Magnetic resonance (MR) image-guided percutaneous laser ablation of uterine fibroids

NICE interventional procedure guidance [IPG30] Published date:

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The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on magnetic resonance (MR) image-guided percutaneous laser ablation of uterine fibroids.

 

As part of the NICE's work programme, the current guidance was considered for review in May 2009  but did not meet the review criteria as set out in the IP process guide. The guidance below therefore remains current.

  • Description

    This procedure is used to treat uterine fibroids (also known as uterine leiomyomas or uterine myomas).

    Symptoms caused by fibroids include abnormal bleeding, pelvic pressure and pain, and reproductive problems.  Fibroids are common and are the most frequent reason for a woman to have a hysterectomy.

    Magnetic resonance (MR) image guided percutaneous laser ablation is a minimally invasive technique for the treatment of uterine fibroids. Patients are given intravenous sedation and analgesia and a catheter is placed in the bladder.

    Under MR guidance needles are inserted into the centre of the targeted uterine fibroid through an area of skin that has been anaesthetised. Bare laser fibres are inserted down the centre of each of the needles into the targeted fibroid. Laser energy is then used to destroy the fibroid.

    A thermal mapping sequence is then used to depict the extent of the heated tissue in the target area as the procedure is carried out. Each procedure may involve up to three successive power applications in an overlapping manner to cover as much of the target fibroid as possible whilst monitoring the exact site of heat deposition with thermal mapping.

  • OPCS4.6 Code(s)

    Procedure

    SNOMED CT preferred term (concept ID)

    MRI guided percutaneous laser ablation of uterine fibroid (822231000000105)

     

    OPCS-4.7

    Q20.8 Other specified other operations on uterus

    Y08.4 Laser destruction of lesion of organ NOC

    Y53.7 Approach to organ under magnetic resonance imaging control

    In addition the ICD-10 code from category D25.- Leiomyoma of uterus would be recorded.

    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

     

    Diagnosis or health condition

    SNOMED CT preferred term (concept ID)

    Uterine leiomyoma (95315005)           

    SNOMED CT provides clinical terms for entry into the patient record to store clinical information relevant to that encounter. The mandated classifications (OPCS-4 or ICD-10) provide a method to collect and aggregate data to allow accurate and consistent data analysis.

    The Clinical Classifications Service of the Health and Social Care Information Centre 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 Clinical Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. Clinical Classifications Service — Health and Social Care Information Centre

     

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