Coil embolisation of ruptured intracranial aneurysms

Summary

The Interventional Procedures Advisory Committee (IPAC) originally considered this procedure as one procedure, entitled coil embolisation for intracranial aneurysms. However, as a result of comments received during the initial consultation in June 2003, IPAC decided to consider the procedure separately for ruptured intracranial aneurysms and for unruptured intracranial aneurysms.

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on coil embolisation of ruptured intracranial aneurysms.

To be alerted to developments regarding the use of the procedure to treat unruptured intracranial aneurysms please refer to www.nice.org.uk/ip_274.

Description

This procedure is used to treat intracranial aneurysms.  Rupture of intracranial aneurysms has a poor prognosis and can be fatal. 

Standard treatment for ruptured intracranial aneurysm involves open surgery to clip the aneurysms inside the skull. Endovascular techniques techniques involve approaching the aneurysm from inside the diseased blood vessel, avoiding the need for open surgery. 

A thin tube, containing the coil device on a guidewire, is inserted into a large artery, usually in the groin, and passed up into the skull under X-ray control. The coil is placed inside the aneurysm and detached from the guidewire. Multiple coils can be placed the aneurysm through the same tube until the aneurysm is densely packed.

The technique is mainly carried out on ruptured aneurysms but may also be used to treat unruptured aneurysms.

OPCS4.6 Code(s):

The OPCS-4 codes are dependent on the size of the aneurysm:

O01.1 Percutaneous transluminal coil embolisation of small aneurysm of artery

or

O01.2 Percutaneous transluminal coil embolisation of medium aneurysm of artery 

or

O01.3 Percutaneous transluminal coil embolisation of large aneurysm of artery

or

O01.4 Percutaneous transluminal coil embolisation of giant aneurysm of artery

 

If the size of the aneurysm is other specified (.8), or unspecified (.9), then one of the following codes is assigned:

O01.8 Other specified transluminal coil embolisation of aneurysm of artery

or

O01.9  Unspecified transluminal coil embolisation of aneurysm of artery

Note: For balloon assisted coil embolisation a code from category O02.- Transluminal balloon assisted coil embolisation of aneurysm of artery is assigned instead of the above.

 

In addition to the primary procedure code above, two extra codes are both required:

Y53.- Approach to organ under image control

Z35.- Cerebral artery 

Note:  Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control: if the method of image control is unspecified, Y53.9 Unspecified approach to organ under image control is assigned.

 

_{The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding}

Details

Contact details:

Links:

	IPG106 Coil embolisation of ruptured intracranial aneurysms: guidance	26 January 2005
	IPG106 Coil embolisation of ruptured intracranial aneurysms: guidance (Web format)	14 February 2011
	IPG106 Coil embolisation of ruptured intracranial aneurysms: understanding NICE guidance	26 January 2005
	IPG106 Emboleiddio aniwrysmau mewngreuanol sydd wedi rhwygo gan ddefnyddio coil: deall canllawiau NICE	29 May 2009
	Overview of embolisation of intracranial aneurysm	12 October 2004
	Overview of embolisation of intracranial aneurysm	27 May 2003
	Interventional procedures consultation document - embolisation of intracranial aneurysms	27 May 2003