New procedure and diagnostic codes added to the private reimbursement schedule in England

In April 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0176 and 0073 with changes to be implemented not later than August 01, 2021.

Two new procedure codes for High-Intensity Focused Ultrasound of the prostate were introduced:

• M6771 Focal High Intensity Focused Ultrasound of the prostate (including cystoscopy);
• M6772 Total gland High Intensity Focused Ultrasound of the prostate (including cystoscopy).

Two new procedure codes related to breast surgery were introduced:

• B2761 Skin/nipple sparing mastectomy (including axillary node biopsy) – bilateral;
• B2927 Reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) (including delayed reconstruction) – bilateral.

One new diagnostic code, 3024G "myChoice CDx", was introduced. myChoice® CDx is a next-generation sequencing-based test detecting deleterious or suspected deleterious mutations in BRCA1, BRCA2 genes, and Genomic Instability Score. This test is used in ovarian cancer patients with positive homologous recombination deficiency (HRD) status to identify who is eligible for treatment with the targeted therapy.

See the full details here.

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