The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Radiofrequency cold ablation for respiratory papillomatosis.


Respiratory papillomatosis is a condition in which non-cancerous wart-like growths called papillomas grow in the throat or airways. It affects both children and adults and can causes voice changes and shortness of breath. The condition is caused by the human papillomavirus and can keep coming back after treatment. This procedure aims to dissolve or shrink the papillomas using an electric current. The procedure uses a lower temperature than other treatments, with minimal heat damage to surrounding healthy tissue.

Coding recommendations

When performed on the larynx:

E35.3 Endoscopic destruction of lesion of larynx

Y10.1 Coblation of organ NOC

When performed on sites below the larynx:

E48.3 Fibreoptic endoscopic destruction of lesion of lower respiratory tract NEC

Y10.1 Coblation of organ NOC

Plus one or more of the following site codes, depending on the site(s) of treatment:

Z24.3 Trachea

Z24.4 Carina

Z24.5 Bronchus

In addition an ICD-10 code from D14.1 Benign neoplasm of larynx, D14.2 Benign neoplasm of trachea, D14.3 Benign neoplasm of bronchus and lung or D14.4 Benign neoplasm of respiratory tract, unspecified plus B97.7 Papillomavirus as the cause of disease classified to other chapters are assigned.

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, 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.

  • National Institute for Health and Care Excellence (NICE)