Guidance
August 2016 - NICE is updating this guidance (see the in development page for information). The NHS should continue to follow the recommendations in this guidance until the update is complete.
The National Institute for Health and Clinical Excellence (NICE) has issued updated full guidance to the NHS in England, Wales, Scotland and Northern Ireland on hysteroscopic sterilisation by tubal cannulation and placement of intrafallopian implants.
June 2016 – Please note NICE is updating its guidance on hysteroscopic sterilisation by tubal cannulation and placement of intrafallopian implants as it is aware of a growing number of reported adverse events in relation to this procedure.
Description
Sterilisation results in the inability to conceive children naturally. It is sometimes chosen as a method of birth control and is usually permanent. In women, hysteroscopic sterilisation by tubal cannulation and placement of intrafallopian implants is used to block the fallopian tubes, with the aim of preventing the eggs from reaching the womb and becoming fertilised. The procedure is performed by passing a small camera and tube (hysteroscope) through the vagina and cervix. A very small implant called a microinsert is placed into each fallopian tube using specialised narrow surgical instruments that are passed through the hysteroscope. The presence of the microinserts causes scar tissue to form in the fallopian tubes, which eventually blocks them.
Coding recommendations
Q35.4 Endoscopic bilateral placement of intrafallopian implants
Includes: Hysteroscopic placement of intrafallopian implants
Or if there is only one remaining solitary fallopian tube the OPCS-4 code is:
Q36.2 Endoscopic placement of intrafallopian implant into remaining solitary fallopian tube Includes: Hysteroscopic placement of intrafallopian implant into remaining solitary fallopian tube.
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.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.