National Consultant Outcomes Excluded OPCS codes 1
NCO 2014 & 2016: Excluded OPCS Codes Title and Version NCO 2014 & 2016: Excluded OPCS codes Date Issued 08/01/2018 Author (S) AN Document History Version Date Comment Author(S) 0.1 08.01.18 Excluded NCO 2014 & 2016 OPCS AN codes collated into this document. 0.2 29.01.18 Revised introduction DB 0.3 06.02.18 Review by Information Consultant ISD RD 1.0 08.02.18 Host on MSN website AS Review Date: 08/07/2018 2
Contents Introduction 4 Non-neurosurgical procedures excluded from analysis 5 3
Introduction Neurosurgeons in Scotland are keen to contribute to the Named Consultant Outcomes work currently being undertaken in England by their professional body the Society of British Neurological Surgeons (SBNS). The SBNS has agreed a series of indicators including consultant/unit mortality and has commissioned the University of Birmingham to undertake the work on their behalf http://www.sbns.org.uk/index.php/audit/. The Managed Service Network for Neurosurgery (MSN) has worked with the Information Services Division of NHS National Services Scotland to produce case mix adjusted named consultant outcomes at 30 days derived from routinely collected data for neurosurgeons in Scotland http://www.msnneuro.scot.nhs.uk/projects/active-named-consultant-outcomes/. The intention in 2018 is to submit the Scottish data to enable a UK comparison of outcomes. Audit Facilitators for the MSN for Neurosurgery carried out a two phased validation process on outcome data from 2014 for a selected group of Consultant Neurosurgeons from each centre. Phase 1 established whether surgical procedures had been allocated to the correct consultant, had been classified correctly as elective/non-elective and established that the correct patient outcome was recorded. The second phase validated the ICD-10 diagnostic codes and the OPCS (v4.5) procedure codes As a high degree of coding accuracy for both ICD10 and OPCS was established from the 2014 extract, a revised methodology was applied to extract 2016 data which was then subjected to Phase 1 (type) validations. Phase 2 validation was carried out on a random cohort of data for the 2016 extract. This translated to 10% of cases from each Consultant Neurosurgeon. The level of accuracy was improved in the 2016 cohort of data. Whilst validating the 2014 outcomes it was identified that some of the OPCS codes related to procedures that were not considered to be neurosurgical operations. It was agreed in consultation with the Consultant Neurosurgeons that these procedures should be excluded from the data set and all future analyses. A list of exclusions is therefore necessary in order to accurately define the neurosurgical denominator cases going forward. A record these excluded OPCS codes is presented in this document. 4
Non-neurosurgical procedures A C D A22.3 Isotopic cisternography A52.3 Epidural blood patch A52.9 Unspecified therapeutic epidural injection A54.2 Injection of therapeutic substance into cerebrospinal fluid A54.8 Other specified therapeutic spinal puncture A54.9 Unspecified therapeutic spinal puncture A55.1 Diagnostic spinal puncture - Radiculography A55.2 Spinal myelography NEC A55.8 Other specified diagnostic spinal puncture A55.9 Unspecified diagnostic spinal puncture A57.4 Injection of destructive substance into spinal root nerve A57.7 Injection of therapeutic substance around spinal nerve root A73.5 Injection of therapeutic substance around peripheral nerve A81.8 Other specified other operations on sympathetic nerve A84.1 Electroencephalography NEC A84.2 EPR A84.4 Evoked potential recording (Neurophysiology) A84.7 Sleep studies NEC A84.9 Unspecified, neurophysiological operations A848 Other specified, neurophysiological operations C01.1 Exenteration of orbit C12.1 Excision of lesion of eyelid NEC C16.4 Tarsorrhaphy NEC C20.1 Complete protective suture of eyelid C23.1 Insertion of weight into upper eyelid C43.4 Subconjunctival injection C75.1 Insertion of prosthetic replacement for lens NEC D10.1 Radical mastoidectomy NEC D10.2 Modified radial mastoidectomy D10.4 Simple mastoidectomy D12.8 Other specified, Other operations on mastoid D20.3 Removal of ventilation tube from tympanic membrane 5
E F G H D23.8 Other specified, Operations on inner ear E03.2 Excision of lesion of septum of nose E06.3 Removal of packing from cavity of nose E06.9 Unspecified packing of cavity of nose E08.1 Polypectomy of internal nose E14.2 Intranasal ethmoidectomy E42.3 Temporary tracheostomy E42.7 Removal of tracheostomy tube Diagnostic fibreoptic endoscopic examination of lower respiratory tract and biopsy of lesion E49.1 of lower respiratory tract. Diagnostic fibreoptic endoscopic examination of lower respiratory tract and lavage of lesion E49.2 of lower respiratory tract. E49.9 Unspecified, diagnostic fibreoptic endoscopic examination of lower respiratory tract. Unspecified diagnostic endoscopic examination of lower respiratory tract using rigid E51.9 bronchoscope E52.1 Irrigation of bronchus NEC E59.3 Biopsy of lesion of lung NEC E64.8 Other specified, therapeutic endoscopic operations on nasal cavity E85.1 Invasive ventilation E85.8 Other specified ventilation support E89.3 Nebuliser therapy F05.3 Suture of lip F09.2 Surgical removal of impacted tooth NEC F10.8 Other specified, Simple extraction of tooth F10.9 Unspecified simple extraction of tooth G23.4 Repair of diaphragmatic hernia using abdominal approach NEC G34.2 Creation of temporary gastrostomy G44.5 Fibreoptic endoscopic percutaneous insertion of gastrostomy G44.7 Fibreoptic endoscopic removal of gastronomy tube G45.9 Unspecified diagnostic fibreoptic endoscopic examination of upper gastrointestinal tract G47.8 Other specified, intubation of stomach Unspecified, diagnostic endoscopic examination of lower bowel using fibreoptic H25.9 sigmoidoscope H30.3 Passage of flatus tube to reduce volvulus of sigmoid colon H46.8 Other specified, other operations on rectum H62.8 Other specified, other operations on bowel 6
L L26.9 Unspecified, transluminal operations on aorta L31.2 Arteriography of carotid artery L31.4 Percutaneous transluminal insertion of stent into carotid artery L35.1 Percutaneous transluminal embolisation of cerebral artery L35.2 Arteriography of cerebral artery L35.3 Percutaneous transluminal insertion of stent into cerebral artery L35.8 Other specified, Transluminal operations on cerebral artery L35.9 Digital Subtraction Angiogram L39.4 Arteriography of subclavian artery L63.4 Arteriography of femoral artery L66.4 Percutaneous transluminal balloon test occlusion of artery L70.3 Ligation of artery NEC L71.3 Percutaneous transluminal embolisation of artery L72.1 Arteriography NEC L75.1 Excision of congenital arteriovenous malformation L75.3 Embolisation of arteriovenous abnormality NEC L75.4 Percutaneous transluminal embolisation of arteriovenous malformation NEC L79.1 Insertion of filter into vena cava L79.5 Removal of filter in vena cava L91.2 Insertion of central venous catheter L91.4 Removal of central venous catheter L91.5 Insertion of tunnelled venous catheter L91.6 Cannulation of vein NEC L94.1 Percutaneous transluminal embolisation of vein L94.2 Percutaneous transluminal cannulation of vein L94.8 Other specified therapeutic transluminal operations on vein L95.1 Venography L97.8 Other specified, Other operations on blood vessel L99.7 Percutaneous transluminal peripheral insertion of central catheter M M47.1 Urethral irrigation of bladder M47.2 Change of urethral catheter into bladder M47.3 Removal of urethral catheter from bladder M47.5 Maintenance of urethral catheter in bladder M47.8 Other specified urethral catheterisation of bladder M47.9 Unspecified urethral catheterisation of bladder 7
O O01.1 Percutaneous transluminal coil embolisation of small aneurysm of artery O01.2 Percutaneous transluminal coil embolisation of medium aneurysm of artery O01.3 Percutaneous transluminal coil embolisation of large aneurysm of artery O01.4 Percutaneous transluminal coil embolisation of giant aneurysm of artery O01.8 Percutaneous transluminal coil embolisation- other specified O01.9 Unspecified transluminal coil embolisation of aneurysm of artery O02.3 Percutaneous transluminal balloon assisted coil embolisation of single aneurysm of artery O02.9 Unspecified transluminal balloon assisted coil embolisation of aneurysm of artery O03.3 Percutaneous transluminal stent assisted coil embolisation of single aneurysm of artery O03.8 Other specified transluminal stent assisted coil embolisation of aneurysm of artery O04.1 Percutaneous transluminal liquid polymer embolisation of aneurysm of artery O04.8 other transluminal embolisation of aneurysm of artery - other specified O05.2 Percutaneous transluminal arterial embolisation of dural arteriovenous fistula O05.3 Percutaneous transluminal venous embolisation of dural arteriovenous fistula O05.8 Other specified, operations on dural arteriovenous fistula Q Q18.1 Diagnostic endoscopic examination of uterus S S28.8 Other specified flap of mucosa S35.3 Split autograft of skin to head or neck S43.1 Removal of clip from skin of head or neck S43.2 Removal of clip from skin S43.3 Removal of suture from skin of head or neck S43.4 Removal of suture from skin NEC S56.4 Dressing of skin of head or neck NEC S57.3 Exploration of skin- toilet of skin NEC S57.6 Cleansing and sterilisation of skin NEC S60.3 Tattooing of skin S60.6 Electrolysis of hair S60.7 Epilation NEC S62.3 Removal of inserted substance from subcutaneous tissue 8
T T05.8 Other specified other operations on chest wall T12.2 Drainage of pleural cavity NEC T12.4 Insertion of tube drain onto pleural cavity T30.2 Reopening of abdomen and re-exploration of intra-abdominal operation site NEC T30.9 Unspecified opening of abdomen T31.8 Other specified operations on anterior abdominal wall T41.8 Other specified, other open operations on peritoneum T45.3 Image controlled percutaneous drainage of abdominal abscess NEC T57.8 Other specified, other operations on fascia T77.9 Unspecified, repair of muscle T87.2 Excision or biopsy of cervical lymph node NEC T96.2 Excision of lesion of soft tissue NEC U U05.1 Computed tomography of head U05.2 Magnetic resonance imaging of head U05.3 Functional magnetic resonance imaging of head U05.4 CT Scan U05.5 Magnetic resonance imaging of spine U05.9 Diagnostic imaging of CNS- unspecified U06.1 Computed tomography of sinuses U06.2 Dacryoscintigraphy U06.4 Plain x-ray of skull U07.3 Plain x-ray of chest U08.1 Computed tomography of abdomen NEC U08.3 Plain x-ray of abdomen U11.2 Doppler ultrasound of vessels of extremities U11.4 Computed tomography scan of cerebral vessels U11.7 Magnetic resonance angiography U11.8 Other specified, Diagnostic imaging of vascular system U12.4 Scan of bladder U13.4 Plain x-ray of joint U20.1 Transthoracic echocardiography U20.2 Transoesophageal echocardiography U21.1 Magnetic resonance imaging NEC U21.5 Contrast fluoroscopy NEC U21.7 Plain x-ray NEC U22.1 Electroencephalograph telemetry U22.9 Other specified, Neuropsychology tests 9
U29.7 Short synacthen test U32.9 Unspecified diagnostic blood test U33.1 Polysomnography U33.9 Unspecified Other diagnostic tests U35.4 Computed tomography of pulmonary arteries V V15.2 Open reduction of fracture of mandible NEC V17.2 Internal fixation of mandible NEC V54.4 Injection around spinal facet of spine V55.1 One Level of Spine V55.2 Two levels of spine W W08.5 Partial excision of bone NEC W19.2 Primary open reduction of fracture of long bone and fixation using rigid nail NEC W20.8 Other specified, primary open reduction of fracture of bone and extramedullary fixation W30.1 Application of external fixation of bone NEC W30.2 Adjustment to external fixation of bone NEC W304 Application of external ring fixation of bone NEC W36.2 Needle biopsy of lesion of bone NEC W36.3 Diagnostic drilling of bone W36.5 Diagnostic extraction of bone marrow NEC W85.8 Other specified, Therapeutic endoscopic operations on cavity of knee joint W90.3 Injection of therapeutic substance into joint. 10
X X28.1 Intermittent intravenous infusion of therapeutic substance X29.2 Continuous IV infusion X30.4 Injection of thrombin NEC X30.8 Other specified, Injection of therapeutic substance X33.2 Intravenous blood transfusion of packed cells X33.3 Intravenous blood transfusion of platelets X34.1 Transfusion of coagulation factor X35.8 IV injection - other X36.9 Unspecified blood withdrawal X37.5 Intramuscular injection for local action X37.8 Other specified intramuscular injection X38.2 Injection of steroid for local action NEC X40.1 Renal dialysis X40.4 Haemofiltration X44.3 Subcutaneous injection of vaccine X48.1 Application of plaster cast X50.1 Direct current cardioversion (external resuscitation) X56.9 Unspecified, Intubation of trachea X59.8 Other specified anaesthetic without surgery X59.9 Unspecified anaesthetic without surgery X62.2 Assessment by multiprofessional team NEC X62.3 Assessment by multidisciplinary team NEC X62.8 Other specified assessment X62.9 Unspecified assessment X65.9 Unspecified radiotherapy delivery X72.9 Unspecified delivery of chemotherapy for neoplasm 11