The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Extracranial to intracranial bypass for intracranial atherosclerosis.

It replaces the previous guidance on High-flow interposition extracranial to intracranial bypass, IPG73, July 2004.

  • Description

    In intracranial atherosclerosis disease, blood vessels (arteries) in the head can become narrowed or blocked. An extracranial to intracranial bypass is an operation to join a blood vessel outside the skull to one inside the skull, bypassing the problem. The aim is to maintain and improve blood supply to the brain to prevent stroke.

  • OPCS4.6 Code(s)

    L29.6 High-flow interposition extracranial to intracranial bypass from external carotid artery to middle cerebral artery


    L29.7 Bypass of carotid artery by anastomosis of superficial temporal artery to middle cerebral artery


    L29.8 Other specified reconstruction of carotid artery

     Note: L29.8 is used to capture all other extracranial to intracranial bypass procedures not included at L29.6 or L29.7. Additional codes are required if a graft is utilised.

    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.

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