The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Electrocautery cutting balloon treatment for pelviureteric junction obstruction.
Pelviureteric junction obstruction is a condition caused by a narrowing of the funnel-shaped part of the kidney (known as the renal pelvis) where urine collects before being carried to the bladder by tubes called ureters. The obstruction may cause episodes of loin pain and/or nausea and vomiting, urinary infections and kidney stones. In some patients the condition could also affect the normal function of the kidney.
This procedure (electrocautery cutting balloon treatment) aims to widen the renal pelvis by inserting a catheter with a balloon and wire into the urinary tract. The wire is used to cut away the tissue that is causing the obstruction.
The correct OPCS-4 codes required to classify this procedure are:
M10.8 Other specified other therapeutic endoscopic operations on kidney
Y17.1 Electrocauterisation of lesion of organ NOC
Y53.4 Approach to organ under fluoroscopic control
Note: Where a stent is inserted during the procedure a code from category Y14.- Placement of stent in organ NOC is also assigned, following Y13.1, to classify the type of stent used.
In addition the ICD-10 code N13.5 Kinking and stricture of ureter without hydronephrosis is assigned.
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.