The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Laparoscopic cryotherapy for renal cancer.
It replaces the previous guidance on cryotherapy for renal cancers (NICE interventional procedures guidance 207, January 2007).
Renal cancer occurs in the lining of the very small tubes in the kidney. Cryotherapy involves applying freezing temperatures to the tumour by inserting a surgical instrument (cryoprobe) through several small incisions in the abdomen (‘keyhole’ surgery), with the aid of an internal telescope and camera system (laparoscope). The aim is to destroy cancer cells.
M10.4 Endoscopic cryoablation of lesion of kidney
Y53.- Approach to organ under image control
M04.3 Open destruction of lesion of kidney
Y75.2 Laparoscopic approach to abdominal cavity NEC
Y13.2 Cryotherapy to lesion of organ NOC
Note: Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control: if the method of image control is unspecified, Y53.9 Unspecified approach to organ under image control is assigned.
Both coding solutions have been given as historically both have been used for laparoscopic cryotherapy, the first combination should be used in preference.
In addition the ICD-10 code C64.X Malignant neoplasm of kidney, except renal pelvis or C65.X Malignant neoplasm of renal pelvis or C79.0 Secondary malignant neoplasm of kidney and renal pelvis would be recorded.
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, and specifically any special arrangements relating to the introduction of new interventional procedures. 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.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
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. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
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.