NICE's guidance on coblation tonsillectomy has now been superceded. Please go to www.nice.org.uk/ipg150 to view the full guidance on electrosurgery (diathermy and coblation) for tonsillectomy issued to the NHS in England, Wales, Scotland and Northern Ireland.
This procedure is used to treat recurrent or chronic tonsillar infection, tonsillar hypertrophy leading to respiratory symptoms or airway obstruction, peritonsillar abscess and recurrent middle ear infection where tonsillar hypertrophy is believed to be an exacerbating factor. Life-threatening complications of these conditions are rare and the main aim of surgery is to relieve symptoms.
About 45,000 people had a tonsillectomy in 2000/2001 in England. About 60% of procedures were carried out in children under the age of 15 (Source: Department of Health Hospital Episode Statistics 2000/2001, data unadjusted for missing or incomplete data).
The technique employs a bipolar probe to generate a radiofrequency electrical current . This produces a flow of sodium ions, which destroys surrounding tissue. The probe is used to dissect out the tonsil while cauterising any blood vessels, which may be identified with an operating microscope.
Coblation probes heat surrounding tissues less than standard diathermy probes (operating temperature is 60ºC with coblation v >100ºC with standard diathermy).
F34.7 Bilateral coblation tonsillectomy
Note: Use a supplementary code for concurrent excision of adenoid (E20.1)
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