advised that this procedure may be carried out in combination with Fiducial marker placement
10/01/2018 A5780 Rhizolysis N/A Inactivate Submitted Current code replaced by a new codeWe think this is covered by A5720 Facet or sacroiliac joint (RF) radiofrequency thermocoagulation cryotherapy or phenol (including rhizolysis under image guidance) - up to 3 joints and A5730 Facet or sacroiliac joint (RF) radiofrequency thermocoagulation cryotherapy or phenol (including rhizolysis under image guidance) - 4 to 6 joints.
10/01/2018 J3900 Therapeutic ERCP with insertion of biliary or pancreatic stent(s), sphincterotomy or stone extraction N/A Coding Principles Submitted Add XR575 as unbundled with the J3900 as the stent insertion is part of the main procedure. The plastic stent code XR570 is already unbundled so the metallic stent XR575 should also be listed as unbundled.
05/01/2018 A7352 Image-guided local anaesthetic blockade of named major nerve or plexus N/A Coding Principles Published Our CMO feels local anaesthetic should be included within the main procedure
05/01/2018 H5520 Laying open of high anal fistula (fistulotomy) (including sigmoidoscopy) N/A Coding Principles Published Our CMO feels these are separate and either/or procedure and so should not be used together.
05/01/2018 H5510 Laying open of low anal fistula (fistulotomy) (including sigmoidoscopy) N/A Coding Principles Published Our CMO feels these are separate and either/or procedure and so should not be used together.
05/01/2018 TBA N/A Eminectomy of temporomandibular joint - bilateral New Code Published This is often performed within the NHS and privately but there is no code for it.
05/01/2018 TBA N/A Eminectomy of temporomandibular joint - unilateral New Code Published This is often performed within the NHS and privately but there is no code for it.
04/01/2018 N/A N/A Removal of mass/tumour from deeper tissue New Code Submitted Improves coding structure and adds clarityA surgeon recently billed W0950 - Radical clearance of sarcoma of trunk or limbs with or without amputation or insertion of prosthesis The patient had an undiagnosed mass in the tissue behind her hip which the surgeon said was a more complex procedure than S0653 - Removal of benign lesion in muscle or deeper tissue (excluding lipoma). Our CMO feels there should be a mid-way code for situations like this where it is unknown if the mass is malignant but the code allows for a more complex removal.
04/01/2018 C1341 Blepharoplasty - three or four eyelids N/A Coding Principles Published As discussed in previous meeting please can we add C1341 to unbundle with itself.
21/12/2017 TBA N/A Ligation of the intersphincteric fistula tract (LIFT) for the treatment of anal fistula New Code Published Brand new procedure/testWe have recently dealt with a request for the LIFT procedure from Professor J Scholefield. This is usually performed for complex or deep fistulas and allows the surgeon to access the fistula between the sphincter muscles and avoid cutting them.
19/12/2017 N/A N/A Biodegradable spacer insertion for prostate radiotherapy. New Code Rejected Brand new procedure/testBrand new procedure/test
11/12/2017 J0210 Hemihepatectomy Hemihepatectomy (resection of four or more segments) Narrative Change Published Improves coding structure and adds clarityWe have had issues with some surgeons using J0200 or J0210 for resecting a liver lesion. We thought it might be helpful to alter the narrative in order to make it clear that these codes should only be used for resecting segments of the liver. Another option would be to publish some guidance in the CCSD schedule as we've done in the past.
11/12/2017 J0200 Partial hepatectomy Partial hepatectomy (left hepatectomy or resection of up to three segments) Narrative Change Published Improves coding structure and adds clarity We have had issues with some surgeons using J0200 or J0210 for resecting a liver lesion. We thought it might be helpful to alter the narrative in order to make it clear that these codes should only be used for resecting segments of the liver. Another option would be to publish some guidance in the CCSD schedule as we've done in the past.
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