Introduction

The OPCS Classification of Interventions and Procedures (OPCS-4) is a Fundamental Information Standard.  The classification is used by Health Care Providers and Strategic Health Authorities.

 OPCS-4 is used to support operational and strategic planning, resource utilisation, performance management, reimbursement, research and epidemiology.OPCS-4 is used to support operational and strategic planning, resource utilisation, performance management, reimbursement, research and epidemiology.  It is used by NHS suppliers to build/update software to support NHS business functions and interoperability.

The OPCS-4 is subject to annual review and potential update to ensure that modern clinical practice is represented appropriately.  This will be continued until further notice as shown below:

*Tables of Coding Equivalences are issued for mapping back to previous versions found at https://www.uktcregistration.nss.cfh.nhs.uk/trud/

The NHS Data Model and Dictionary contains a number of data collections that require OPCS-4 codes, such as Central Returns and Commissioning Data Sets.  All data collections should use the latest version of the  OPCS-4 classification as specified in the table above.

Background

The classification of Surgical Operations and Procedures was originally issued by the Office of Population Censuses and Surveys (OPCS). The 4th revision was first implemented in hospital information systems in 1987. This was subject to a significant number of amendments and a consolidated version was reproduced in 1990.

The OPCS Classification of Surgical Operations and Procedures (OPCS-4.2) was substantially enhanced to ensure that modern clinical practice was represented appropriately within the classification and a new version was implemented in 2006 titled OPCS Classification of Interventions and Procedures (OPCS-4.3) with a commitment to undertake annual review and potential update. The classification comprises a list of alphanumeric codes with mainly anatomically based chapters, most of which relate to the whole or part of a body system. Each chapter is designated alphabetically e.g. Chapter A covers the nervous system and Chapter K is assigned to the heart. The alphabetic character for each chapter forms the prefix of the 3 and 4 digit codes within it. The strict link between chapters and body systems with specific procedures being listed for individual organs was breached in OPCS-4.3 because of limited capacity.

There are instances where an existing category needs extension because all the available codes have been allocated. In such cases an extended category is created within the Tabular List chapter. These categories are referred to as principal category or extended category and identified by an accompanying note to ease navigation.

Chapters that have reached capacity are extended using alphanumeric categories which are assigned using the free alpha O. This has occurred within three chapters (Chapters L, W and Z). Codes created in this way still form part of an existing chapter even though they have a different alpha prefix to the rest of that chapter. Such new codes will, therefore, logically sit at the end of the body system chapter and are readily identified within the alphabetical index. There is an additional chapter (Chapter X) for operations on multiple systems using miscellaneous procedures.

The classification is published in two volumes. The Tabular List and Alphabetical Index are available from The Stationary office at www.tsoshop.co.uk

OPCS-4 Requests Portal

The OPCS-4 Requests Portal allows stakeholders to submit change requests to the NHS Classification Service all year round. A cut-off date is necessary to support the annual review of requests and business case to proceed with an update to the classification.

More information about this classification and access to the OPCS-4 Requests Portal can be found at:
http://www.connectingforhealth.nhs.uk/systemsandservices/data/clinicalcoding/codingstandards/opcs4/44submissions

High Cost Drugs and Chemotherapy Regimens

The listings of High Cost Drugs and Chemotherapy Regimens which are mapped to OPCS-4 codes are provided as look-up tables downloadable either from:

• the NHS Classifications Service website
  http://www.connectingforhealth.nhs.uk/systemsandservices/data/clinicalcoding/ or
• the Terminology Reference Data Update Distribution Service website (user registration required)
  https://www.uktcregistration.nss.cfh.nhs.uk/trud/

Release: January 2010

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1115 (Immediate) - DSCN 10/2010 Data Standards: Updating of e- Government Interoperability Framework and Government Data Standards Catalogue References

Release: December 2009

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1100 (Immediate) - DSCN 25/2009 NHS Prescription Services Update
• CR1045 (1 December 2009) - DSCN 17/2009 Referral to Treatment Clock Stop Administrative Event
• CR1003 (1 December 2009) - DSCN 16/2009 Commissioning Data Sets: Mandation of 18 Week Referral To Treatment Data Items

Release: November 2009

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1113 (Immediate) - DSCN 24/2009 Information Standards Board for Health and Social Care Update
• CR1087 (Immediate) - DSCN 23/2009 Health Professions Council Update
• CR1081 (Immediate) - DSCN 22/2009 Data Standards: NHS Data Model and Dictionary Maintenance Update
• CR1019 (27 November 2009) - DSCN 21/2009 Data Standards: Organisation Data Service (ODS) - Optical Sites and Optical Headquarters
• CR1034 (27 November 2009) - DSCN 20/2009 Data Standards: Organisation Data Service (ODS) - Care Homes in England and Wales and their Headquarters

Release: September 2009

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1065 (1 October 2009) - DSCN 15/2009 Data Standards: Organisation Data Service – Local Health Boards

Release: June 2009

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1014 (1 June 2009) - DSCN 13/2009 Religious and Other Belief System Affiliation
• CR1074 (Immediate) - DSCN 12/2009 Data Standards: Care Quality Commission
• CR1056 (Immediate) - DSCN 11/2009 Data Standards: NHS Data Model and Dictionary Maintenance Update
• CR1072 (1 December 2009) - DSCN 10/2009 Data Standards: National Radiotherapy Data Set
• CR1073 (Immediate) - DSCN 09/2009 Central Returns: Diagnostic Waiting Times and Activity Data Set
• CR1066 (Immediate) - DSCN 08/2009 Data Standards: NHS Prescription Services and NHS Dental Services
• CR1047 (1 April 2011) - DSCN 07/2009 Data Standards: Diabetic Retinopathy Screening Dataset v3.6 
• CR1059 (Immediate) - DSCN 06/2009 Data Standard: National Workforce Data Set v2.1
• CR914 (April 2008 (Retrospective)) - DSCN 05/2009 NHS Stop Smoking Services Quarterly Monitoring Return
• CR899 (Immediate) - DSCN 02/2009 NHS Data Model and Dictionary Maintenance Update

Release: March 2009

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1001 (1 April 2009) - DSCN 03/2009 Introduction of Commissioning Data Set Schema Version 6-1 (2008-04-01) and update to Commissioning Data Set Schema Version 6-0 (2008-01-14)
• CR976 (31 March 2009) - DSCN 26/2008 Subject: KP90 - Admissions, Changes in Status and Detentions under the Mental Health Act
• CR1017 (1 April 2009) - DSCN 25/2008 Critical Care Minimum Data Set
• CR1002 (1 April 2009) - DSCN 24/2008 Data Standards: Introduction of Commissioning Dataset Version 6.1
• CR1016 (Immediate) - DSCN 23/2008 4 Byte Version of the Read Codes - Withdrawal

Release: December 2008

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1022 (1 January 2009) - DSCN 29/2008 Data Standards: 18 Weeks Referral to Treatment (RTT) Time, Performance Sharing
• CR901 (Immediate) - DSCN 28/2008 Removal of references to EDIFACT and the NHS Wide Clearing Service (NWCS) 
• CR843 (1 April 2009) - DSCN 22/2008 Data Standards: National Radiotherapy Data Set
• CR1011 (1 January 2009) - DSCN 20/2008 Data Standards: National Cancer Waiting Times Minimum Data Set 

Release: November 2008

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1026 (3 November 2008) - DSCN 21/2008 Information Standard: Mental Health Act 2007 Mental Category

Release: August 2008

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR1018 (Immediate) - DSCN 19/2008 Data Standards: Change of Name for National Administrative Code Services (NACS) to Organisation Data Service (ODS)
• CR956 (1 September 2008) - DSCN 18/2008 Central Return: Human Papillomavirus (HPV) Immunisation Programme – Vaccine Monitoring Minimum Dataset
• CR861 (Immediate) - DSCN 16/2008 Central Return:  Hospital and Community Services Complaints and General Practice (including Dental) Complaints - KO41(a) and KO 41(b)
• CR964 (Immediate) - DSCN 14/2008 Central Return: 18 Weeks ‘Adjusted’ Referral to Treatment (RTT) Dataset
• CR965 (Immediate) - DSCN 13/2008 Data Standards: Organisation Data Service (ODS) - Change to the Default Codes Set to Support Changes to GMS Contract
• CR879 (Immediate) - DSCN 12/2008 Data Standards: Quarterly Monitoring: Cancelled Operations Data Set (QMCO)

Release: May 2008

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR502 (Immediate) - DSCN 10/2008 Data Standards: National Workforce Data Definitions (v2.0)
• CR910 (1 April 2008) - DSCN 08/2008 Data Standards: National Direct Access Audiology Patient Tracking List (PTL) and Waiting Times (WT) data sets
• CR900 (Immediate) - DSCN 07/2008 Data Standards: Inter-Provider Transfer Administrative Minimum Data Set
• CR934 (1 April 2008) - DSCN 06/2008 Data Standards: Mental Health Minimum Data Set (version 3.0)
• CR935 (Immediate) - DSCN 05/2008 Data Standards: 18 Weeks Rules Suite
• CR925 (1 September 2008) - DSCN 04/2008 Genitourinary Medicine Clinic Activity Data Set Change to an Information Standard
• CR942 (1 June 2008) - DSCN 03/2008 General Practice and General Medical Practitioner (GMP) - changes resulting from the introduction of the General Medical Services (GMS) Contract

Release: February 2008

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR812 (Immediate) - DSCN 01/2008 Central Return: Diagnostics Waiting Times Census Data Set
• CR881 (31 December 2007) - DSCN 42/2007 Central Return: Referral To Treatment Summary Patient Tracking List
• CR904 (Immediate) - DSCN 41/2007 Data Standards: Admission Intended Procedure Update
• CR824 (1 February 2008) - DSCN 39/2007 Data Standards: 48 Hour Genitourinary Medicine Access Monthly Monitoring (GUMAMM)

Release: November 2007

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR919 (Immediate) - DSCN 38/2007 Data Standards: Mental Health Minimum Data Set Schema
• CR814 (1 April 2008) - DSCN 37/2007 Data Standards: Introduction of Mental Health Minimum Data Set version 2.1
• CR930 (31 December 2007) - DSCN 35/2007 Data Standards: A correction to the version 6 Commissioning Data Set schema
• CR834 (Immediate) - DSCN 34/2007 Data Standards: Referral Request Received Date
• CR875 (Immediate) - DSCN 33/2007 Data Standards: National Administrative Codes Service: Introduction of codes for the new Pan SHAs
• CR880 (Immediate) - DSCN 29/2007 Data Standards: Amendments to Doctor Index Number (DIN) Description

Release: August 2007

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR845 (Immediate) - DSCN 28/2007 Data Standards: Treatment Function Code (Referral to Treatment Period)
• CR831 (1 October 2007) - DSCN 27/2007 Data Standards: Update to Commissioning Data Set XML Schema v5
• CR825 (1 October 2007) - DSCN 16/2007 Data Standards: Source of Referral for Outpatients (18 Weeks)

Release: June 2007

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR799 (31 December 2007) - DSCN 18/2007 Data Standards: Introduction of Commissioning Data Set Version 6
• CR833 (Immediate) - DSCN 17/2007 Data Standards: Introduction of Commissioning Data Set validation table
• CR801 (Immediate) - DSCN 15/2007 Data Standards: Cover of Vaccination Evaluated Rapidly (COVER) Return

Release: May 2007

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR800 (31 December 2007) - DSCN 14/2007 Commissioning Data Set Schema Version 6-0
• CR856 (1 October 2007) - DSCN 13/2007 Data Standards: Discharge Ready Date
• CR869 (Immediate) - DSCN 12/2007 Data Standards: Update to Clinical Coding Introduction
• CR827 (1 October 2007) - DSCN 09/2007 Data Standards: Earliest Reasonable Offer Date
• CR817 (1 October 2007) - DSCN 08/2007 Data Standards: Introduction of Age into Commissioning Data Sets
• CR849 (May 2007) - DSCN 07/2007 National Administrative Codes Service: Introduction of new identification codes for Dental Consultants
• CR822 (Immediate) - DSCN 06/2007 Data Standards: Update to Organisation Codes
• CR850 (Immediate) - DSCN 05/2007 National Administrative Codes Service: Amendments to Default Codes
• CR786 (1 April 2007) - DSCN 04/2007 Quarterly Monitoring Accident and Emergency Services (QMAE) Central Return

Release: February 2007

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR811 (Immediate) - DSCN 03/2007 Diagnostic Waiting Times and Activity
• CR826 (1 October 2007) - DSCN 02/2007 Extension of Treatment Function to Support the Measurement of 18 Week Referral to Treatment Periods
• CR813 (1 April 2007) - DSCN 01/2007 Paediatric Critical Care Minimum Data Set
• CR768 (1 January 2007) - DSCN 18/2006 Changes to the NHS Data Dictionary to support the measurement of 18 week referral to treatment periods
• CR798 (6 November 2006) - DSCN 19/2006 Commissioning Data Set (CDS) Version 5 XML Message Schema
• CR776 (1 October 2006) - DSCN 05/2006 Data Standards: Accident and Emergency Enhancements to Investigation and Treatment Codes

Release: September 2006

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR795 (31 October 2006) - DSCN 22/2006 Organisation Codes / Organisation Site Codes
• CR792 (1 April 2007) - DSCN 15/2006 Neonatal Critical Care
• CR719 (1 April 2006) - DSCN 09/2006 Measuring and Recording of Waiting Times
• CR791 (1 April 2007) - DSCN 13/2006 Priority Type
• CR774 (1 September 2006) - DSCN 12/2006 Person Marital Status

Release: May 2006

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR764 (1 April 2006) - DSCN 08/2006 Diagnostics waiting times and activity
• Correction to menu structure to include Critical Care Minimum Data Set

Release: April 2006

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR608 (1 October 2006) - DSCN 07/2006 Introduction of Commissioning Data Set Version 5 and its associated XML schema into the NHS Data Dictionary.
• CR756 (1 September 2005) - DSCN 19/2005 PbR Commissioning for Out of Area Treatments (OATs) and Charge-Exempt Overseas Visitors
• CR724 (1 April 2006) - DSCN 13/2005 Critical Care Minimum Data Set
• CR754 (1 April 2006) - DSCN 17/2005 Treatment Function and Main Specialty Code Revisions
• CR763 (1 April 2006) - DSCN 20/2005 New Treatment Functions for therapy services and anticoagulant service
• CR767 (Immediate) - DSCN 02/2006 Referral Request Received Date
• CR690 (1 September 2005) - DSCN 16/2005 Marital Status

Release: August 2005

Data Set Change Notices incorporated into the NHS Data Model and Dictionary:

• CR555 (1 April 2005) - DSCN 11/2005 Data Standards: COVER - Hepatitis B immunisation for babies
• CR715 (Immediate) - DSCN 10/2005 Data Standards: Treatment Function Codes - correction and clarification of names and descriptions
• CR706 (1 April 2005) - DSCN 09/2005 Data Standards: Cancer Registration Data Set
• CR691 (1 July 2005) - DSCN 06/2005 Data Standards: NSCAG Commissioner Code

For all Data Set Change Notices, see the Data Set Change Notice (DSCN) Website

Identifies the type of PERSON GENDER recorded.

Note:
PERSON GENDER CODE "0 Not Known" is only applicable to "Person Gender Current".

National Codes:

Notes:
This is the ORGANISATION CODE of the ORGANISATION at which the authorising pathologist is based.

Notes:
This is the same as the attribute ORGANISATION CODE.

This is the code of an ORGANISATION that has been involved in the PATIENT PATHWAY following the ORGANISATION that issued the PATIENT PATHWAY IDENTIFIER.

For the Inter-Provider Transfer Administrative Minimum Data Set, multiple occurences of the ORGANISATION CODE (ON PATHWAY) may be recorded to reflect all ORGANISATIONS involved in the PATIENT PATHWAY.For the Inter-Provider Transfer Administrative Minimum Data Set, multiple occurrences of the ORGANISATION CODE (ON PATHWAY) may be recorded to reflect all ORGANISATIONS involved in the PATIENT PATHWAY.

Notes:
This is the same as the attribute ORGANISATION CODE.

This is the code of the ORGANISATION that is receiving the PATIENT from another Health Care Provider.

Notes:
This is the same as ORGANISATION CODE (RESPONSIBLE PCT) with the exception of PERSONS receiving a Stop Smoking Service at or near their workplace, which may be some distance from their home.

For example, a Stop Smoking Service might be provided for commuters at their workplace in a large city. In such circumstances it is likely that PERSONS will be drawn from a range of places in the surrounding area e.g. commuters to London who live all around the south-east of England. Where a SERVICE is judged to meet these criteria, the Primary Care Trust providing the SERVICE is the responsible Primary Care Trust.

Notes:
This is the ORGANISATION CODE TYPE of the CDS COPY RECIPIENT IDENTITY.

Notes:
This is the ORGANISATION CODE TYPE of the CDS PRIME RECIPIENT IDENTITY.

Notes:
This is the ORGANISATION CODE TYPE of the CDS SENDER IDENTITY.

Notes:
This is the same as ORGANISATION NAME.

This is the name of the ORGANISATION that is receiving the PATIENT from another Health Care Provider.

Notes:
This is the same as ORGANISATION NAME.

This is the name of the ORGANISATION that is referring the PATIENT to another Health Care Provider.

Notes:
This records the first REFERRAL REQUEST RECEIVED DATE for a specific health care service to be provided, which was received. This date must be recorded on any subsequent REFERRAL REQUESTS for the same health care service and should never be altered or removed, even if the Health Care Provider changes, until the specific health care service is provided for the PATIENT, or is no longer required.