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 laser myomectomy.
Further recommendations have been made as part of the clinical guideline on heavy menstrual bleeding published in January 2007. Clinical and cost-effectiveness evidence was reviewed in the development of this guideline which has led to this more specific recommendation. The IP guidance on Laparoscopic laser myomectomy disease remains current, and should be read in conjunction with the clinical guideline.
This procedure is used to treat uterine fibroids (leiomyomas).
Fibroids are benign tumours of the uterine muscle. They are very common. They may cause pain, heavy menstrual bleeding (menorrhagia) and reduced fertility.
Hysterectomy is the standard treatment for women with fibroids whose symptoms have not resolved with medical treatment. Laparoscopic myomectomy is the destruction of fibroids via a laparoscope passed through a small incision in the abdomen and then through the wall of the uterus. The fibroids may be destroyed with a laser or electrocautery.
Q09.2 Open myomectomy
Y75.2 Laparoscopic approach to abdominal cavity NEC
Y08.4 Laser destruction of lesion of organ NOC
The NHS Classifications Service has advised NICE that currently these are the most suitable OPCS-4 codes to describe this procedure. The OPCS-4 classification is designed to categorise procedures for analysis and it is not always possible to identify a procedure uniquely.
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