Balloon angioplasty of pulmonary vein stenosis in infants

NICE interventional procedures guidance [IPG75] 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 of pulmonary vein stenosis in infants.

As part of the NICE's work programme, the current guidance was considered for review but did not meet the review criteria as set out in the IP process guide. The guidance below therefore remains current.

  • Description

    This procedure is used to treat pulmonary vein stenosis.

    Pulmonary vein stenosis (narrowing) may be congenital, or acquired following surgery to correct other congenital cardiac anomalies. It is rare. Untreated, it leads to severe lung damage. It is often associated with other cardiac abnormalities.

    Balloon angioplasty of pulmonary vein stenosis, sometimes combined with stenting, is a palliative treatment of children with a very poor prognosis, or sometimes a temporary measure for children awaiting further interventions.

    The procedure involves dilatation of the narrowing using a balloon, during a transarterial cardiac catheterisation procedure. A stent may be inserted following dilatation to maintain patency. There is no reliable alternative treatment.

  • OPCS4.6 Code(s)

    With stenting:

    L80.4 Percutaneous transluminal insertion of stent into pulmonary vein

    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

    Without stenting:

    L80.2 Percutaneous transluminal balloon angioplasty of pulmonary vein

    Y53.- Approach to organ under image control


    L80.3 Percutaneous transluminal cutting balloon angioplasty of pulmonary vein

    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.

    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.

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