The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Insertion of endobronchial valves for lung volume reduction in emphysema.

This guidance updates and replaces NICE interventional procedure 318 (November 2009).


Emphysema is a long-term progressive disease of the lungs that causes difficulty in breathing. It is included in a group of diseases called chronic obstructive pulmonary disease, or COPD. In emphysema, there is damage to the lung tissue. This can lead to the lungs becoming over inflated.

In the insertion of endobronchial valves, a small flexible camera is moved down the windpipe and small one-way valves are inserted into selected airways (3 or 4 valves are usually inserted). The aim of the procedure is to prevent air entering the diseased parts of the lung which then collapse.

Coding recommendations

E54.6 Reduction of lung volume

Y74.8 Other specified minimal access to thoracic cavity

Y02.2 Insertion of prosthesis into organ NOC

In addition an ICD-10 code from category J43.- Emphysema 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. 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)