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 balloon dilatation for subglottic or tracheal stenosis.


Subglottic or tracheal stenosis is a narrowing of the windpipe between the throat and the lungs, which can cause wheezing, hoarseness and shortness of breath. It most commonly occurs after a person has needed to use a ventilator (breathing machine) and has had a tube down their windpipe for some time. In this procedure, a small balloon is introduced into the narrowed windpipe through an endoscope (a flexible telescope), which is inserted down the throat. The balloon is then gently inflated to widen the narrowed windpipe.

Coding recommendations

Balloon dilatation of tracheal stenosis with the use of a bronchoscope:

E48.8 Other specified therapeutic fibreoptic endoscopic operations on lower respiratory tract

Y40.3 Balloon dilation of organ NOC

Z24.3 Trachea

In addition ICD-10 code J39.8 Other specified diseases of upper respiratory tract or Q32.1 Other congenital malformations of trachea is assigned.

Balloon dilatation of subglottic stenosis with the use of a laryngoscope:

E35.8 Other specified other therapeutic endoscopic operations on larynx

Y40.3 Balloon dilation of organ NOC

In addition ICD-10 code Q31.1 Congenital subglottic stenosis or J95.5 Postprocedural subglottic stenosis is 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)