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 laser revascularistion for refractory angina pectoris. Full guidance has also been published on laser transmyocardial revascularistion for refractory angina pectoris.
Patients with refractory angina pectoris have chest pain (because of insufficient oxygen delivery to their heart muscle) that cannot be controlled by optimal medical or surgical management. Percutaneous laser revascularisation involves insertion of a catheter into major vessels of the groin, which is advanced to the heart, to drill holes on the heart muscle using a laser beam. The aim is to enable blood flow from the heart chambers into the heart muscle, to relieve myocardial ischaemia and reduce chest pain.
K23.4 Revascularisation of wall of heart
Includes: Revascularisation of heart
Y08.5 Laser modification of organ NOC
Y53.4 Approach to organ under fluoroscopic 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.
Note: U20.1 Transthoracic echocardiography, U20.2 Transoesophageal echocardiography, U20.3 Intravascular echocardiography or U20.4 Epicardial echocardiography is also assigned when echocardiography is used during the procedure.
In addition a code from the ICD-10 category I20.- Angina pectoris would be recorded.
The NHS 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 NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. http://systems.hscic.gov.uk/data/clinicalcoding