Notification of changes to Bupa schedule of procedures

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22 NOVEMBER 2017 Notification of changes to Bupa schedule of procedures This bulletin aims to keep you up-to-date with any changes to procedure codes published in the Bupa Schedule of Procedures.

1 22 NOVEMBER 2017 Notification of changes to Bupa schedule of procedures This bulletin aims to keep you up-to-date with any changes to procedure codes published in the Bupa Schedule of Procedures. To ensure you are always viewing the latest version of the Schedule, please refer to the new online code search tool found at The new changes in the Schedule effective this month are shown below. To help you ensure that you are using the current version, the Schedule is live and up-to-date if viewed via If you have any questions, please call Bupa Provider Services on Lines are open 8am to 6pm, Monday to Friday and 8am to 1pm on Saturday. Calls may be recorded and may be monitored. Thank you Dr Tim Woodman Medical Director healthcare policy and evidence, UK customer Notification of changes to Bupa schedule of procedures 22 November

2 Notice of changes to the Schedule 1) Description changes No changes this month 2) Surgeon s category: L7032 changed from MINOR 5 to INTER 1 3) Anaesthetist s category: 4) Hospital category: 5) Footnote changes: Code Footnote added Effective date A5720 * 31/07/2017 W3650 * 31/07/2017 X5020 ii 31/10/2017 S0602 ii 31/10/2017 S0603 ii 31/10/2017 S0604 ii 31/10/2017 6) Follow-up consultation fee charge allowed on same day as procedure charge: Code X5020 S0602 S0603 Narrative External cardioversion Primary excision of malignant lesion - Head & Neck Primary excision of malignant lesion 22 November

3 S0604 S Trunk & Limbs Secondary excision of malignant lesion - Head & Neck Secondary excision of malignant lesion - Trunk & Limbs 7) IV sedation or IV regional anaesthesia charge allowed alongside procedure charge: 8) Ophthalmic local anaesthesia charge allowed alongside procedure charge: 9) IC level 2 or 3 changes and LOS changes C8654 LOS increased from 1 to 7 10) Essential notes to the Schedule 11) Sub-chapter change (to align with CCSD Schedule): 12) New codes: code Description SCC ACC HCC LOS Footnote Effective date A1301 A7020 Revision or replacement of cerebroventricular shunt MAJOR 1 MAJOR 3 MAJOR 2 10/11/2017 Replacement of neurostimulator to peripheral nerve MAJOR 1 INTER 1 MAJOR 1 10/11/ November

4 B2917 B3016 F2621 H4685 T3920 Reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) (including delayed reconstruction) MAJOR 4 MAJOR /07/2017 Mastectomy and immediate reconstruction of breast using fat transfer 2 MAJOR 3 MAJOR 2 10/11/2017 Frenotomy /frenectomy of tongue under local anaesthetic MINOR 2 (n/a) MINOR - 10/11/2017 Insertion of biodegradable perirectal spacer under image guidance (as sole procedure) MINOR 3 MINOR 5 MINOR O/P 15/03/2017 Multivisceral resection of retroperitoneal sarcoma CMO 2 CMO 2 CMO /11/2017 W7720 W8170 Minimally invasive sacroiliac joint stabilisation surgery for chronic sacroiliac pain under image guidance /11/2017 Biodegradable subacromial spacer insertion for rotator cuff tears MAJOR 4 MAJOR 2 INTER 1 10/11/2017 X3760 Simple intramuscular injection, without X-ray control (as sole procedure) Cash Value - MINOR O/P 10/11/2017 E2880 Epley manoeuvre Cash Value (n/a) - O/P 22/11/2017 E5540 Laser resection of lung metastases CMO 1 4 CMO /11/2017 G1470 G4610 Fibreoptic endoscopic photodynamic therapy (PDT) of lesion of oesophagus MAJOR 3 INTER 5 MAJOR 2 22/11/2017 Transoral incisionless fundoplication (TIF) 1 H3382 Proctectomy /11/ /11/ November

5 J0312 K4610 L9980 M1120 Microwave ablation for primary or metastatic cancer of the liver CMO 3 - CMO 3 D/C 22/11/2017 Minimally invasive direct coronary artery bypass (MIDCAB) including harvesting of graft Cash Value CMO 5 CMO /11/2017 Sclerotherapy of lymphatic or peripheral venous malformation INTER 2 MINOR 5 MINOR D/C 22/11/2017 Diagnostic ureterorenoscopy (+/- cystoscopy) INTER 2 INTER 4 INTER D/C 22/11/2017 M1130 Therapeutic ureterorenoscopy (+/- cystoscopy and insertion/removal of stent) MAJOR 3 INTER 5 INTER 1 22/11/2017 W7761 Repair of hip labral tear CMO /10/2017 T7231 Open release of constriction of sheath of tendon (e.g. trigger finger) INTER 3 INTER 4 INTER D/C 24/10/2017 T7232 T2501 A Percutaneous release of constriction of sheath of tendon (e.g. trigger finger) INTER 1 - MINOR O/P 24/10/2017 Open repair of incisional or ventral hernia requiring mesh INTER 3 INTER 5 INTER 1 24/10/2017 Replacement of neurostimulator to brain MAJOR 5 MAJOR 5 MAJOR D/C 30/10/2017 Intensive care - consultant daily care, when no operative anaesthesia performed Cash value /10/2017 C7525 Repositioning of lens implant INTER 5 (n/a) INTER 1 30/10/2017 C7940 Intravitreal injection of pharmaceutical agent (not elsewhere classified) MINOR 3 (n/a) MINOR O/P 30/10/2017 C0840 Orbital injection MINOR 3 (n/a) MINOR O/P 30/10/ November

6 E2501 Fibre optic examination of the pharynx +/- biopsy/removal of foreign body MINOR 4 MINOR 4 MINOR O/P 30/10/2017 E3681 Stroboscopy of larynx MINOR 2 MINOR 1 MINOR O/P 30/10/2017 B2989 B2914 A5762 A E1354 X3270 Mastectomy followed by immediate Deep Inferior Epigastric Flap (DIEP) reconstruction - unilateral Cash Value CMO 5 CMO /07/2017 Mastectomy followed by immediate Deep Inferior Epigastric Flap (DIEP) reconstruction - bilateral Cash Value CMO 5 CMO /07/2017 Medial Branch Block (under x-ray control) - 3 to 4 levels INTER 1 INTER 1 INTER D/C 20/09/2017 Placement of tined lead neurostimulator not at time of permanent implant MAJOR 1 INTER 1 MAJOR 1 30/10/2017 Non face to face consultation (e.g. telephone, skype) - up to 15 minutes Cash value /10/2017 Closure of oro-antral fistula with distant flap and bone graft MAJOR 2 INTER 5 INTER D/C 30/10/2017 Extracorporeal photopheresis (ECP) - single session MINOR 3 INTER 3 MINOR D/C 30/10/2017 XR181 Ultrasound guided insertion of tunneled abdominal or pleural drain INTER 3 (n/a) INTER D/C 30/10/2017 XR362 Embolisation of pelvic vein varices MAJOR 3 (n/a) MAJOR D/C 30/10/2017 C1540 W4214 W4216 Surgical correction of trichiasis /upper lid entropion (including graft/flap) INTER 5 INTER 3 INTER D/C 30/10/2017 Customised unicompartmental knee replacement 5 Customised bicompartmental knee replacement /10/ /10/ November

7 W4218 Customised total prosthetic replacement of knee joint CMO /10/ Non face to face consultation (e.g. telephone, skype) - 16 to 29 minutes Cash value /10/2017 Non face to face consultation (e.g. telephone, skype) - 30 minutes or more Cash value /10/2017 A5480 Intrathecal chemotherapy MINOR 2 - MINOR O/P 09/11/2017 A7012 Implantation of gastroelectrical stimulation (GES) for gastroparesis /10/2017 B1280 B2917 B2918 C8810 E1352 Ultrasound guided radiofrequency ablation of benign thyroid nodule MINOR 3 - MINOR O/P 13/07/2017 Reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) (including delayed reconstruction) MAJOR 4 MAJOR /07/2017 Mastectomy and immediate reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) - unilateral MAJOR 4 MAJOR /07/2017 Transpupillary thermotherapy for intraocular tumours MINOR 4 INTER 3 INTER D/C 09/11/2017 Closure of oro-antral fistula with distant flap MAJOR 2 INTER 5 INTER D/C 09/11/2017 E2810 Peroral endoscopic myotomy (POEM) for achalasia MAJOR 3 MAJOR 2 MAJOR 1 09/11/ November

8 K6120 Q2231 V4080 V4081 V4310 XR287 XR391 Insertion of leadless (wireless) pacemaker INTER 5 MAJOR 5 INTER D/C 09/11/2017 Oophorectomy and salpingectomy, +/- biopsy eg. omentum, peritoneum, lymph node (as sole procedure) - unilateral MAJOR 1 MAJOR 3 MAJOR 1 09/11/2017 Anterolateral access with instrumentation +/- decompression +/- discectomy (including graf stabilisation and all fusion approaches) - lumbar region (1 or 2 levels) CMO 4 5 CMO /11/2017 Anterolateral access with instrumentation +/- decompression +/- discectomy (including graf stabilisation and all fusion approaches) - lumbar region (3 or more levels) CMO 5 CMO 1 CMO /11/2017 Vertebral corpectomy,discectomy, decompression and fusion (including bone grafting) CMO 4 CMO 1 CMO /11/2017 Catheter cerebral venography and manometry MAJOR 2 MINOR 5 INTER D/C 13/11/2017 Embolisation of arteriovenous malformation (AVM) e.g. of foot, minor organ INTER 3 MINOR 5 MINOR D/C 13/11/2017 W0951 Radical clearance of sarcoma of head and neck necessitating flap reconstruction /01/1900 E3681 Stroboscopy of larynx MINOR 2 MINOR 1 MINOR O/P 30/10/2017 B2989 Mastectomy followed by immediate Deep Inferior Epigastric Flap (DIEP) reconstruction - unilateral Cash Value CMO 5 CMO /07/2017 T2503 Laparoscopic repair of incisional or ventral hernia not requiring mesh INTER 4 INTER 5 INTER D/C 24/10/ November

9 13) Error Corrections 14) Code inactivations (as per CCSD Schedule changes): Code Narrative Effective from AA663 Injection of viscosupplementation into joint (with or without x-ray control) 09/11/2017 W7712 Stabilisation of unidirectional instability of shoulder joint (including anterior, 09/11/ /11/2017 posterior and arthroscopic) C3114 Surgical correction of squint - inferior oblique surgery 09/11/2017 C3115 Surgical correction of squint - other vertical muscles 09/11/2017 W7760 Labral repair (shoulder stabilisation) 09/11/2017 W4211 Customised knee arthroplasty 09/11/2017 T8900 Operations on lymphatic duct not elsewhere classified 09/11/2017 T7983 Open sub acromial decompression and limited, less than 2cm tear rotator cuff repair 09/11/2017 T7230 Release of constriction of sheath of tendon (e.g. trigger finger) 09/11/2017 T2502 Laparoscopic repair of incisional hernia 09/11/2017 M4290 Endoscopic investigation of bladder using hexaminolevulinate blue light florescence +/- resection of lesions 09/11/ Renal cyst aspiration (and ablation 09/11/2017 AA663 Injection of viscosupplementation into joint (with or without x-ray control) 09/11/2017 W7712 Stabilisation of unidirectional instability of shoulder joint (including anterior, posterior and arthroscopic) 09/11/2017 CCSD coding principles ( unbundling ) additions Please refer to the CCSD website at: for a full list of the Coding Principles. Code Narrative Code Narrative A5293 Transforaminal epidural (lumbar) A5210 A5230 A5410 A5420 A5480 Epidural injection (lumbar) Epidurogram Epidural blood patch Injection of therapeutic substance into CSF Intrathecal chemotherapy 22 November

10 A7350 V2500 Local anaesthetic blockade of named major nerve or plexus Primary posterior fusion +/- decompression +/- discectomy - lumbar region (1 or 2 levels) A5211 Epidural injection (caudal) A5230 Epidurogram A5294 Transforaminal epidural (caudal) A5410 A5480 A7350 V2500 Epidural blood patch Intrathecal chemotherapy Local anaesthetic blockade of named major nerve or plexus Primary posterior fusion +/- decompression +/- discectomy - lumbar region (1 or 2 levels) A5220 Epidural injection (thoracic) A5230 Epidurogram A5292 Transforaminal epidural (thoracic) A5410 A5420 Epidural blood patch Injection of therapeutic substance into CSF A5480 Intrathecal chemotherapy A7350 Local anaesthetic blockade of named major nerve or plexus A5200 Epidural injection (cervical) A5230 Epidurogram A5291 Transforaminal epidural (cervical) A5410 A5420 Epidural blood patch Injection of therapeutic substance into CSF A5480 Intrathecal chemotherapy A7350 Local anaesthetic blockade of named major nerve or plexus Intramuscular injection with x- X3770 ray control (e.g. piriformis block) AC100 Local anaesthetic by main operator Dorsal root ganglion block (local anaesthetic or neurolytic) (as sole procedure) A5290 A5752 A5762 A5772 Transforaminal epidural Medial Branch Block (under x-ray control) 1 to 2 levels Medial Branch Block (under x-ray control) 3 to 4 levels Medial Branch Block (under x-ray control) 5 to 6 levels 22 November

11 15) CCSD coding principles ( unbundling ) removals: No changes this month 22 November

Notification of changes to AXA PPP Schedule of Procedures & Fees March 2018

Notification of changes to AXA PPP Schedule of Procedures & Fees March 2018 Call our Specialist Fees Team 01892 772160 Mon-Fri 9am-1pm specialistfees@axa-ppp.co.uk We may record and monitor calls for quality assurance, training and as a record of our conversation.. Notification