Balloon angioplasty with or without stenting for coarctation or recoarctation of aorta in adults and children

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 balloon angioplasty with or without stenting for coarctation or recoarctation of the aorta in adults and children.

Description

Aortic coarctation is a congenital narrowing of part of the aorta, most commonly the aortic arch, usually close to the origin of the left subclavian artery.

Balloon angioplasty of aortic coarctation is a minimally invasive procedure which involves inserting a catheter into a large blood vessel, usually in the groin, and passing it up to the area of narrowing under X-ray control. A balloon is then inflated within the narrowing. A stent (a small tube) may be placed within the narrowing to keep it dilated. Balloon angioplasty and stenting may be carried out as a first treatment (in 'native' coarctation) or if previous surgical or angioplastic treatment fails and coarctation recurs ('recoarctation').

The standard treatment for native and recurrent coarctation involves open chest surgery.

OPCS4.6 Code(s):

Without stenting:

L26.1 Percutaneous transluminal balloon angioplasty of aorta 

Y53.- Approach to organ under image control

With stenting:

L26.5 Percutaneous transluminal insertion of stent into aorta

A supplementary code from L76.- Endovascular placement of stent or  L89.- Other endovascular placement of stent would be added to identify the type and number of stents

Y53.- Approach to organ under image control

Note: Current coding rules state that when angioplasty and stent procedures are performed concurrently, and individual codes are available for the angioplasty and stent, only the code for the stent insertion is required. This is because the angioplasty is implicit within the code for stent insertion.

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 ICD-10 code Q25.1 Coarctation of aorta 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

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Links:

	IPG74 Balloon angioplasty with or without stenting for coarctation or recoarctation of the aorta in adults and children: guidance	28 July 2004
	IPG74 Balloon angioplasty with or without stenting for coarctation or recoarctation of the aorta in adults and children: guidance (web format)	04 February 2011
	IPG74 Balloon angioplasty with or without stenting for coarctation or recoarctation of the aorta in adults and children: understanding NICE guidance	28 July 2004
	IPG74 Angioplasti gan ddefnyddio balw n gyda neu heb stentau i drinachosion lle mae'r aorta wedi'i hamgáu neu wedi'i hail-amgáu mewn oedolion a phlant: deall canllawiau NICE	19 May 2009
	IPG74 Balloon angioplasty with or without stenting for coarctation or recoarctation of the aorta in adults and children: distribution list	28 July 2004
	Interventional procedure consultation document - balloon angioplasty or stenting for coarction or recoarction of the aorta	24 February 2004
	Overview of balloon angioplasty or stenting for coarction or recoarction of the aorta	20 February 2004