The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on the lumbar infusion test for the investigation of normal pressure hydrocephalus.

  • Description

    Normal pressure hydrocephalus (NPH) is a condition in which a clear, colourless fluid called cerebrospinal fluid (or CSF) accumulates around the brain and spinal cord. Symptoms include abnormal gait, urinary incontinence and impaired cognitive function. NPH can be managed by surgical intervention, for example with shunt surgery. The lumbar infusion test may be useful for selecting those patients who are most likely to benefit from this type of surgery. This test involves the insertion of a lumbar needle through the skin of the lower back into the spinal sac, recording the pressure of the CSF as fluid is infused into the spinal sac.

  • OPCS4.6 Code(s)

    A55.8 Other specified diagnostic spinal puncture

    Y44.2 Monitoring of pressure in organ NOC

    Z06.3 Lumbar spinal cord

    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.

    In addition the ICD-10 code G91.2 Normal-pressure hydrocephalus is assigned.

    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.

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