The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on extracorporeal shockwave therapy for refractory tennis elbow.

Guidance has also been issued on Extracorporeal shockwave therapy for refractory Achilles tendinopathy and Extracorporeal shockwave therapy for refractory plantar fasciitis. It replaces the previous guidance on Extracorporeal shockwave therapy for refractory tendinopathies (plantar fasciitis and tennis elbow) (NICE interventional procedure guidance 139, November 2005).

Description

Tennis elbow is a condition affecting the tendons of the elbow which connect the muscles of the forearm to the upper arm bone. It may be associated with tiny tears in the fibres of the tendon and is usually caused by overuse or injury. Symptoms include pain in the outer part of the elbow, weakness or stiffness. In extracorporeal shockwave therapy, a machine is used to deliver sound waves to the painful area. It is not known exactly how it works, but it is thought that it might stimulate healing of the tendons.

Coding recommendations

Procedure

SNOMED CT preferred term (concept ID)

Extracorporeal shock wave therapy (439794000)

OPCS-4.7

T74.8 Other specified other operations on tendon  

Y53.2 Approach to organ under ultrasonic control (if ultrasound guidance is utilised)

Z55.2 Extensor muscle of forearm

In addition the ICD-10 code M77.1 Lateral epicondylitis would be recorded.

Diagnosis or health condition

SNOMED CT preferred term (concept ID)

Lateral epicondylitis (202855006)

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.

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