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

On October 10, 2024, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 198 and 094 with changes to be implemented no later than December 5, 2024. 

Fifty-two new procedure codes related to ENT, gastrointestinal, men’s health, urology, neurology and neurosurgery, gynecology, orthopedics, robotic surgery, and surgical procedures areas were introduced. Some examples of newly added codes are provided below:

• GA403 Laser assisted voice adjustment for gender affirmation;
• GA510 Metoidioplasty +/- urethral reconstruction (+/- scrotoplasty) (including cystoscopy) for gender affirmation;
• GA304 Augmentation mammoplasty for gender affirmation +/- implant, +/- fat transfer – unilateral;
• GA100 Cycle of ovarian stimulation and egg recovery with oocyte cryopreservation for gender affirmation;
• G6083 Robotic assisted small bowel resection +/- stoma.

Two new diagnostic codes were added in diagnostic nomenclature, including 9007G “Assessment of recurrence risk in bladder cancer by circulating tumour DNA profiling”.

See the full details here.

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