Balloon angioplasty with or without stenting for coarctation or recoarctation of the aorta in adults and children

NICE interventional procedures guidance [IPG74] 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 balloon angioplasty with or without stenting for coarctation or recoarctation of the aorta in adults and children.

  • Description

    Aortic coarctation is a congenital narrowing of part of the aorta, most commonly the aortic arch, usually close to the origin of the left subclavian artery.

    Balloon angioplasty of aortic coarctation is a minimally invasive procedure which involves inserting a catheter into a large blood vessel, usually in the groin, and passing it up to the area of narrowing under X-ray control. A balloon is then inflated within the narrowing. A stent (a small tube) may be placed within the narrowing to keep it dilated. Balloon angioplasty and stenting may be carried out as a first treatment (in 'native' coarctation) or if previous surgical or angioplastic treatment fails and coarctation recurs ('recoarctation').

    The standard treatment for native and recurrent coarctation involves open chest surgery.

  • OPCS4.6 Code(s)

    Without stenting:

    L26.1 Percutaneous transluminal balloon angioplasty of aorta 

     

    Y53.- Approach to organ under image control

    With stenting:

    L26.5 Percutaneous transluminal insertion of stent into aorta

    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. Please note that the .8 and .9 codes from extended category L89 must not be used.

     

    Y53.- Approach to organ under image control

    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 code Q25.1 Coarctation of aorta is assigned.

    The Clinical Classifications Service of the Health and Social Care Information Centre 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 Clinical Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. Clinical Classifications Service — Health and Social Care Information Centre

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