High-intensity focused ultrasound for atrial fibrillation in association with other cardiac surgery

NICE interventional procedure guidance [IPG184] Published date:

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The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on High intensity focused ultrasound ablation of atrial tissue for atrial fibrillation as an associated procedure with other cardiac surgery in July 2006. In accordance with the Interventional Procedures Programme process guide, guidance on procedures with special arrangements are reviewed 3 years after publication and the procedure is reassessed if important new evidence is available.

The guidance was considered for reassessment in October 2009 and it was concluded that NICE will not be updating this guidance at this stage. However, if you believe there is new evidence which should warrant a review of our guidance, please contact us via the email address below.

  • Description

    Atrial fibrillation (AF) is the irregular and rapid beating of the upper two chambers of the heart (the atria). This is caused by a disruption in the electrical impulses that control the heartbeat. Symptoms, if present, can include palpitations, dizziness, breathlessness and fatigue. This procedure uses an ultrasound device to send a focused beam of ultrasound energy to burn and destroy a targeted area of the heart in order to disrupt the abnormal electrical impulses.

  • OPCS4.6 Code(s)

    Procedure

    SNOMED CT preferred term (concept ID)

    High intensity focused ultrasound ablation of left atrium (853811000000105)

     

    OPCS-4.7

    One of the following codes would be assigned:

    K52.1 Open ablation of atrioventricular node

    K52.8 Other specified open operations on conducting system of heart

    The following code would be assigned in addition to one of the above codes:

    Y11.5 Ultrasonic destruction of  organ NOC

    If code K52.8 is chosen, the site code Z33.6 Atrium of heart is assigned following Y11.5.

    Note: Codes are for patients undergoing concomitant open-heart surgery.

    In addition ICD-10 code I48.X Atrial fibrillation and flutter would be recorded.

    The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding

     

    Diagnosis or health condition

    SNOMED CT preferred term (concept ID)

    Atrial fibrillation (49436004)    

    SNOMED CT provides clinical terms for entry into the patient record to store clinical information relevant to that encounter. The mandated classifications (OPCS-4 or ICD-10) provide a method to collect and aggregate data to allow accurate and consistent data analysis.

    The Clinical Classifications Service of the Health and Social Care Information Centre is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.  The Clinical Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. Clinical Classifications Service — Health and Social Care Information Centre

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