Thirty new procedure codes were added to private reimbursement schedule in England in February 2018

26

Mar 2018

The Clinical Coding and Schedule Development (CCSD) develops and maintains procedural and diagnostics nomenclature for private payers in England. Once codes are added to the Schedule, a rivate insurance company can develop reimbursement tariff for these procedures and tests.

The CCSD Group has approved procedure codes for planning, preparation and delivery of radiotherapy for publication to the CCSD Schedule in February.

The following codes for planning and preparation of radiotherapy were selected:

  • Planning and preparation for the delivery of Stereotactic Body Radiotherapy (SBRT)/Stereotactic Ablative Radiotherapy (SABR) (X6002);
  • Planning and preparation for the delivery of Stereotactic Radiosurgery (SRS) (X6003);
  • Forward planning and preparation for the delivery of intensity modulated radiotherapy (IMRT), including adaptive IMRT (X6004);
  • Inverse planning and preparation for the delivery of intensity modulated radiotherapy (IMRT), including adaptive IMRT (X6005);
  • Planning and preparation for the delivery of static total body irradiation (TBI) (X6006);
  • Planning and preparation for the delivery of rotational total body irradiation (TBI) (X6007);
  • Planning and preparation for the delivery of interstitial radiotherapy (X6008);
  • Planning and preparation for the delivery of Selective Internal Radiotherapy (SIRT) (X6009);
  • Planning and preparation for the delivery of 3D conformal radiotherapy (3DCRT) (X6010);
  • Planning and preparation for the delivery of superficial radiotherapy with imaging, dosimetry and calculation using orthovoltage (X6011);
  • Planning and preparation for the delivery of magnetic resonance image (MRI) radiotherapy (X6012);
  • Planning and preparation for the delivery of Proton Beam Therapy (PBT) for ocular tumours (X6013);
  • Planning and preparation for the delivery of low dose brachytherapy (X6014);
  • Planning and preparation for the delivery of high dose brachytherapy (X6015);
  • Simple mould or mask (X6050);
  • Complex mould or mask (X6051).

The following codes for delivery of radiotherapy were selected:

  • Planning and delivery of intraoperative radiation therapy (IORT) (X7001);
  • Delivery of a fraction of Stereotactic Body Radiotherapy (SBRT) / Stereotactic Ablative Radiotherapy (SABR) (X7002)
  • Delivery of a fraction of Stereotactic Radiosurgery (SRS) (X7003);
  • Delivery of forward planned intensity modulated radiotherapy (IMRT), including adaptive IMRT (X7004);
  • Delivery of inverse planned intensity modulated radiotherapy (IMRT), including adaptive IMRT (X7005);
  • Delivery of a fraction of static total body irradiation (TBI) (X7006);
  • Delivery of a fraction of rotational total body irradiation (TBI) (X7007);
  • Delivery of interstitial radiotherapy (X7008);
  • Delivery of Selective Internal Radiotherapy (SIRT) (X7009).

The new codes for other procedures are provided below:

  • Localised patient specific knee resurfacing arthroplasty (W5851);
  • Localised patient specific twin knee resurfacing arthroplasty (W5852);
  • Balloon dilatation of the Eustachian tube (D2240);
  • Insertion of magnetic marker for non-palpable breast lesions under imaging control (XR937);
  • MRI-guided focused ultrasound (MRgFUS) thalamotomy for essential tremor (A0321).

See full details here.

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