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.

Coding recommendations

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

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