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NOMESCO Classification of Surgical Procedures NOMESCO Classification of Surgical Procedures 93:2010 Nordic Medico-Statistical Committee (NOMESCO) NOMESCO Classification of Surgical Procedures (NCSP), version 1.15 Organization in charge of NCSP maintenance and updating: Nordic Centre for Classifications in Health Care WHO Collaborating Centre for the Family of International Classifications in the Nordic Countries Norwegian Directorate of Health PO Box 7000 St. Olavs plass 0130 Oslo, Norway Phone: +47 24 16 31 50 Fax: +47 24 16 30 16 E-mail: [email protected] Website: www.nordclass.org Centre staff responsible for NCSP maintenance and updating: Lars Berg, Centre Head Glen Thorsen, Trine Fresvig, Expert Advisers on NCSP Nordic Reference Group for Classification Matters: Denmark: Søren Bang, Ole B. Larsen, Solvejg Bang, Danish National Board of Health Finland: Jorma Komulainen, Matti Mäkelä, National Institute for Health and Welfare Iceland: Lilja Sigrun Jonsdottir, Directorate of Health, Statistics Iceland Norway: Øystein Hebnes, Trine Fresvig, Glen Thorsen, KITH, Norwegian Centre for Informatics in Health and Social Care Sweden: Lars Berg, Gunnar Henriksson, Olafr Steinum, Annika Näslund, National Board of Health and Welfare Nordic Centre: Lars Berg, Lars Age Johansson, Olafr Steinum, Trine Fresvig, Lilien Telfer © Nordic Medico-Statistical Committee (NOMESCO) 2010 Islands Brygge 67, DK-2300 Copenhagen S Phone: +45 72 22 76 25 Fax: +45 32 95 54 70 E-mail: [email protected] Cover by: Sistersbrandts Designstue, Copenhagen Printed by: AN:sats - Tryk & Design a-s, Copenhagen 2010 ISBN 978-87-89702-75-9 PREFACE Preface to NOMESCO Classification of Surgical Procedures Version 1.15 The Nordic Medico-Statistical Committee (NOMESCO) published the first printed edition of the NOMESCO Classification of Surgical Procedures (NCSP) in 1996. Denmark introduced a Danish version of NSCP (NCSP-D) the same year. In 1997, Finland and Sweden introduced national versions (NCSP-F and NCSP-S respectively), whereas Iceland implemented the Nordic (English-language) version of NCSP (NCSP-E). In 1999, Norway adopted a Norwegian version of NCSP (NCSP-N). Thus all five Nordic countries have used NCSP since 1999. A procedure for annual updating of NCSP has been established. The responsibility for updating the classification lies with the Nordic Centre for Classifications in Health Care, in Oslo, Norway. The Centre maintains an electronic discussion group for suggested changes and a Reference group for Nordic classification matters which makes formal recommendations as to changes in the classification. The final decisions are taken by the Board of the Nordic Centre. Information on the NCSP update routine can be found in the section on Structure and classification guidelines. The Nordic version of NCSP has been updated fifteen times. NCSP Version 1.15 is effective from January 1, 2011. NOMESCO and the Nordic Centre decided to make new printed copies of the Nordic version of NCSP available to interested parties on a print-on-demand basis. This version of NCSP 1.15 includes the original preface to the basic Nordic edition of NCSP as well as the guidelines on the structure and use of the classification. The body of the classification incorporates all fourteen updates made so far which have been fully integrated in the text. The first revision consisted mainly of corrections to the original version, whereas later revisions introduce new codes which can be seen as a development of the classification. These changes are based on suggestions from national classification authorities and the discussion in the electronic forum. The changes introduced between the thirteenth and fourteenth revisions are presented in Appendix 2. The changes in the earlier revisions are presented at the website of the Nordic Centre (http://www. nordclass.org). Questions about the maintenance and updating procedure should be directed to the Nordic Centre for Classifications in Health Care. Requests for printed versions of NCSP should be directed to NOMESCO. The classification is also available at the website of the Nordic Centre, from where it can be downloaded in PDF-format (http://www. nordclass.org) Oslo and Copenhagen November 2010 Lars Berg Johannes Nielsen Head of the Nordic Classification Centre Secretary of NOMESCO 5 PREFACE Preface to first edition At the initiative of NOMESCO, a study comparing surgical frequencies and activities in the Nordic countries was set up in the early 1980’s and resulted, in 1989, in the publication of an abbreviated Nordic list of surgical procedures for Denmark, Finland, Norway and Sweden. Based on the experience gained from this work, it was decided to set up a working group, under NOMESCO, to prepare the structure of a common Nordic classification for surgical procedures. The following persons were appointed as members of the Working Group: Henning Bay-Nielsen, Chairman (Denmark), Peter Sylvest Olsen (Denmark), Timo Niinimäki (Finland) Steffen Birkeland (Noway), Glen Thorsen (Norway), Sven Aschberg (Sweden) (until January 1992), Hubertus van Paaschen (Sweden) (since January 1992) and Björn Smedby (WHO Collaborating Centre for the Classification of Diseases in the Nordic Countries). The Working Group prepared a proposal for a Nordic classification for surgical procedures which was presented and approved at a Nordic seminar in November 1991. At the seminar specialists in each area were appointed to prepare the chapters and as contact persons. In all approximately 100 experts have been associated with the project. The following persons have been responsible for preparing the chapters: Steffen Birkeland and Glen Thorsen (Norway): Structure and classification guidelines Olli Heiskanen (Finland): Chapter A. Nervous system. Arto Sivula (Finland): Chapter B. Endocrine system. Henry Aasved (Norway): Chapter C. Eye and adjacent structures. Magnus Lind (Sweden): Chapter D. Ear, nose and larynx. Pentti Ahonen and Heikki Puhakka (Finland): Chapter E. Teeth, jaws, mouth and pharynx. Odd Geiran (Norway): Chapter F. Heart and major thoracic vessels. Nils B. Fjeld (Norway): Chapter G. Chest wall, pleura, mediastinum, diaphragm, trachea, bronchus and lung. Börje Sundell (Finland): Chapter H. Mammary gland. Glen Thorsen (Norway): Chapter J. Digestive system and spleen. Henning Bay-Nielsen (Denmark): Chapter K. Urinary system, male genital organs and retroperitoneal space. Karin Pihl (Sweden): Chapter L. Female genital organs. Karin Pihl (Sweden): Chapter M. Obstetric procedures. Niels Dieter Röck (Denmark): Chapter N. Musculo-skeletal system. David Bergqvist and Staffan Törngren (Sweden): Chapter P. Peripheral vessels and lymphatic system. Börje Sundell (Finland): Chapter Q. Skin. 6 PREFACE The chapters T, U, X, Y and Z have been prepared by the Editorial Committee, which had the following members: Henning Bay-Nielsen, Chairman (Denmark), Timo Niinimäki (Finland), Jónas Magnússon (Iceland), Steffen Birkeland (Norway) (until July 1995), Glen Thorsen (Norway) (from January 1995) and Hubertus van Paaschen (Sweden). Since the seminar held in November 1991, the Editorial Committee has been responsible for the coordination of final decisions concerning the classification. The Secretary of NOMESCO, Johannes Nielsen, has been Secretary to the Working Group and the Editorial Committee. The translation into English has been undertaken by Glen Thorsen. Henning Bay-Nielsen Chairman of the Editorial Committee 7 CONTENTS Contents Structure and classification guidelines 13 Chapter A Nervous system 22 AA Skull and intracranial structures 22 AB Spinal cord and nerve roots 26 AC Peripheral nerves 28 AD Autonomic nervous system 28 AE Miscellaneous operations on the nervous system 29 AW Reoperations in surgery of the nervous system 29 Chapter B Endocrine system 31 BA Thyroid gland 31 BB Parathyroid gland 32 BC Adrenal gland 32 BD Carotid body 32 BW Reoperations in endocrine surgery 32 Chapter C Eye and adjacent structures 34 CA Orbit 34 CB Eyelid and eyebrow 35 CC Lacrimal apparatus 37 CD Eyeball 38 CE Extraocular muscles 39 CF Conjunctiva 40 CG Cornea and sclera 41 CH Anterior chamber, anterior chamber angle, iris and ciliary body 42 CJ Operations on lens 44 CK Choroid, vitreous body and retina 45 CW Reoperations on eye and adjacent structures 48 Chapter D Ear, nose and larynx 49 DA Auricle 50 DB External auditory canal 50 DC Eardrum and middle ear 50 DD Ossicles of ear 51 DE Mastoid and temporal bone 51 DF Inner ear 51 DG Eustachian tube 52 DH Nose 52 DJ Septum of nose 53 DK Control of epistaxis 53 DL Plastic operations on nose 53 DM Maxillary antrum 53 8 CONTENTS DN Operations on ethmoidal sinus and bone 54 DP Frontal and sphenoidal sinuses 54 DQ Larynx 55 DW Reoperations in surgery of ear, nose and larynx 55 Chapter E Teeth, jaws, mouth and pharynx 57 EA Lips 57 EB Teeth 58 EC Gingiva and alveoli 59 ED Mandible 59 EE Maxilla 60 EF Miscellaneous operations on jaws 61 EG Mandibular joint 62 EH Palate 63 EJ Tongue and floor of mouth 63 EK Cheek 64 EL Salivary glands 65 EM Tonsils and adenoids 66 EN Pharynx and adjacent structures 66 EW Reoperations for complications in surgery of teeth, jaws, mouth and pharynx 67 Chapter F Heart and major thoracic vessels 69 FA Major thoracic veins 70 FB Pulmonary artery with branches 71 FC Thoracic and thoracoabdominal aorta, excluding malformations 74 FD Malformations relating to thoracic aorta 76 FE Pericardium 78 FF Atrium, atrial septum and pulmonary veins 79 FG Tricuspid valve 81 FH Ventricular septum 82 FJ Right ventricle and pulmonary valve 84
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