Implantable ventricular assist devices

Procedure coding

Typically, procedure coding is well-established for ventricular assist devices in European countries. 

For example, in England, a specific OPCS code K54.1 “Open implantation of ventricular assist device” exists to cover implantable VADs. Percutaneous VADs are coded separately. 

In some countries, only a limited number of procedure codes exist, while in others, a very detailed classification of VADs is available. 

For example, in Germany, OPS procedure coding distinguishes between different types of VAD systems, including mono- and bi-ventricular, intra- or para-corporeal devices, etc. 

Policy considerations

Due to high cost, VADs can be subject to specific policies from payers or national decision-makers in the countries where such frameworks exist. 

For example, in England, the national payer, NHS England, developed so-called Service Specifications for the use of ventricular assist devices, in which NHS England outlined patient pathways, eligible hospitals, responsibilities of different stakeholders, etc. 

Future challenges 

Classic VADs have established reimbursement and funding in most of the European countries. New health technology assessments are unlikely to be relevant. 

Classic VADs are unlikely to benefit from the innovative payment schemes. 

Novel ventricular assist devices with unique designs or properties, or different cost profiles might need to develop specific procedure codes and adjust payment mechanisms to fully leverage their unique technology or cost profile. 

An important topic for VAD is the expansion of indications towards destination therapy (in the countries, where it is not yet established).