2022 DRG (LKF) model announced in Austria

28

Jun 2021

In mid-June 2021, the document "Changes and innovations in the 2022 LKF model" (Änderungen und Neuerungen in den LKF-Modellen 2022) was published. The document summarizes the most significant changes and innovations in the LKF model for inpatient and outpatient care. The newly added procedure codes concern mainly the cardiovascular, E-Health, and gastrointestinal area.

For 2022, the main changes will include the addition of 66 new procedure codes (including two provisional codes), the introduction of eight new procedure codes for billing in the day-case settings and two procedure codes for billing in outpatient settings, the addition of ten new DRGs, update of cases flat rates, adjustments of the cases daily component calculation and re-evaluation of the length of stay indicators. The 2022 model will enter into force on January 1, 2022. Some examples of the introduced procedure codes are listed below:

  • AH031 Implantation of a pulse generator for neuromodulation - 4-pin, rechargeable (LE = per application);
  • AH041 Implantation of a pulse generator for neuromodulation - 8-pin, rechargeable (LE = per application);
  • DA150 Correction of acquired (acute) defects of the heart septa with the heart-lung machine (HLM) (LE = per session);
  • DD075 Percutaneous transluminal lithotripsy of a coronary artery (LE = per application);
  • DE532 Telemedical control of a pacemaker (one and two-chamber system) (LE = per session);
  • DE536 Telemedical control of an implanted, automatic cardioverter or defibrillator, a system for cardiac resynchronization therapy (CRT) or a cardiac monitor (LE = per session);
  • HE145 Correction of congenital malformations of the esophagus - thoracoscopic (LE = per session);
  • HH023 Endoscopic full-thickness resection (EFTR) - colon (LE = per session);
  • HL510 Liver function test with the application of a C13-labeled substrate (LE = per session);
  • XN160 Short-term circulatory support with micro-axial flow pump - percutaneous (LE = per session);
  • XN170 Minimally invasive implantation of self-expanding prostheses in the anal sphincter apparatus (LE = per session).

The XN codes are provisional and temporarily included in the DRG system until the benefits of the procedures are established.

The newly introduced DRGs are provided below:

  • MEL01.18 Complex interventions on the spine;
  • MEL32.02 Treatment in the unit for psychosomatics and psychotherapy (PSO) in a regular cycle (children and adolescents);
  • AMG20.13 Ambulatory day treatment on a unit for PSO (children and adolescents);
  • APG01.04 Sleep-laboratory;
  • APG01.10 Structured diagnostics/therapy/follow-up care for neurological diseases;
  • APG01.32 Electroconvulsive therapy;
  • APG02.15 Cryocoagulation of the retina;
  • APG10.12 Ambulatory interventions - musculoskeletal system;
  • APG21.01 Observation/therapy/aftercare in children with specific diseases;
  • APG00.10 Outpatient contact with other services.

The full details in German can be found 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).

Not ready for a subscription service? Subscribe to our free-of-charge newsletter delivered every second week to get updates about key reimbursement developments in Europe (10-12 news every two weeks). First EU issues of both newsletters are available for download free-of-charge.

The latest related news

02

Dec 2022

On November 15, 2022, a new body called “Organization for Outpatient Physician Tariffs AG (OAAT)” was founded under the leadership of the Bernese government councillor. It involves all tariff partners (associations of health insurers curafutura and santésuisse, as well as the association of hospitals H+, the association of physicians FMH, and medical tariff commission MTK/CTM), who have joined forces in order to reach the goal of improving the outpatient reimbursement system.

Read more

30

Nov 2022

In November 2022, the National Board of Health and Welfare released the Swedish version of the NordDRG system to come into force in January 2023, including the list of DRG codes, names, and cost-weights. A total of 77 new DRGs will be implemented. Key new DRGs were introduced in cardiovascular, gastrointestinal, and endoscopy fields, also for breast reconstruction and bone-anchored hearing implants.

Read more

29

Nov 2022

On November 18, 2022, the Innovation Committee at the Federal Joint Committee (G-BA) announced that sixteen applications for Innovation Funding of the new forms of care were accepted. These applications relate to the funding announcement of March 17, 2021. Most projects relate to interdisciplinary or cross-sectoral care and pathways.

Read more

24

Nov 2022

In November 2022, NHS Digital published a final summary of core changes from OPCS-4.9 to OPCS-4.10 to be introduced from April 01, 2023. OPCS-4 is a statistical classification for clinical coding of interventions and procedures undertaken within the NHS. It is updated every three years. A total of 236 new four-character codes will be implemented in OPCS-4.10. Key changes concern cardiovascular, gastrointestinal, endoscopy, ENT, nephrology and urology, neurology and neurosurgery, obstetrics and gynecology, orthopedic, and breast surgery fields.

Read more

22

Nov 2022

On October 27, 2022, the BfArM (Federal Institute for Drugs and Medical Devices) published the final version of the 2023 OPS procedure coding classification. The OPS, together with the ICD-10-GM (International Statistical Classification of Diseases and Related Health Problems, 10th revision, German Modification), forms the basis for the reimbursement systems in outpatient and inpatient care in Germany.

Read more