Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism

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 Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism.

It replaces the previous guidance on Percutaneous occlusion of the left atrial appendage for atrial fibrillation, IPG181, June 2006.

Description

Atrial fibrillation (AF) is the irregular and rapid beating of the upper two chambers of the heart (the atria) which increases the risk of stroke. In people with AF, blood clots often form in the left atrial appendage, which is a small sac off the left atrium. These clots can travel in the blood to the brain, where they may block the blood flow, causing a stroke. In this procedure, a special device is inserted that blocks the mouth of the left atrial appendage in order to prevent migration of the blood clot.

NICE Pathways

This guidance has been incorporated into the following NICE Pathways, along with other related guidance and products.

Visit the NICE Pathway: stroke

OPCS4.6 Code(s):

K57.8 Other specified other therapeutic transluminal operations on heart 

Y07.5 Occlusion of organ NOC

Y53.- Approach to organ under image control

Z33.6 Atrium of heart

Note:  U20.2Transoesophageal echocardiography is also assigned when transoesophageal echocardiography (TOE) is used during the procedure.

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 I48.X Atrial fibrillation and flutter would be recorded.

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

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Links:

	IPG349 Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism (review of IPG181): guidance	23 June 2010
	IPG349 Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism (review of IPG181): guidance (web format)	07 April 2011
	IPG349 Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism (review of IPG181): understanding NICE guidance	23 June 2010
	IPG349 Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism (review of IPG181): understanding NICE guidance (MS Word format)	23 June 2010
	IPG349 Blocio atodyn atrïaidd chwith y galon er mwyn atal strôc mewn ffibriliad atrïaidd nad yw'n falfaidd, gan ddefnyddio cathetr: deall canllawiau NICE	21 July 2010
	Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism (review of IPG181): consultation comments table	23 June 2010
	Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism - Interventional Procedures Consultation Document	22 February 2010
	Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism - Interventional Procedures Overview	22 February 2010