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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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2023 DRG tariff system (Takstsystem) guide published in Denmark

In November 2022, the Danish Health Data Agency (Sundhedsdatastyrelsen) published the DRG tariffs, as well as psychiatric and rehabilitation rates for 2023. Later, on December 1, 2022, the DRG tariff system (Takstsystem) guide for 2023 was also published. Among other changes, nine new DRGs, specifically in ENT, e-health, neurology and neurosurgery, ophthalmology, intensive care and OR, cardiovascular, and IVD fields, were introduced.

The DRG tariff system guide (Takstsystem) provides an overall description of billing rules, tariffs, and grouping logic (including the changes to be introduced in 2023). The most significant changes listed in the DRG tariff system guide for 2023 include the following:

  • The tariff calculation for 2023 is based on costs and activity for the years 2021 and 2020;
  • The surcharge for the stay beyond the DRG trim point was established in the amount of 2,240 DKK per bed day;
  • There is a new model for handling telemedicine:
    • In the 2023 DRG system, virtual activity is treated equally to physical activity. All DRGs of the type 'TE' (Telemedicine, Telephone, and email consultations) are removed from the grouping logic, except for DRG 65TE029 'Written communication to the patient with clinical content'. In addition, a gray zone marking of 81 DRGs was prepared, i.e., DRGs for which the virtual activity is allowed. A special DRG 70OP03 “Collection of virtual contacts”, is created to capture the virtual activity that is not grouped into other groups.

Also, nine new DRGs were introduced, and thirteen DRGs were deleted. Some examples of newly introduced DRGs are provided below:

  • 02MP19 “Double-sided cataract operation without general anesthesia”;
  • 05PR05 “'Installation of central venous catheter (CVC)”;
  • 04PR03 “Procedures without contact in relation to CPAP treatment”.

The full details in Danish can be found here.

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