The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on laparoscopic radical prostatectomy in November 2006.It replaces the previous guidance on 'Laparoscopic radical prostatectomy‘ (Interventional Procedures Guidance no. 16, October 2003).
NICE has also published a clinical guideline on prostate cancer in February 2008, available from www.nice.org.uk/cg58.
This procedure is used to treat localised prostate carcinoma. It involves the insertion of a laparoscope and a four trocars through the abdominal wall. The prostate, adjacent tissue and lymph nodes are separated and removed and the urethra reconnected.
One of the following OPCS-4 codes is selected:
M61.1 Total excision of prostate and capsule of prostate
M61.8 Other specified open excision of prostate
Plus a relevant code to identify intra-peritoneal laparoscopic approach from:
Y75.1 Laparoscopically assisted approach to abdominal cavity
Y75.2 Laparoscopic approach to abdominal cavity NEC
Y75.5 Laparoscopic ultrasonic approach to abdominal cavity
Or one of the following codes to identify extra-peritoneal approach:
Y76.5 Robotic assisted minimal access approach to other body cavity
Y76.8 Other specified minimal access to other body cavity
Note: The codes M61.1 and M61.8 do not include any associated lymph node removal, and associated lymph node removal is classified with an additional code from categories T85-T87.
In addition the ICD-10 code C61.X Malignant neoplasm of prostate would be recorded if the prostatectomy took place for cancer of prostate.
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