Hybrid procedure for interim management of hypoplastic left heart syndrome in neonates
Summary
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on the hybrid procedure for interim management of hypoplastic left heart syndrome in neonates.
Description
Some babies are born with a poorly developed left side of their heart. The hybrid procedure is a combination of surgical and 'endovascular' techniques to help establish blood flow to and from the left side of the heart. It is performed soon after birth with the aim of delaying more major surgery until the baby is older and better able to withstand it.
The hybrid procedure involves both surgery, in which bands are placed around the branches of the pulmonary artery, and catheterisation techniques, in which stents (metal mesh tubes) are inserted to keep the ductus arteriosus open.
OPCS code:
L03.2 Percutaneous transluminal stent implantation into arterial duct
L76.- Endovascular placement of stent or L89.- Other endovascular placement of stent
L12.1 Application of band to pulmonary artery
Y49.1 Median sternotomy approach
If endovascular banding of pulmonary artery is carried out, then L13.8 Other specified transluminal operations on pulmonary artery is assigned, instead of L12.1 and Y49.1
K16.1 Percutaneous transluminal balloon atrial septostomy
Y53.- Approach to organ under image control
Note: The individual components of the hybrid procedure may be carried out synchronously or may be staged depending on individual patient need.
Codes within categories L76.- and L89.- are used to specify the type of stent used; if the type of stent is not specified in the clinical record L76.9 Unspecified endovascular placement of stent is assigned.
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.
In addition the ICD-10 code Q23.4 Hypoplastic left heart syndrome would be recorded on the baby’s record.
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
British Paediatric Cardiac Association
Paediatric Intensive Care Society
Royal College of Paediatrics and Child Health
Society for Cardiothoracic Surgery in Great Britain and Ireland
British Cardiovascular Intervention Society
Contact details:
(for general enquiries or comments)
Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA
