The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on fetal cystoscopy for diagnosis and treatment of lower urinary outflow tract obstruction.

Description

Lower urinary outflow tract obstruction prevents an unborn baby from passing urine. This can reduce the volume of amniotic fluid, and can cause problems with development of the baby's lungs and kidneys. Fetal cystoscopy is a procedure in which a flexible endoscope (a special video camera) is inserted into the baby's bladder to identify the cause of obstruction and to guide treatment in order to allow urine to pass freely.

Coding recommendations

Depending on whether the procedure is diagnostic or therapeutic, either:

R02.8 Other specified diagnostic endoscopic examination of fetus

or

R01.8 Other specified therapeutic endoscopic operations on fetus

A code from Y95.- Gestational age must be assigned in a subsidiary position where this information is available.

Y53.2 Approach to organ under ultrasonic control

A site code can be added as appropriate

Note: If both diagnostic and therapeutic procedures are carried out together, only the code for the therapeutic procedure would be needed.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.