The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Irreversible electroporation for treating primary liver cancer.


Primary liver cancer is cancer that begins inside the liver. The most common primary liver cancers are hepatocellular carcinoma and cholangiocarcinoma. Irreversible electroporation is a process that uses electrical pulses to kill cancer cells. It is applied directly to the tumour through special needles. The main difference between this procedure and thermal techniques for destroying tumours is that it does not produce extreme heat or cold.

Coding recommendations

Percutaneous approach with image guidance:

J12.8 Other specified other therapeutic percutaneous operations on liver
Y12.3 Electrochemotherapy to lesion of organNOC
Y53.- Approach to organ under image control

In addition ICD-10 code C22.9 Malignant neoplasm of liver, unspecified 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.

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. 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.

  • National Institute for Health and Care Excellence (NICE)