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

In April 2023, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 189 and 085 with changes to be implemented no later than June 15, 2023.

Eighteen new procedure codes were implemented in cardiovascular, endocrine, endoscopy, gastrointestinal, interventional radiology, neuromodulation, peripheral vascular, robotic surgery, men's health, and general surgery fields. Some examples of newly added codes are provided below:

• K5761 Pulsed Field Ablation (PFA) of paroxysmal atrial fibrillation (including mapping);
• B1802 Robot assisted radical thymectomy;
• M7072 Transperineal micro invasive laser ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia;
• L2730 Endovascular insertion of stent graft for thoracic TEVAR.

Eight new codes for in-vitro diagnostics were introduced. Some examples are provided below:

• 8006A Faecal Antitrypsin;
• 0005O HMG-CoA Reductase Antibodies;
• 2999G SCMD Multi Gene Panel 5.

See more information here.

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