Epithelial radiofrequency ablation for Barrett's oesophagus
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 Epithelial radiofrequency ablation for Barrett's oesophagus.
It replaces the previous guidance on Circumferential epithelial radiofrequency ablation for Barrett's oesophagus (Interventional Procedures Guidance no. 244 November 2008).
Further recommendations have been made as part of the clinical guideline on Barrett’s oesophagus – ablative therapy published in August 2010, as follows:
Consider using radiofrequency ablation alone or photodynamic therapy alone for flat high-grade dysplasia, taking into account the evidence of their long-term efficacy, cost and complication rates.
Clinical and cost-effectiveness evidence was reviewed in the development of this guideline which has led to this more specific recommendation. More information is available from http://guidance.nice.org.uk/CG106. The IP guidance on epithelial radiofrequency ablation for Barrett’s oesophagus remains current, and should be read in conjunction with the clinical guideline.
Description
Barrett's oesophagus is a condition characterised by an abnormal lining of the oesophagus, which occurs in patients with a long history of heartburn and gastro-oesophageal reflux disease. In a minority of people Barrett's oesophagus may progress through a series of stages (dysplasia) to cancer.
Circumferential ablation employs a balloon-mounted coil a few centimetres in length on a probe inserted under endoscopic guidance into the targeted area of the oesophagus. The coil delivers a controlled emission of radiofrequency energy to ablate the tissue of the lining of the oesophagus to a thin depth. The probe is repositioned and further energy delivered in cases with large / long areas of Barrett's oesophagus. Repeat treatments may be necessary.
OPCS4.6 Code(s):
G14.5 Fibreoptic endoscopic destruction of lesion of oesophagus NEC
Y13.4 Radiofrequency controlled thermal destruction of lesion of organ NOC
When the examination is not limited to just the oesophagus, the following OPCS-4 codes are assigned:
G43.5 Fibreoptic endoscopic destruction of lesion of upper gastrointestinal tract NEC Y13.4 Radiofrequency controlled thermal destruction of lesion of organ NOC
Z27.1 Oesophagus
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
Association of upper Gastrointestinal Surgeons of GB and Ireland
British Society of Gastroenterology
Association of Cancer Physicians
Contact details:
(for procedure specific enquiries or comments)
ip@nice.org.uk
Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA
Links:
This page was last updated: 04 April 2011
