Laparoscopic radical hysterectomy for early stage cervical cancer

NICE interventional procedures guidance [IPG338] 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 Laparoscopic radical hysterectomy for early stage cervical cancer.

It replaces the previous guidance on Laparoscopic radical hysterectomy for early stage cervical cancer (Interventional Procedures Guidance no. 24).  

  • Description

    This procedure is used to treat stage I or IIA cervical cancer.

    Radical hysterectomy involves surgical removal of the uterus, the supporting ligaments and the upper vagina, together with removal of the pelvic lymph nodes and sometimes the para-aortic lymph nodes. A standard radical hysterectomy is performed through an incision in the abdomen. Laparoscopic radical hysterectomy is a minimally invasive procedure that aims to achieve the same excision via a laparoscopic approach.

  • OPCS4.6 Code(s)

    One of the following OPCS-4 codes is selected:

     

    Q07.1 Abdominal hysterocolpectomy and excision of periuterine tissue

    Q07.2 Abdominal hysterectomy and excision of periuterine tissue NEC

     

    The following code is assigned directly after one of the above codes:

     

    Y75.2 Laparoscopic approach to abdominal cavity NEC

     

    For the removal of the lymph nodes one, or a combination, of the following codes is assigned depending on which lymph nodes are removed and if excision or block dissection is performed:

     

    T85.4 Block dissection of para-aortic lymph nodes

    T85.6 Block dissection of pelvic lymph nodes

    T87.5 Excision or biopsy of para-aortic lymph node

    T87.8 Other specified excision or biopsy of lymph node

     

    The following code is assigned directly after each of the above codes:

     

    Y75.2 Laparoscopic approach to abdominal cavity NEC

    In addition an ICD-10 code from category C53.- Malignant neoplasm of cervix uteri 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

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