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

In April 2022, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 0183 and 0080 with changes to be implemented no later than June 14, 2022.

Eleven new procedure codes were added:

• F4306 Transoral robotic horizontal supra-glottic laryngectomy (as sole procedure);
• F4308 Transoral robotic mucosectomy for microscopic primary tumor (as sole procedure);
• Y3811 Removal of indwelling pleural catheter;
• V4282 Revision correction of adult degenerative or adult idiopathic scoliosis including decompression +/- fusion (including spinal cord monitoring);
• A5430 Image-guided transforaminal injection of fibrin sealant;
• B2818 Mastectomy and immediate reconstruction of breast using expandable prosthesis and acellular dermal matrix (ADM) - unilateral;
• B2819 Mastectomy and immediate reconstruction of breast using expandable prosthesis and acellular dermal matrix (ADM) – bilateral;
• B2994 Reconstruction of breast using stacked flap (including delayed reconstruction) not elsewhere classified - unilateral (2 flaps);
• B2995 Reconstruction of breast using stacked flap (including delayed reconstruction) not elsewhere classified - bilateral (2 flaps per breast);
• T9021 Sentinel node mapping +/- sampling with magnetic lymphatic tracer for breast cancer;
• W9047 Autologous protein solution injection.

The following diagnostic imaging codes were introduced:

• IM379 Dynamic ultrasound of the thorax and ribs;
• IM380 US Doppler (not otherwise specified) unilateral;
• IM381 US Doppler (not otherwise specified) bilateral.

The following in-vitro diagnostic codes were introduced:

• 5940B Indirect Immunofluorescence for blistering skin conditions;
• 5941B Hepatitis E RNA;
• 5942B Parechovirus PCR;
• 9003G Invitae breast cancer STAT panel;
• 9004G Invitae prostate cancer panel;
• 9005G Invitae colorectal cancer panel.

See the full details here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). First EU issues of both newsletters are available for download free-of-charge.

Not ready for a subscription service? Subscribe to our free-of-charge newsletter delivered every second week to get updates about key reimbursement developments in Europe (10-12 news every two weeks).