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Reimbursement summary for angioplasty of arteries of lower extremities

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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The 2021 procedure coding system (NCMP-NCSP-NCRP) issued in Norway

In early November 2020, the final version of the procedure coding system for 2021 was issued by the Norwegian Directorate for e-Health. The coding system consists of three parts: NCMP for medical procedures, NCSP for surgical, and NCRP for radiological procedures. The following documents are available:

  • All procedure codes 2020-2021
  • Changes in NCMP 2020-2021
  • Cumulative Changes in NCMP 2006-2021
  • Changes in NCSP 2020-2021
  • Cumulative Changes in NCSP 1999-2021
  • Changes in NCRP 2020-2021

The following changes were made in the surgical procedure coding system (NCSP):

  • Two new surgical procedure codes introduced for laparoscopy:
  • JCE31 “Laparoscopic surgery for oesophageal atresia or congenital tracheoesophageal fistula”
  • JGB21 “Laparoscopic partial recto-sigmoidectomy and abdominoperineal pull-through anastomosis”
  • Two new categories added for knee ligament procedures - for primary reconstruction and revision reconstruction, and 16 new codes added
  • New procedure code NAT27 “Posterior correction of the thoracolumbosacral column with ilium fixation, with an internal instrument”

Two new radiology procedure codes (NCRP) were introduced:

  • PJK40K “Marker insertion in the axillary lymph node, ultrasound-guided” - a new procedure for neoadjuvant treatment of breast cancer
  • SAC0AK “UL Neuromuscular ultrasound” for investigation and follow-up of neuromuscular disease

Nine new medical procedure codes added (NCMP):

  • AXDP05 “Video Head Impulse Test (vHIT)”

High speed video for measuring vestibular reflex during rapid head movements. Including interpretation of video recordings. Note: Introduced at the request of Helse Bergen

  • JAGD55 “Patient-administered peritoneal dialysis”
  • MAFX11 “Lactate measurement in the fetal scalp”
  • WO6100 “Preparation of a new (re) habilitation plan”
  • OCAA00 “Revision of (re) habilitation plan”
  • RXGD50 “Initiation of patient-administered hemodialysis”

Including: training in the use of medical technical equipment Note: There is already a corresponding start-up code for patient-administered peritoneal dialysis, and it is natural that there is also a corresponding start-up code for patient-administered hemodialysis

  • RXGD55 “Patient-administered hemodialysis”
  • WABA30 “Insulation due to radiation protection considerations”

Note: New code for isolation measures for use when the patient has been treated with radioactive medicine or has been exposed to radioactive exposure that may endanger the environment.

  • WMAA11 “Interdisciplinary assessment of known condition”. New code for reporting interdisciplinary assessment when the patient has a known diagnosis and is followed up interdisciplinary.

The coding guide is planned to be issued in December 2020.

See the full details here.

This news is just one of about 300 market access news collected by our team in the subscription services “HTA Alerts” and “Reimbursement Alerts” every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). First EU issues of both newsletters are available for download free-of-charge.

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