There has been a lot of uncertainty about the coding, and recording in NVD/NVR with regard to fenestrated endografts. Some units have been recording these as suprarenal aneurysms, to avoid their inclusion in analysis and publication of outcome data for elective infra-renal aneurysms.
The NVR will now allow us, through the recording of the procedural code as a FEVAR, to specifically exclude them from the publication of outcome data.
Therefore we would advise that, for those which are true juxta-renal or infra-renal aneurysms, that they are recorded as infra-renal aneurysms (using the OPCS code L27.1 and by selecting complex EVAR in the type of repair), with the supplementary/procedural code entered for FEVAR (O20.2).
Clearly if they are truly suprarenal (4 fenestrations/branched grafts) they should be recorded at such, by using the L27.2/L28.2 codes.
There has also been uncertainty about the coding and recording of isolated iliac aneurysms and limb extensions. For extensions, we are planning to alter the NVR to enable reintervention data to be recorded appropriately. In terms of coding, we will add the procedural codes for trans-luminal insertion of iliac stent to NVR (L54). However, it would seem appropriate, given the lack of a single OPCS code for the endovascular management of iliac aneurysms, to continue as most centres currently do, and to record these as aorto-iliac interventions (L27.6/L28.6).