The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on balloon catheter dilation of paranasal sinus ostia for chronic sinusitis.
Sinusitis occurs when air-filled cavities of the face (the sinuses) become inflamed. Balloon catheter dilation aims to help keep the sinus passages open and unobstructed by gently inflating a small balloon, which is introduced through the nose via a flexible tube.
Depending on which sinus the procedure is performed on one of the following OPCS-4 codes is assigned:
E13.8 Other specified other operations on maxillary antrum
E14.8 Other specified operations on frontal sinus
E15.8 Other specified operations on sphenoid sinus
E17.8 Other specified operations on unspecified nasal sinus
The following three codes are assigned directly after one of the codes listed above:
Y76.1 Functional endoscopic sinus surgery
Y40.3 Balloon dilation of organ NOC
Y53.4 Approach to organ under fluoroscopic control
In addition an ICD-10 code from category J32.- Chronic sinusitis 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, 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.