CCSD code G7402 – Open ileostomy formation

Key takeaways

CCSD code G7402 is open formation of an ileostomy, a Chapter 11 abdominal procedure that Bupa grades MAJOR 3.

Bill the laparoscopic operation as G7403, and don’t add G7402 when a resection code already includes the stoma.

Plan on pre-authorization for every G7402 case, and confirm the policy terms in each insurer’s portal.

Most rejections trace back to a missing authorization number, lapsed recognition, or an op note that doesn’t match the code.

Claims reach UK insurers through Healthcode, so the invoice details must match the clinical record exactly.

What is CCSD code G7402?

CCSD code G7402 is the UK private-billing code for open formation of an ileostomy. The surgeon brings a loop or the end of the ileum through an abdominal incision to form a stoma. Insurers pay it as a surgical fee, billed through Healthcode.

G7402 sits in Chapter 11 of the CCSD Schedule, which covers the abdomen, in the jejunum/ileum section. Bupa’s February 2026 schedule places it in the MAJOR 3 band. Neighboring codes sit in our CCSD procedure codes library.

• Descriptor: Open formation of ileostomy
• Chapter: 11, Abdomen (excluding urinary and reproductive organs)
• Section: 11.4.0, Jejunum/ileum
• Bupa band: MAJOR 3 (February 2026 schedule)
• Laparoscopic version: G7403
• Submitted via: Healthcode, the UK private billing clearinghouse
• Not used for: NHS activity, which is coded in OPCS-4

What G7402 covers and what it doesn’t

G7402 pays for one operation: forming the ileostomy through an open incision. Loop and end ileostomies both fall under it when the approach is open. Other work on the same day usually needs its own code, or no code at all.

Resection is where claims slip. CCSD lists several bowel resection and proctocolectomy codes as combinations it won’t accept with G7402. G6080 is one of them, because its descriptor already allows for a stoma.

Insurers can add their own bundling rules on top of the CCSD baseline. Check the CCSD technical guide and the insurer’s schedule before you rely on any row above.

What to document first

A G7402 claim stands or falls on the op note. Write it before the invoice goes out, never after a query arrives. The note has to show an open approach, because the laparoscopic operation carries a different code.

Build the record in this order:

1. Authorization: Record the insurer’s authorization number before the operation date.
2. Procedure: Name it the way the descriptor does, open formation of ileostomy. Add the indication and the stoma type.
3. Approach: State that the operation was open. If a laparoscopic start converted to open, record the conversion and check the insurer’s rule before you choose G7402 or G7403.
4. Date and site: Match the operation date and hospital on the note to the invoice.
5. Supporting documents: Keep the op note, consent form and any histology report ready to attach if the insurer asks.

Before you submit G7402: Checklist

Run these six checks before the invoice leaves the practice. Each one maps to a common rejection reason.

• Recognized status: The surgeon is on the insurer’s recognized specialist list.
• Pre-auth number: The authorization number is on the invoice and matches the insurer’s record.
• Descriptor match: The op note describes an open ileostomy, not a laparoscopic one.
• Date and facility match: The invoice date and hospital match the clinical record.
• Supporting op note: The signed op note is ready to send if the insurer requests it.
• Anesthesia coded separately: The anesthetist bills their own code, so your invoice carries only the surgical fee.

Does G7402 need pre-authorization?

Yes, plan on it. An ileostomy is a major inpatient operation, and UK insurers expect authorization before surgery. The exact rules sit in each policy, so confirm them for every patient.

The Bupa procedure fee schedule and each insurer’s portal show what applies to the code.

Insurer rules change when schedules update. Check the live portal each time, not last year’s PDF.

Who pays G7402?

Every major UK private medical insurer (PMI) uses CCSD codes, so G7402 is billable to all of them in principle. Payment on a given claim turns on three questions:

• Does the insurer recognize the surgeon?
• Does the patient’s policy cover the condition?
• Was pre-authorization obtained before surgery?

The Bupa code search tool and the AXA Health specialist forms portal show fees and conditions per code. Our Bupa CCSD codes reference explains how Bupa grades and pays procedures.

The Vitality fee finder and the Aviva fee schedule also list fees by CCSD code. Fees change every year, so check the current schedule before you raise an invoice.

Codes commonly confused with G7402

Ileostomy codes come in a tight family, and picking the nearest-looking one is how claims go wrong. Billing a bigger operation than you did is upcoding. Billing a smaller one loses income you earned.

Surgeons moving from NHS work feel this most. OPCS-4 conventions don’t map one-to-one onto CCSD, so a familiar NHS code can lead you to the wrong private one. The laparoscopic version, G7403, is the most common mix-up.

Bands come from Bupa’s February 2026 schedule. CCSD lists G7403, G7512, G7513, G7530 and G6080 as unacceptable combinations with G7402, so don’t bill them together. When in doubt, check the descriptor in the current schedule at ccsd.org.uk.

Why claims get denied

G7402 rejections fall into six causes. Start with the reason code on the Healthcode remittance, match it below, then apply the fix.

• Missing pre-authorization: The insurer has no authorization on record. Ask whether it accepts a retrospective request, then resubmit with the number in the authorization field.
• Unrecognized provider: The billing surgeon isn’t on the insurer’s list. Apply for recognition, and ask the insurer how it handles the open claim.
• Wrong code: The op note describes a different operation. Recode from the descriptor, and add a correction note if the insurer asks for one.
• Unacceptable combination: G7402 went out alongside a code such as G7403 or G6080. Drop the code the op note doesn’t support and resubmit.
• Missing documents: The insurer asked for an op note, consent form or histology report. Attach it and flag the invoice as a resubmission, not a new claim.
• Policy exclusion: The patient’s policy doesn’t cover the condition. Confirm with the insurer, then discuss self-pay with the patient before the bill becomes a debt.

Each insurer sets its own time limit for claims and resubmissions. Check that limit and log every rejection date, so none lapses.

How a G7402 claim moves through Healthcode

Healthcode is the clearinghouse UK private practices use to send CCSD-coded invoices to insurers. The chart below shows the five stages, and what stops a claim at each one.

1. Log in to Healthcode with your practice’s credentials. Check that the surgeon’s profile shows current recognition with the target insurer.
2. Create the invoice and find the patient by membership number and date of birth. Details that don’t match the insurer’s record get rejected straight away.
3. Enter G7402 in the procedure field. Check that the descriptor shown reads open formation of ileostomy.
4. Enter the authorization number in its field. Leave it blank only if the insurer confirmed that this claim needs none.
5. Attach any documents the insurer requires, then submit. Keep Healthcode’s acknowledgement with the clinical record.

Payment times vary by insurer. A clean claim has every field complete, a recognized surgeon and an authorization on file. Those three checks remove the most common reasons a claim comes back.

How Pabau supports CCSD surgical billing

In many surgical practices, a secretary rekeys operation details into the Healthcode portal. The authorization number sits in an email thread, and the op note lives in another system. Each handoff is a chance for the invoice and the record to disagree.

Pabau, the practice management platform we build, keeps those pieces on one patient record. The op note, consent form and authorization number sit together, and the invoice is created from the procedure entry. Our medical billing software then sends it to Healthcode.

• Invoice generation: Create a Healthcode invoice from the procedure entry, with patient and insurer details pulled from the record.
• Clinical documentation: Op notes, consent records and histology reports stay on the patient record, ready if an insurer asks.
• Audit trail: Every change to the record is timestamped, so you can show what was documented and when.

For hospital-based surgeons billing several CCSD codes per episode, that means fewer portal logins and fewer queries back from insurers.

Bill surgical CCSD codes with less admin

Pabau creates Healthcode invoices from the procedure entry and keeps the op note, consent form and authorization number on the patient record.

Book a demo

Conclusion

G7402 pays cleanly when three things line up before surgery. You need recognition with the insurer, an authorization number, and an op note that says open ileostomy. Get those right and the rest of the claim is data entry.

The trap worth remembering is the combination rule. If the stoma came with a resection, the resection code usually carries it, and G7402 on top invites a rejection. Check the op note against the code family before every invoice.

Want fewer claims bouncing back from Healthcode? Book a demo to see how Pabau turns a surgical op note into an insurer-ready invoice.

Continue your research

Did the whole operation run laparoscopically? CCSD code G7403 covers the keyhole ileostomy and how it differs from G7402.

Was the stoma formed during a resection? CCSD code G6080 explains the laparoscopic small bowel resection code that already allows for a stoma.

Billing a jejunostomy instead? CCSD code G6000 covers open formation of jejunostomy, the next code up the small bowel.

Removing a segment of jejunum? CCSD code G5810 walks through billing an excision of jejunum to UK insurers.

Want Bupa’s bands and fees in one place? Bupa CCSD codes explains how Bupa grades and pays CCSD procedure codes.

Frequently asked questions about CCSD code G7402