Insertion of metal rib reinforcements to stabilise a flail chest wall

NICE interventional procedures guidance [IPG361] 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 Insertion of metal rib reinforcements to stabilise a flail chest wall.

  • Description

    The condition in which multiple rib fractures allow a segment of the rib cage to move independently from the main chest wall is called a flail chest. The effect compromises breathing and may be life-threatening.

    In this procedure, metal (usually titanium) is used to stabilise the ‘flail’ segment of chest wall. This procedure aims to improve lung function and reduce the length of critical care and hospital stay

  • OPCS4.6 Code(s)

    The following OPCS-4 codes are available:

    W19.8 Other specified primary open reduction of fracture of bone and intramedullary fixation

    W19.9 Unspecified primary open reduction of fracture of bone and intramedullary fixation

    W20.1 Primary open reduction of fracture of long bone and extramedullary fixation using plate NEC

    W20.6 Wiring of sternum

    W20.8 Other specified primary open reduction of fracture of bone and extramedullary fixation

    W20.9 Unspecified primary open reduction of fracture of bone and extramedullary fixation

     

    The following site codes can be added to identify which ribs are involved:

    Z74.3 First rib

    Z74.4 Second to tenth rib

    Z74.5 Eleventh or twelfth rib

    Z74.6 Rib NEC

     

    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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