Transcatheter aortic valve implantation for aortic stenosis

NICE interventional procedures guidance [IPG421] 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 Trancatheter aortic valve implantation for aortic stenosis.

This document replaces previous guidance on Trancatheter aortic valve implantation for aortic stenosis (interventional procedure guidance IP 685).

  • Description

    Catheter insertion of a new aortic valve to treat aortic stenosis.

    Aortic stenosis occurs when the aortic valve, which separates the main pumping chamber of the heart from the circulation, becomes partially narrowed. This reduces the flow of blood out of the heart. Transcatheter aortic valve implantation may be an alternative to surgical valve replacement in patients for whom conventional aortic valve replacement is not suitable, or who at very high risk. The procedure is performed through a tube, which is usually inserted into a large blood vessel at the top of the leg or elsewhere (transluminal approach), but it is sometimes also inserted into the apex of the heart (transapical approach). Through this tube, a replacement valve is inserted and deployed over the faulty native valve.

  • OPCS4.6 Code(s)

    Transluminal approach:

    K26.2 Xenograft replacement of aortic valve

    Y79.- Approach to organ through artery

    Y53.- Approach to organ under image control

    Note: 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.

     

    Transapical / transventricular approach:

    K26.2 Xenograft replacement of aortic valve

    Y49.4 Transapical approach to heart

    The NHS Classifications Service has advised NICE that currently these are the most suitable OPCS-4 codes to describe this procedure. The OPCS-4 classification is designed to categorise procedures for analysis and it is not always possible to identify a procedure uniquely.

    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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