The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on minimally invasive total hip replacement.
It replaces the previous guidance on minimally invasive two-incision surgery for total hip replacement (IPG112, February 2005) and single mini-incision surgery for total hip replacement (IPG152, January 2006).
Hip replacement surgery using a minimally invasive approach may be an option for people with worn or damaged hip joints. This condition is usually due to degeneration of the joint (osteoarthritis), which can make walking painful.
The procedure replaces the damaged hip joint (the top part of the upper leg bone and the socket in the hip bone that it fits into) with an artificial one. In order to undertake the surgery through small incisions without muscle damage, specially designed equipment is used to support the leg and pull back the surrounding tissues so the surgeon can see the joint. X-rays are sometimes used to check the position of the bones and the artificial joint.
A code from one of the following OPCS-4 categories is assigned with the fourth character depending on the type of replacement procedure performed:
W37.- Total prosthetic replacement of hip joint using cement
W38.- Total prosthetic replacement of hip joint not using cement
W39.- Other total prosthetic replacement of hip joint
W93.- Hybrid prosthetic replacement of hip joint using cemented acetabular component
W94.- Hybrid prosthetic replacement of hip joint using cemented femoral component
W95.- Hybrid prosthetic replacement of hip joint using cement
Note: It is not possible to capture the fact that a minimally invasive approach has been performed using OPCS-4 codes.
The OPCS-4 code Y53.4 Approach to organ under fluoroscopic control can be assigned in addition if fluoroscopic guidance 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. www.connectingforhealth.co.uk/clinicalcoding