Three new procedure codes were added to private reimbursement schedule in England in July

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Aug 2017

The Clinical Coding and Schedule Development (CCSD) develops and maintains procedural and diagnostics nomenclature for private payers in England. Once codes are added to the Schedule, a private insurance company can develop reimbursement tariff for these procedures and tests.

The CCSD Group has approved the following procedure codes for publication to the CCSD Schedule in July:

  • Video-assisted anal fistula treatment (H5580)
  • Infracoccygeal sacropexy using mesh to repair uterine prolapse +/- ureterolysis (Q5460)
  • Infracoccygeal sacropexy using mesh to repair vaginal vault prolapse +/- ureterolysis (P2453)

The following requests have been declined or withdrawn:

  • CCSD declined requests for laying open of low anal fistula (fistulotomy) +/- insertion of stitch, +/- video assistance, (including sigmoidoscopy) and Laying open of high anal fistula (fistulotomy) +/- insertion of stitch, +/- video assistance (including sigmoidoscopy) due to implementation of new code for Video-assisted anal fistula treatment (VAAFT)

There were no changes to CCSD Diagnostic Schedule in July.

See full information here.

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Aug 2017

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Aug 2017

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Jun 2017

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Jun 2017

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Jun 2017

In second two weeks of May, National Institute for Health and Care Excellence has published two Medtech Innovation Briefings (collagen paste for anal fistulae and portable pulse‑echo ultrasound device to assist diagnosis of osteoporosis) one Interventional Procedure Guidance for endoscopic full thickness removal of non-lifting colonic polyps.

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09

May 2017

National Commission for the Evaluation of Medical Devices and Health Technologies (CNEDiMTS) positively appraised Verrata and Verrate Plus guidewires for add-on reimbursement via LPPR title V. Level of added clinical value was considered moderate (ASA III) in comparison with management strategy, based solely on angiography data. This decision complements decision early this year in relation to St. Jude Medical’s (now Abbott) PressureWire FFR wires.

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08

May 2017

Ministerial decree to enlist Medtronic's IN.PACT Admiral for the LPPR title V for add-on reimbursement was published on 6th of May 2017 in the Official Journal of French Republic. This is not only the first peripheral DCB on the List, but one of the first invasive non-implantable devices to get add-on reimbursement in France.

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05

May 2017

A new decree changed reimbursement approach for critical care in France. Before, it was reimbursed via daily supplements on top of base DRG tariff. New model introduces a mixed payment system with daily supplements and additional annual flat-rate fee, which depends on the size of the intensive care unit and activity in the previous year.

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04

May 2017

Check out reimbursement summary for the most established transcatheter mitral valve repair procedure in England, France and Germany. Reimbursement is established in Germany and France (for one indication). It is in process to be established in England and in France (for other indications).

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03

May 2017

National Institute for Health and Care Excellence (NICE) in the UK issued one Interventional Procedure Guidance, one Med Tech Innovation Briefing and updated two of Clinical Guidelines in April 2017.

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01

May 2017

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.

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26

Apr 2017

KCE issued a report, in which it reviewed provision of day surgery in Belgium, incentives for provision of day surgery in France and England and developed recommendations for incentive policy for day surgery in Belgium to policy-makers.

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24

Apr 2017

National Institute for Health and Care Excellence (NICE) in the UK issued two Interventional Procedure Guidance, one Medical Technology Guidance, five Med Tech Innovation Briefings and updated number of Clinical Guidelines in March 2017.

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24

Apr 2017

In Belgium, number of procedures and devices can only be reimbursed for the hospitals, that meet certain requirements. INAMI has released a new lists of hospitals eligible for reimbursement for a number of procedures and devices in cardiovascular, neuromodulation, urology and orthopedics areas.

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19

Apr 2017

The French National Authority for Health (HAS) has released report about evaluation of cardiac defibrillation probes and proposed updated nomenclature.

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13

Apr 2017

The procedure will be included into Prescribed Specialized Services. About 8000 patients can benefit from the treatment annually. Other stroke treatments are commissioned by Clinical Commissioning Groups.

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04

Apr 2017

NICE in the UK has released a consultation document in relation to the TAVI procedure (Interventional Procedure Guidance). Publication of the final guidance, which will replace the guidance from the 2012, is expected in July 2017.

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31

Mar 2017

NHS England has confirmed number of steps, included into the Cancer Strategy Implementation Plan: investment of 94 million pounds into linear accelerators and building up 10 new Rapid Diagnostic and Assessment Centres.

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24

Mar 2017

From 1st of April 2017 bariatric surgery will be fully transferred for commissioning by Clinical Commissioning Groups from national payer, the NHS England. English physicians are concerned that provision of surgery will face restrictions by local payers.

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