Guidance
The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Endopyelotomy for pelviureteric junction obstruction.
Description
Pelviureteric junction obstruction is a condition caused by a narrowing of the funnel-shaped part of the kidney (known as the renal pelvis) where urine collects before being carried to the bladder by tubes called ureters. The obstruction may cause episodes of loin pain and/or nausea and vomiting, urinary infections and kidney stones. In some patients the condition could also affect the normal function of the kidney.
This procedure (endopyelotomy) aims to widen the renal pelvis by inserting small instruments either up through the urinary tract or down through the skin and into the kidney. The instruments are used to remove the tissue that is causing the obstruction by cutting or burning it away or by applying laser.
Coding recommendations
The primary OPCS-4 code for this procedure is dependent on the route of access used:
For an endoscopic approach via the ureter, the primary code is:
M10.8 Other specified other therapeutic endoscopic operations on kidney
In addition, one of the following codes is assigned depending on the type of cutting device used:
Y08.6 Laser incision of organ NOC
Y13.1 Cauterisation of lesion of organ NOC
Y30.1 Incision of lesion of organ NOC
For a percutaneous approach in the flank, the primary codes are:
M13.8 Other specified percutaneous puncture of kidney
Y53.- Approach to organ under image control
In addition, one of the following codes is assigned depending on the type of cutting device used:
Y08.6 Laser incision of organ NOC
Y13.1 Cauterisation of lesion of organ NOC
Y30.1 Incision of lesion of organ NOC
If a stent is inserted during the procedure a code from category Y14.- Placement of stent in organ NOC can be assigned to specify the type of stent inserted.
In addition the ICD-10 code N13.8 Other obstructive and reflux uropathy is assigned.