Percutaneous venoplasty for chronic cerebrospinal venous insufficiency for multiple sclerosis

NICE interventional procedures guidance [IPG420] 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 Percutaneous venoplasty for chronic cerebrospinal venous insufficiency in Multiple Sclerosis.

  • Description

    It is possible that there is a link between blocked veins in the head, neck and chest and progression of multiple sclerosis. This procedure aims to open blocked or narrowed veins by inflating a small balloon in the vein, allowing for better blood flow and a reduction in the symptoms of multiple sclerosis.

  • OPCS4.6 Code(s)

    Without stenting:

    L94.7 Percutaneous transluminal balloon angioplasty of vein NEC

    Y53.- Approach to organ under image control

    Z91.8 Specified vein of upper body NEC

    With stenting:

    L94.5 Percutaneous transluminal insertion of stent into vein NEC

    A supplementary code from L76.- Endovascular placement of stent or  L89.- Other endovascular placement of stent would be added to identify the type and number of stents

    Y53.- Approach to organ under image control

    Z91.8 Specified vein of upper body NEC

    Note: Current coding rules state that when angioplasty and stent procedures are performed concurrently, and individual codes are available for the angioplasty and stent, only the code for the stent insertion is required. This is because the angioplasty is implicit within the code for stent insertion.

     Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control: if the method of image control is unspecified, Y53.9 Unspecified approach to organ under image control is assigned.

    In addition ICD-10 codes I87.1 Compression of vein andG35.X Multiple sclerosis are assigned to identify the stenosed vein(s) and multiple sclerosis.

    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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