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 full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Radiation therapy for early Dupuytren's disease.


In Dupuytren’s disease, connective tissue in the hands (called the palmar fascia) becomes thickened and shortened (contracted). This causes ridges in the palm, and stiff fingers that bend towards the palm and cannot be straightened.

The aim of treatment is to soften the contracted tissue to allow the patient to regain use of their hand. Radiation therapy for early Dupuytren’s disease involves directing low energy X-rays at the affected tissue with the aim of stopping the disease becoming more widespread. Treatment can be repeated in some patients.

Coding recommendations

X65.4 Delivery of a fraction of external beam radiotherapy NEC

Y91.3 Superficial or orthovoltage treatment for radiotherapy

Z89.4 Hand NEC

In addition ICD-10 code M72.0 Palmar fascial fibromatosis [Dupuytren] is assigned.

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