The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on intramuscular diaphragm stimulation for ventilator-dependent chronic respiratory failure due to neurological disease.


Some patients with spinal cord injuries cannot breathe on their own and require a mechanical ventilator to assist them. Intramuscular diaphragm stimulation involves keyhole abdominal surgery (laparoscopy) to implant electrodes into the breathing muscle (diaphragm) close to its main nerve supply. Wires are connected through the skin to a battery-operated electrical stimulation system which causes the diaphragm to contract as it does in normal breathing. The aim of the procedure is to allow patients to breathe without mechanical assistance and to improve their quality of life.

Coding recommendations

A70.1 Implantation of neurostimulator into peripheral nerve

Y75.2 Laparoscopic approach to abdominal cavity NEC

Z53.1 Diaphragm

In addition an ICD-10 code from category J96.- Respiratory failure, not elsewhere classified and a code to describe the specific type of neurological disease are assigned.

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