The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Endoscopic radiofrequency therapy of the anal sphincter for faecal incontinence.
Faecal incontinence occurs when a person loses (often only partially) voluntary control of their bowel movements, resulting in leakage of faeces. The condition may relate to inadequate formation of the anus from birth. It can also relate to diseases of the nervous system (such as spina bifida, spinal cord injury, multiple sclerosis), pelvic organ prolapse, or previous pelvic surgery or radiotherapy. In women, another cause is injury to the anal canal during childbirth. In this procedure, radiofrequency energy is applied to the anal wall, with the aim of inducing muscle changes to improve muscle tone and help control bowel movement.
H57.8 Other specified other operations on the anal sphincter to control continence
In addition ICD-10 code R15.X Faecal incontinence is assigned.
The NHS Classifications Service has advised NICE that currently these are the most suitable OPCS-4 codes to describe this procedure. The OPCS-4 classification is designed to categorise procedures for analysis and it is not always possible to identify a procedure uniquely.
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.