Summary of Changes OPCS-4.5 to OPCS-4.6

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Programme Sub Programme Technology Office Data Standards & Products/ Clinical Classifications Document Record ID Key NPFIT-SHR-SHI-0313.01 Acting Director, Data Standards & Products Nicholas Oughtibridge Status Approved Owner Lynn Bracewell Version V1.0 Author Ruth Toner Version Date 04-01-11 Summary of Changes OPCS-4.5 to OPCS-4.6 Crown Copyright 2011

Amendment History: Version Date Amendment History 0.1 01-11-10 Pre-release of DRAFT summary of changes 1.0 04-01-11 Final Reviewers: This document must be reviewed by the following: Name Signature Title / Responsibility Date Version Lisa Swain Clinical Classifications Advisor Ruth Toner Development / QA Manager All Approvals: This document must be approved by the following: Name Signature Title / Responsibility Date Version Lynn Bracewell Head of Clinical Classifications Ruth Toner Development / QA Manager All Document Control: The controlled copy of this document is maintained in the NHS CFH Electronic Document and Records Management System. Any copies of this document held outside of that system, in whatever format (e.g. paper, email attachment), are considered to have passed out of control and should be checked for currency and validity. Glossary of Terms: Terms, acronyms and abbreviations commonly used within NHS CFH can be found in the Glossary of Terms http://intranet.connectingforhealth.nhs.uk/departments/npo/glossary/glossary. If any terms are used in this document that are not currently included in the glossary please send them to cfh.glossary@nhs.net. All 1.0 Crown Copyright 2011 Page 2 of 11

Contents 1 About this document... 4 1.1 Purpose... 4 2 Core changes to OPCS-4.5... 4 2.1 Chapter A - NERVOUS SYSTEM... 5 2.2 Chapter B - ENDOCRINE SYSTEM AND BREAST... 5 2.3 Chapter C - EYE... 5 2.4 Chapter D - EAR... 5 2.5 Chapter E - RESPIRATORY TRACT... 5 2.6 Chapter F - MOUTH... 6 2.7 Chapter G - UPPER DIGESTIVE TRACT... 6 2.8 Chapter H - LOWER DIGESTIVE TRACT... 6 2.9 Chapter J - OTHER ABDOMINAL ORGANS - PRINCIPALLY DIGESTIVE6 2.10 Chapter K - HEART... 6 2.11 Chapter L - ARTERIES AND VEINS... 7 2.12 Chapter M - URINARY... 7 2.13 Chapter N - MALE GENITAL ORGANS... 7 2.14 Chapter P - LOWER FEMALE GENITAL TRACT... 7 2.15 Chapter Q - UPPER FEMALE GENITAL TRACT... 7 2.16 Chapter R - FEMALE GENITAL TRACT ASSOCIATED WITH PREGNANCY, CHILDBIRTH AND PUERPERIUM... 8 2.17 Chapter S - SKIN... 8 2.18 Chapter T - SOFT TISSUE... 8 2.19 Chapter U - DIAGNOSTIC IMAGING, TESTING AND REHABILITATION. 9 2.20 Chapter V - BONES AND JOINTS OF SKULL AND SPINE... 9 2.21 Chapter W - OTHER BONES AND JOINTS... 9 2.22 Chapter X - MISCELLANEOUS OPERATIONS... 10 2.23 Chapter Y - SUBSIDIARY CLASSIFICATION OF METHODS OF OPERATION... 10 2.24 Chapter Z - SUBSIDIARY CLASSIFICATION OF SITES OF OPERATION... 11 Crown Copyright 2011 Page 3 of 11

1 About this document 1.1 Purpose The purpose of this document is to provide a summary of core changes that have been made to codes and descriptions contained in the Tabular List Four Character Subcategories in OPCS-4.5 to produce OPCS-4.6. 2 Core changes to OPCS-4.5 This summary list does not reflect changes made to the Introduction, Tabular List of Three Character Categories, excludes, includes, code ranges or notes at chapter or individual code level, High Cost Drugs, Chemotherapy Regimens or the Alphabetical Index. It is therefore unsafe to use this information to assign codes or to annotate existing OPCS-4.5 books, as it does not reflect all changes made to produce OPCS-4.6. Changes are identified as follows: New code(s) and description are underlined Words in OPCS-4.5 that have been deleted have been struck through Words in OPCS-4.6 that have been added are underlined. Crown Copyright 2011 Page 4 of 11

2.1 Chapter A - NERVOUS SYSTEM A11.4 Cortical mapping A51.4 Endoscopic division of epidural adhesions 2.2 Chapter B - ENDOCRINE SYSTEM AND BREAST B34.1 Subareolar excision of mammillary mammary duct B34.2 Excision of mammillary mammary duct NEC B34.3 Excision of lesion of mammillary mammary duct B34.5 Exploration of mammillary mammary duct NEC B37.5 Lipofilling of breast B39.4 Reconstruction of breast using pedicled omental flap B39.5 Reconstruction of breast using free omental flap 2.3 Chapter C - EYE C10.6 Biopsy of lesion of eyebrow C44.3 Endothelial graft to cornea C44.4 Photorefractive keratectomy C44.5 Laser subepithelial keratomileusis C61.5 Viscogonioplasty 2.4 Chapter D - EAR 2.5 Chapter E - RESPIRATORY TRACT E20.4 Suction diathermy adenoidectomy E37 Diagnostic microendoscopic examination of larynx E37.1 Diagnostic microendoscopic examination of larynx and biopsy of lesion of larynx E37.8 Other specified E37.9 Unspecified Crown Copyright 2011 Page 5 of 11

2.6 Chapter F - MOUTH F14.4 Removal of orthodontic appliance NEC F14.6 Insertion of orthodontic anchorage F14.7 Removal of orthodontic anchorage 2.7 Chapter G - UPPER DIGESTIVE TRACT G48.5 Insertion of gastric balloon G48.6 Attention to gastric balloon G71.7 Reversal of duodenal switch G80.3 Diagnostic endoscopic balloon examination of ileum 2.8 Chapter H - LOWER DIGESTIVE TRACT H03.3 Exteriorisation of appendix H62.6 Proctoscopy 2.9 Chapter J - OTHER ABDOMINAL ORGANS - PRINCIPALLY DIGESTIVE J08.3 Endoscopic microwave ablation of lesion of liver using laparoscope J12.7 Percutaneous microwave ablation of lesion of liver 2.10 Chapter K - HEART K64 Percutaneous operations on heart K64.1 Percutaneous radiofrequency ablation of epicardium K64.8 Other specified K64.9 Unspecified Crown Copyright 2011 Page 6 of 11

2.11 Chapter L - ARTERIES AND VEINS L05.4 Percutaneous transluminal balloon dilation of interposition tube prosthesis between pulmonary artery and aorta L16.3 Bypass of aorta by anastomosis of axillary artery to bilateral femoral arteries O15.2 Insertion of umbilical venous catheter O15.3 Insertion of umbilical arterial catheter 2.12 Chapter M - URINARY M33.6 Percutaneous removal of ureteric stent from ureter NEC M60 Open operations on outlet of male bladder M60.1 Insertion of male retropubic continence device NEC M60.2 Removal of male retropubic device NEC M60.8 Other specified M60.9 Unspecified 2.13 Chapter N - MALE GENITAL ORGANS 2.14 Chapter P - LOWER FEMALE GENITAL TRACT 2.15 Chapter Q - UPPER FEMALE GENITAL TRACT Q13.1 Transfer of embryo to uterus NEC Q19 Plastic operations on uterus Q19.1 Connection of uterus to vagina Q19.8 Other specified Q19.9 Unspecified Q20.6 Focused ultrasound to lesion of uterus Q21 Other introduction of gamete into uterine cavity Crown Copyright 2011 Page 7 of 11

Q21.1 Transmyometrial transfer of embryo to uterus Q21.8 Other specified Q21.9 Unspecified Q35.4 Endoscopic bilateral placement of intrafallopian implants Q36.2 Endoscopic placement of intrafallopian implant into remaining solitary fallopian tube Q54.4 Suspension of uterus using mesh NEC Q54.5 Sacrohysteropexy Q54.6 Infracoccygeal hysteropexy 2.16 Chapter R - FEMALE GENITAL TRACT ASSOCIATED WITH PREGNANCY, CHILDBIRTH AND PUERPERIUM 2.17 Chapter S - SKIN S06.6 Re-excision of skin margins of head or neck S06.7 Re-excision of skin margins NEC 2.18 Chapter T - SOFT TISSUE T74.6 Autologous blood injection into tendon T98 Repair of recurrent other hernia of abdominal wall T98.1 Repair of recurrent ventral hernia using insert of natural material T98.2 Repair of recurrent ventral hernia using insert of prosthetic material T98.3 Repair of recurrent ventral hernia using sutures T98.8 Other specified T98.9 Unspecified Crown Copyright 2011 Page 8 of 11

2.19 Chapter U - DIAGNOSTIC IMAGING, TESTING AND REHABILITATION U17.6 Patency capsule examination U18.3 Mammography U30.2 Carotid sinus massage test U33.2 Application of ambulatory blood pressure monitor U33.3 Removal of ambulatory blood pressure monitor U34 Other diagnostic electrocardiography U34.1 Cardiac provocation test U34.8 Other specified U34.9 Unspecified U35.3 Transcranial doppler ultrasound velocimetry U35.4 Computed tomography of pulmonary arteries U36.4 Ultrasound elastography 2.20 Chapter V - BONES AND JOINTS OF SKULL AND SPINE V40.2 Posterior instrumented fusion of cervical spine NEC V40.3 Posterior instrumented fusion of thoracic spine NEC V40.4 Posterior instrumented fusion of lumbar spine NEC V40.5 Removal of instrumentation from spine V46.5 Removal of fixation device from spine 2.21 Chapter W - OTHER BONES AND JOINTS W03.6 Osteotomy of multiple metatarsals and fixation HFQ W15.7 Osteotomy of bone of foot and fixation HFQ W20.2 Primary open reduction of fracture of long bone and extramedullary fixation using circlage cerclage W91.3 Manipulation of prosthetic joint NEC Crown Copyright 2011 Page 9 of 11

2.22 Chapter X - MISCELLANEOUS OPERATIONS X45.3 Donation of lobe of lung X47 Other exchange blood transfusion X47.1 Low-density lipoprotein apheresis X47.8 Other specified X47.9 Unspecified X85.5 Neurodegenerative condition drugs Band 1 X87.4 Vasopressin antagonist drugs Band 1 X89.5 Allergic emergency drugs Band 1 X90.7 Myelodysplastic syndrome drugs Band 1 X96.2 Allergen immunotherapy drugs Band 1 X96.3 Poison management drugs Band 1 2.23 Chapter Y - SUBSIDIARY CLASSIFICATION OF METHODS OF OPERATION Y06.6 Vacuum excision of lesion of organ NOC Y06.7 Radiofrequency excision of lesion of organ NOC Y07.5 Occlusion of organ NOC Y10 Destruction of organ NOC Y10.1 Coblation of organ NOC Y10.8 Other specified Y10.9 Unspecified Y37 Introduction of other substance into organ NOC Y37.1 Introduction of photodynamic substance into organ NOC Y37.8 Other specified Y37.9 Unspecified Y39.4 Lipofilling injection into organ NOC Y39.5 Tattooing of organ NOC Y51.5 Approach to organ through appendicostomy Y74.5 Mediastinoscopic approach to mediastinal cavity Crown Copyright 2011 Page 10 of 11

Y79 Approach to organ through artery Y79.1 Transluminal approach to organ through subclavian artery Y79.2 Transluminal approach to organ through brachial artery Y79.3 Transluminal approach to organ through femoral artery Y79.4 Transluminal approach to organ through aortic artery Y79.8 Other specified Y79.9 Unspecified 2.24 Chapter Z - SUBSIDIARY CLASSIFICATION OF SITES OF OPERATION Z60.5 Muscle of chest O16 Body region O16.1 Pelvis NEC O16.2 Spine NEC O16.8 Specified body region NEC O16.9 Body region NEC O28 Other cerebral artery O28.1 Basilar artery O28.8 Specified other cerebral artery NEC O28.9 Other cerebral artery NEC O30 Other large intestine O30.1 Hepatic flexure O30.2 Splenic flexure O30.8 Specified other large intestine NEC O30.9 Other large intestine NEC Crown Copyright 2011 Page 11 of 11