CCSD code M6750 – Transurethral needle ablation of the prostate

Key takeaways

CCSD code M6750 covers transurethral needle ablation (TUNA) of the prostate. TURP, HoLEP, UroLift and Rezum each carry their own CCSD code.

The M6750 fee covers the surgeon’s operative time and RF needle passes. Anaesthesia and post-operative follow-up are billed separately.

UK private insurers, including Bupa, AXA Health and Aviva, typically require pre-authorisation for TUNA, and the reference number must appear on the claim.

Pabau, the practice software we build, keeps CCSD codes, operative notes and insurer submissions on one patient record for UK urology practices.

What is CCSD code M6750?

CCSD code M6750 is the code for transurethral needle ablation (TUNA) of the prostate in the CCSD official schedule. UK private insurers use that schedule to pay consultants. The official descriptor is: Transurethral needle ablation (TUNA) of the prostate.

M6750 sits in the prostate section of chapter 12 of the schedule, Urinary system and male reproductive organs, alongside the other prostate procedures. Bupa grades it MAJOR 1, with a listed fee of £475 at the time of writing.

Coders working in UK private practice use M6750 when the consultant urologist has performed needle-based radiofrequency ablation of periurethral prostatic tissue as a standalone procedure. Any other prostate intervention requires its own CCSD code, however similar the outcome.

What does transurethral needle ablation (TUNA) involve?

Transurethral needle ablation (TUNA) delivers radiofrequency (RF) energy through needles passed into periurethral prostatic tissue via the urethra. The heat creates localised lesions and reduces the bulk of tissue that obstructs urinary flow.

The procedure treats benign prostatic hyperplasia (BPH) causing lower urinary tract symptoms (LUTS). It suits men whose medical therapy has failed or who are unsuitable for more invasive surgery.

The clinical steps, relevant to coders verifying the operative note, are:

1. The patient is positioned and anaesthesia is administered (local, sedation, or general depending on patient and surgeon preference).
2. A cystoscope is passed transurethrally to visualise the urethra and confirm anatomical landmarks.
3. TUNA needles are deployed from the catheter-mounted applicator into the lateral lobes of the prostate under cystoscopic guidance.
4. RF energy is delivered at a controlled temperature (typically 100-110°C at the needle tip) for a timed treatment period per needle position.
5. The needle is repositioned and the energy cycle repeated until the planned number of passes is completed across both lobes.
6. The instruments are withdrawn and a urethral catheter is placed temporarily if required.

The signal coders look for in the operative note is an explicit mention of radiofrequency energy delivered through transurethral needles, plus the number of passes. Operative notes that leave this out are the most common documentation reason for denial.

Clinical indications: When is TUNA appropriate?

TUNA is indicated for men with symptomatic BPH causing moderate to severe LUTS. It suits those who have not responded to medical management, or who prefer a minimally invasive option over TURP. UK private insurers typically accept the following documented indications when processing an M6750 claim:

• Confirmed BPH diagnosis with documented LUTS (International Prostate Symptom Score, IPSS, of 8 or above is widely used as a threshold)
• Prostate volume in the range that makes TUNA technically feasible (typically 20-100 mL; very large prostates may favour TURP or HoLEP)
• Failure of or intolerance to alpha-blocker therapy or 5-alpha-reductase inhibitors
• Patient unfit for or declining general anaesthesia for TURP (TUNA can be performed under local anaesthesia or sedation)
• Absence of active urinary tract infection, urethral stricture, or bladder neck obstruction requiring a different surgical approach

NICE issued Interventional Procedures Guidance IPG15 for TUNA in October 2003 with special arrangements. The procedure may be performed in NHS or private settings under two conditions. Each case is recorded in a clinical governance register, and patients are told about the evidence base.

This guidance is not full NICE approval. Coders should not cite IPG15 as evidence of routine insurer cover, because each payer’s policy governs private reimbursement independently.

Private urology practices that treat men’s health patients also benefit from purpose-built software. Pabau’s men’s health clinic software tracks treatment pathways, consultation notes and procedure coding alongside insurer submissions.

What the M6750 fee does and does not include

The M6750 fee covers the consultant urologist’s professional time for the entire TUNA procedure from induction through completion of needle passes. The table below summarises what is bundled within that fee and what must be billed as a separate CCSD line item.

The most common billing error is a duplicate cystoscopy charge. It happens when the cystoscopy was a navigation step during TUNA rather than a standalone diagnostic episode. Confirm this distinction in the operative note before adding a cystoscopy line to the claim.

Related CCSD codes to know alongside M6750

Several CCSD codes appear on the same episode as M6750 or are confused with it during coding. The table below lists the codes most relevant to urology billers working with prostate procedures.

Confirm the current CCSD codes for UroLift and Rezum in the live schedule before you submit. Both are newer procedures, and their entries change more often than older codes. The CCSD official schedule is the authoritative reference.

TUNA vs TURP vs UroLift vs Rezum: Coding the right procedure

These four procedures all treat symptomatic BPH, but their mechanisms are distinct and each maps to a different CCSD code. The operative note is the coder’s primary distinguishing document.

If the operative note references a TURP resectoscope loop, the correct code is M6530, not M6750, whatever the BPH indication. Cross-check the mechanism, not the outcome, when selecting the CCSD code.

Documentation requirements to support a valid M6750 claim

UK private insurers audit M6750 claims against the clinical record. An operative note that lacks procedure-specific detail is the leading cause of denial. Use digital clinical documentation tools to capture and store structured operative records against each patient episode at the point of care.

The minimum documentation elements required to support a valid M6750 claim are:

• Confirmed BPH diagnosis: The clinical record must state the indication clearly; ICD-10 N40.x codes should appear on the claim alongside M6750.
• IPSS or equivalent severity score: Documenting symptom severity supports medical necessity and aligns with NICE IPG15 special arrangements.
• Failed conservative treatment: A note of which alpha-blockers or 5-ARIs were tried, for how long, and why they were inadequate.
• Prostate volume: Measured by transrectal ultrasound (TRUS) or pelvic MRI; volume informs procedure suitability and clinical justification.
• Operative note with needle placement detail: Must name the device used, number of needle passes, RF energy parameters (temperature/duration), and lobes treated.
• Anaesthetic record: Type of anaesthesia used; this supports the separate anaesthetic claim and confirms the procedure was performed under appropriate conditions.
• Pre-authorisation reference number: Must appear on the claim form; absence is an immediate denial trigger at most insurers.

Keep structured patient records that link operative notes, pre-authorisation letters and ICD-10 codes to each episode. When an insurer queries a claim, the answer is then already on file.

Pre-authorisation requirements for M6750

TUNA is an elective surgical procedure and UK private insurers typically require pre-authorisation before it is performed. The pre-authorisation reference number issued by the insurer must be included on the M6750 claim submission; claims submitted without it are routinely returned unpaid.

The major UK insurers each have their own pre-authorisation portal and clinical information requirements. The table below summarises the key touchpoints. Policies change, so verify current requirements directly with the payer before proceeding.

Pabau’s Bupa CCSD code schedule reference provides additional context on how Bupa processes CCSD-coded claims, including fee bandings and unbundling rules relevant to urology procedures.

Common claim denial reasons for CCSD M6750

M6750 claims draw close insurer scrutiny for three reasons. TUNA has detailed documentation requirements, some payers question its evidence base, and its code sits next to more commonly billed prostate codes. The five checkpoints below close off each common denial before the claim leaves the practice.

The most frequent denial reasons and their resolutions are:

• Missing pre-authorisation reference number: The number was not entered on the claim form, or authorisation was not obtained before the procedure. Resolution: Obtain pre-auth before the procedure date; include the reference number on every M6750 submission.
• Wrong procedure code submitted: The TURP code, M6530, was entered in error. This slip is common when the surgeon performs TURP more often than TUNA. Resolution: Verify the operative note against the CCSD code before submission, because TUNA and TURP codes are not interchangeable.
• Insufficient operative note detail: The note describes the outcome (“prostate deobstructed”) rather than the mechanism (“RF energy delivered via transurethral needles”). Resolution: Use a structured operative note template that explicitly captures device name, needle passes, RF parameters, and lobes treated.
• Indication not adequately documented: The clinical record lacks a confirmed BPH diagnosis, IPSS score, or evidence of failed medical therapy. Resolution: Ensure the pre-operative assessment is in the record and that the ICD-10 N40.x diagnostic code is included on the claim.
• Duplicate cystoscopy charge: A separate cystoscopy CCSD code was added when the cystoscopy was integral to the TUNA approach. Resolution: Bill cystoscopy separately only when it was a distinct diagnostic episode. That means a different date, or a context clearly separate from the TUNA procedure.
• Procedure not covered under the patient’s policy: Some plans exclude minimally invasive BPH procedures or apply a waiting period. Resolution: Verify coverage and policy terms at the pre-authorisation stage, before the procedure takes place.

How to submit an M6750 claim through Healthcode

Healthcode is the primary electronic billing platform for UK private healthcare, used by the majority of UK insurers to process CCSD-coded claims. The steps below follow the standard Healthcode workflow for M6750.

Healthcode updates its interface from time to time, so contact its support team if the screens differ from this guidance.

1. Log in and open a new invoice. Select the consultant’s provider number and the insurer to which you are submitting. Confirm the patient’s membership number and date of birth match the insurer’s records before proceeding.
2. Enter the procedure date and hospital/clinic site. TUNA is typically performed as a day-case or short inpatient episode; select the correct admission type.
3. Add the CCSD code M6750. In the procedure code field, enter M6750 and confirm the descriptor reads “Transurethral needle ablation (TUNA) of the prostate”. Do not substitute or modify the code.
4. Add the ICD-10 diagnostic code. Enter the appropriate N40.x BPH code (see the ICD-10 section below) in the diagnosis field. Some insurers also accept a free-text diagnosis; use “benign prostatic hyperplasia” to match the ICD-10 description.
5. Enter the pre-authorisation reference number. This is the reference issued by the insurer when pre-auth was granted. Healthcode checks that a reference is present for procedure codes that require one, and the submission will not complete without it.
6. Attach supporting documentation if required. Some insurers request the operative note or a clinical summary at submission. Healthcode allows document attachments in PDF format; include the structured operative note if the payer’s protocol requires it.
7. Review and submit. Check the provider number, patient details, procedure code, diagnostic code and pre-auth reference, then submit. Healthcode returns an acknowledgement. Keep the transaction reference in case the claim is queried.

Pabau’s private healthcare claims management tools record CCSD codes against each patient episode in the clinical record. Claims then go to Healthcode without anyone re-entering the data.

Diagnostic codes to use with M6750 (ICD-10)

UK private insurers require an ICD-10 diagnostic code on CCSD-coded claims. For M6750, the correct codes sit within the N40 category (benign prostatic hyperplasia). The ICD-10 sub-codes distinguish between BPH with and without lower urinary tract symptoms.

N40.1 is the diagnostic code most often paired with M6750 in UK private billing. LUTS is what leads most patients to choose TUNA over continued medical management. Some insurers specify a preferred sub-code at the pre-authorisation stage; check the insurer’s clinical guidelines if N40.1 is queried.

How Pabau keeps M6750 claims clean from referral to payment

An M6750 claim is usually pieced together from four places: the referral letter, the operative note, the insurer’s pre-authorisation email and the Healthcode portal. Every field typed twice is a chance to drop the reference number or enter the TURP code by mistake.

In Pabau, those pieces live on one patient record. Your team saves the pre-authorisation reference against the episode and writes the operative note from a structured template. M6750 and the N40.x code are recorded on the same record, and UK claims go to insurers through Healthcode and Bupa from there.

The claim then leaves with its reference number, a mechanism-level operative note and the right diagnosis code already attached. Fewer invoices come back for rework, and a query is answered from the record rather than an inbox.

Manage CCSD coding and private insurer submissions from one place

Pabau keeps CCSD codes, operative notes and pre-authorisation references on one record, so UK urology practices submit cleaner claims through Healthcode.

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Conclusion

Treat M6750 as a mechanism code first. If the operative note does not say radiofrequency energy went in through transurethral needles, the claim is not ready, however clear the BPH indication is.

The trade-off is admin up front. Pre-authorisation and a detailed operative note take time before the procedure, but far less time than chasing a returned invoice weeks later.

Book a demo to see how Pabau links the operative note, pre-authorisation reference and Healthcode claim for private urology practices.

Continue your research

Looking for practice management software built for UK private healthcare? Men’s health clinic software from Pabau covers the clinical, billing, and scheduling workflows specific to urology and men’s health private practices.

Want to reduce claim errors through better clinical documentation? Digital clinical documentation from Pabau lets practitioners capture structured operative notes and consent records that map directly to CCSD coding requirements.

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