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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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CCAM and NGAP Nomenclatures updated in France

On May 31, 2022, a decision of the National Union of Health Insurance Funds relating to the update of the Nomenclatures of procedures - Common classification of medical procedures (CCAM) and General nomenclature of professional acts (NGAP) - was published in the Official Journal of the French Republic. Various changes were introduced in the CCAM, such as the inclusion of new procedure codes, provisionally registered codes, modification of the billing conditions, and removal of some codes.

Changes in the NGAP concerned the modifications of a few existing procedures. The decision takes into effect 30 days after its publication for CCAM changes and the day after its publication for NGAP changes.

Regarding the CCAM changes, these will be reflected in version 70 of the CCAM nomenclature, which will enter into force on June 30, 2022. A total of nine new CCAM codes were created. New CCAM codes were introduced in the field of ophthalmology, men’s health, and diagnostic imaging. Some examples are listed below:

  • QEQH204 “Unilateral or bilateral spectral angiomammography” (with the CCAM fee of €112.62); It is provisionally registered for the period of three years on the proposal of the High Council of Nomenclatures
  • JGLJ060 “Injection of spacer product by the transperineal route with ultrasound guidance” (with the CCAM fee of €89.33)
  • BELA340 “Implantation of an artificial iris on a pseudophakic eye in the sulcus behind an iris residue and in front of the implant with a capsular support” (with the CCAM fee of €129.46 excluding anesthesia)
  • BEGA607 “Removal of an artificial iris” (with the CCAM fee of €103.42 excluding anesthesia)

The decision can be found here. The updated CCAM Nomenclature can be found here.

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