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.
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
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