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.


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.

Coding recommendations

A55.8 Other specified diagnostic spinal puncture

Y44.2 Monitoring of pressure in organ NOC

Z06.3 Lumbar spinal cord

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