The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on electrically-stimulated intravesical chemotherapy for superficial bladder cancer.
This procedure, also known as electromotive drug administration (EMDA) of intravesical chemotherapy, can be used for patients with bladder cancer, either before or after surgery. A solution including a chemotherapy drug is injected into the bladder using a thin tube inserted through the urethra. At the same time, an electrode is inserted in the bladder and other electrodes are placed on the skin of the lower abdomen. An electric current is then created with the aim of improving absorption of the chemotherapeutic drugs.
This would be recorded using the codes for intravesical chemotherapy as there is no current way to identify ‘electrically-stimulated’ using OPCS-4 codes.
Intravesical instillation of chemotherapy is coded by using M49.4 Introduction of therapeutic substance into bladder, followed by the appropriate combination of chemotherapy codes from categories X70-X73 depending on which chemotherapy regimen is administered.
In addition an ICD-10 code from category C67.- Malignant neoplasm of bladder or C79.1 Secondary malignant neoplasm of bladder and other and unspecified urinary organs 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. www.connectingforhealth.co.uk/clinicalcoding