The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on percutaneous intradiscal electrothermal therapy for low back pain.

It replaces the previous guidance on percutaneous intradiscal electrothermal therapy for lower back pain (Interventional Procedures Guidance no. 81, August 2004).  

  • Description

    In some patients, low back pain is thought to occur when one or more of the tough discs that sit between the bones (vertebrae) in the spine become worn. This procedure involves inserting a needle into the affected disc (a video image similar to an X-ray is used to help find the correct position). A narrow tube is then passed through the needle into the disc. The tube is heated slowly and kept in place for a few minutes.

  • OPCS4.6 Code(s)

    V52.2 Destruction of intervertebral disc NEC

    V55.- Levels of spine

    Y10.2 Electrocauterisation of organ

    Y53.- Approach to organ under image control

    Z99.- Intervertebral disc

    The Clinical 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.

    Note: Codes within category V55.-  are assigned in second place each time a spinal operation is coded: if the levels of spine are not specified, V55.9 Unspecified levels of spine is used.


    Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control: if the method of image control is unspecified, Y53.9 Unspecified approach to organ under image control is assigned.

    The NHS 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 NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.


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