Guidance
The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Insertion of customised exposed titanium implants, without soft tissue cover, for complex orofacial reconstruction.
This guidance and NICE interventional procedure guidance 449 together replace interventional procedure guidance 28 – Customised titanium implants for orofacial reconstruction (December 2003)
Description
Titanium implants can be inserted to replace bones in the face as part of orofacial reconstruction, that is, rebuilding the face when there is severe damage to the bones or deformity. This is most commonly needed after injury or surgery to remove tumours, or to treat deformities of the face that have been present from birth.
In this procedure, the implants are customised (made specially to fit the person). An accurate model is made of the bones of the person’s face. The model is used as a template to make the implant, which is then fixed in position using titanium screws during an operation. The implant is not covered by soft tissue.
Coding recommendations
This procedure cannot be expressed in the OPCS-4 classification by a single code. Code assignment would depend on where the implant was placed and if any other procedures involving the adjacent structures were also performed. The procedure must therefore be coded on a case by case basis, subject to the other actions carried out as documented in the patient’s medical record.