Belgian INAMI-RIZIV updated the List of reimbursable devices

08

Jun 2022

On May 25, 2022, the National Institute for Health and Disability Insurance (INAMI-RIZIV) published an updated List of reimbursable devices that came into force on June 01, 2022. A total of 12 new codes with the corresponding conditions of reimbursement were added to the List, which concerned sacral neurostimulation in fecal incontinence treatment, soft tissue markers, and osteosynthesis devices.

Five new codes related to sacral neurostimulation in fecal incontinence treatment with the corresponding conditions were added to the List; some examples are provided below:

  • 182733 - 182744 “First rechargeable neurostimulator for the treatment of fecal incontinence using sacral nerve stimulation” with the maximum price of €6,740.86;
  • 182770 - 182781 “Charger for rechargeable neurostimulator for treating fecal incontinence using sacral nerve stimulation” with the maximum price of €1,485.75;
  • 182814 - 182825 “Replacement of charger for rechargeable neurostimulator for the treatment of fecal incontinence using sacral nerve stimulation” with the maximum price of €1,485.75.

All five codes belong to the category I.A.a “Implants or invasive medical devices for long-term use, which are reimbursed on the basis of individual price, when registered on the nominative list”, without a patient co-payment. There is a specific Nominative list with brand-specified devices 319/Stimulators and electrodes for sacral nerve stimulation connected to these codes.

Six new codes related to osteosynthesis with the corresponding conditions were added to the List; some examples are provided below:

  • 182350 - 182361 “Osteosynthesis plate with up to eight holes, to treat a malunion or pseudarthrosis of the sternum” with the fee of €184.91;
  • 182394 - 182405 “Set of osteosynthesis implants, including all fixation elements, for the surgical fixation of a rib flap used during the service 227356-227360 or 282656-282660 of the Nomenclature, per rib treated” with the fee of €634.32;
  • 182416 - 182420 “One or more osteosynthesis implants, excluding fixation elements, for the surgical fixation of an acute traumatic rib fracture in a patient without a rib flap used during the service 282656-282660 of the Nomenclature, per rib treated” with the fee of €190.36;
  • 182453 - 182464 “Osteosynthesis plate with more than eight holes, for surgical fixation of a complex fracture of the sternum used during the service 282516-282520 of the Nomenclature” with the fee of €364.38;

All six codes belong to the category I.D.a “Implants and invasive medical devices for long-term use, which are reimbursed on a lump-sum basis, without registration on the nominative list”, without a patient co-payment. So, there is no list of brand-specified devices connected to these new codes.

One new code was added to sub-chapter H.1 "Breast" of the chapter "Gynecology" of the List: 182836 – 182840, “Soft tissue marker, which is non-wire and does not use radioisotopes, for long-term placement and is surgically removed with the target tissue” with the fee of €150 with the corresponding conditions. It belongs to the category I.D.a “Implants and invasive medical devices for long-term use, which are reimbursed on a lump-sum basis, without registration on the nominative list”, without a patient co-payment. So, there is no list of brand-specified devices connected to this new code.

See the full details in French and Dutch 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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