The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on intravesical microwave hyperthermia with intravesical chemotherapy for superficial bladder cancer.

The guidance was considered for reassessment in January 2011 and it was concluded that NICE will not be updating this guidance at this stage. However, if you believe there is new evidence which should warrant a review of our guidance, please email


This procedure is used for early-stage bladder cancer, and may be used before or after surgery. Solutions of chemotherapeutic drugs are delivered into the bladder using a thin tube inserted through the urethra. At the same time, an antenna placed inside the bladder emits microwaves that heat up the bladder lining. The heating is intended to damage the cancer cells and enhance the effect of the chemotherapeutic drugs.

Coding recommendations


SNOMED CT preferred term (concept ID)

Intravesical microwave hyperthermia (840911000000106)

Bladder instillation of anticarcinogenic agent (44194005)

This type of heated chemotherapy cannot currently be specifically captured using OPCS-4. 

At present this is captured using the following codes:

M49.4 Introduction of a therapeutic substance into bladder

X70-X71 Procurement  of drugs for chemotherapy for neoplasm Bands 1-10 (depending on the cytotoxic drug used)

X72 Delivery of chemotherapy for neoplasm (the delivery code is for outpatients and day cases only)

Y53.2 Approach to organ under ultrasonic control (if used).

In addition an ICD-10 code from category C67. - Malignant neoplasm of bladder is assigned.

Diagnosis or health condition

SNOMED CT preferred term (concept ID)

Carcinoma of urinary bladder, superficial (425231005)

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.