The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on total wrist replacement.
Arthritis is a condition that causes swelling and damage to the cartilage and bone around the joints, including the wrist. It is painful and can reduce the function of the joint. Total wrist replacement aims to create an artificial wrist joint consisting of metal implants attached to the end of the arm and to the hand, separated by a spacer to allow movement of the hand.
A code from one of the following categories is selected as appropriate:
W43.- Total prosthetic replacement of other joint using cement
W44.- Total prosthetic replacement of other joint not using cement
W45.- Other total prosthetic replacement of other joint
Plus an additional site code Z82.9 Joint of wrist or hand NEC
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.