The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on intraoperative nerve monitoring during thyroid surgery.


The thyroid gland lies close to the vocal cords and the nerves that control movement of the vocal cords (recurrent laryngeal nerves). When surgery is performed on the thyroid gland, a nerve monitor is sometimes used during the operation with the aim of helping to prevent potential damage to the nerves.

Coding recommendations

The procedure undertaken on the thyroid would be coded using the appropriate OPCS-4 codes. It is not possible to classify the use of intraoperative nerve monitoring during the procedure using OPCS-4 codes.