Capsule endoscopy

On April 4, 2025, NHS England published the final NHS Payment Scheme (NHSPS) for the 2025/26 financial year (starting on April 1st), defining payment mechanisms for the provision of NHS-funded hospital and ambulatory care and some public health services. No significant changes were made to the general payment model. The key changes include the introduction of reimbursement for activities from Community Diagnostic Centres and a new Best Practice Tariff to incentivize shifting suitable procedures from day case/hospital to outpatient settings.

In mid-December 2022, the Danish Health Data Agency (Sundhedsdatastyrelsen) published an update of the Health Care Classification System (Sundheds-væsenets Klassifikations System, SKS). The most significant changes include: 11 new diagnosis codes, 27 new procedure codes, and eight additional codes (Tillægskoder) were added. The newly added procedure codes mainly concern the obstetrics and gynecology, surgical procedures, endocrine, gastrointestinal, and radiology fields, and some other technology groups.

On December 9, 2021, the Danish Treatment Council (Behandlingsråd), during its meeting, approved three topics selected for developing the so-called major analyses (større analyser) in 2022. The approved topics include handheld focused ultrasound in emergency medicine, artificial intelligence (AI) as decision support for colonoscopy, and intelligent/high-tech beds for use in intensive care units.

In late October 2021, the Treatment Council (Behandlingsråd) published three topics chosen for developing the so-called major analyses (større analyser) in 2022. The selected topics include patient-centered diabetes technology, hand-held focused ultrasound in emergency medicine, and artificial intelligence as decision support for colonoscopy.

In March 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0175 and 0072 with changes to be implemented not later than May 01, 2021. Six new procedure codes related to gynecology, capsule endoscopy, and intracranial stereotactic radiotherapy were introduced. No changes were made in diagnostic test coding.

The report presents a summary of reimbursement situation for capsule endoscopy in ambulatory settings. Indications include gastrointestinal bleeding, Crohn's disease, malignant neoplasm of small intestine and celiac disease. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland.