The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on laparoscopic uterine nerve ablation (LUNA) for chronic pelvic pain.
Pelvic pain in women can have a number of causes, including endometriosis (a condition in which tissue that is normally found lining the inside of the womb also occurs outside the womb, usually in the pelvic cavity). In many cases of pelvic pain, the cause is unknown. Laparoscopic uterine nerve ablation (LUNA) involves the destruction of a small segment of ligament that carries nerve fibres within the pelvis.
A60.8 Other specified destruction of peripheral nerve
Y75.2 Laparoscopic approach to abdominal cavity NEC
Z11.8 Specified sacral plexus NEC
In addition the ICD-10 code R10.2 Pelvic and perineal pain would be recorded if the cause of the pain is unknown.
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.