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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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DIMDI opens application period for new procedure codes for 2019 in Germany

Procedure codes (OPS), together with diagnosis codes (ICD-10) and patient-specific characteristics, lead to specific Diagnosis-Related Groups (DRG) and thereby determine reimbursed tariffs of inpatient procedures in Germany. The German Institute of Medical Documentation and Information (DIMDI) maintains and develops procedural codes. An update of the procedure code catalogue is released by DIMDI annually on January 1st.

Creation of specific procedure codes in the German system is relevant, if available codes do not describe a procedure specifically and lead to grouping of the procedure into DRG with insufficient reimbursement tariff. In this case, in order to change the allocation to a DRG or establish add-on category, the creation of a specific code is necessary.

Applications should be submitted by medical societies (umbrella organisations) or associations within the German healthcare system via a standardized form. Manufacturers can support the process by providing information required. Deadline for submission of applications is February 28th 2018. DIMDI reviews the application using defined policy framework and releases a preliminary version of the new OPS catalogue on August 15 th. The final OPS version will become effective on January 1st 2019. The Institute for Hospital Remuneration System (InEK) is responsible for the association of OPS with relevant DRGs.

Further information about the process, application forms and the email address for submissions are available on DIMDI’s website.

Previous applications are published in German here.

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