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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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The DRG changes in Norway in 2020

MTRC has summarized the most important DRG changes in Norway, which came in force in 2020.

The selection of the most significant changes is provided below:

  • Five new DRGs were added:
    • 993O “Collaboration and follow-up meeting with a partner outside the specialist health service for somatic issues”
    • 994T “Telephone consultations for somatic issues”
    • 995O “Follow-up interview with a partner outside the specialist health service for somatic issues”
    • TD998A “Group-oriented patient education in mental health care (PHV) / substance abuse treatment (TSB) – adults”
    • TD998B “Group-oriented patient education in PHV / TSB children”
  • One DRG was deleted:
    • 996P “Treatment measures aimed at a group of patients in selected MDCs”. Activity from this DRG will be included in DRG 996O “Treatment initiatives aimed at a group of patients”.
  • Four DRGs’ names were changed:
    • TD02A “Group-directed measures - Other group-directed treatment – adults”
    • TD02B “Group-directed measures - Other group-directed treatment - children and adolescents”
    • TD03A “Family-directed outpatient treatment – Adults”
    • TD03B “Family-directed outpatient treatment - Children and adolescents”
  • Other changes:
    • Grouping logic for daycare DRGs (980 DRGs) has changed. Now the case will be grouped in daycare DRG if the following conditions are met:
      • urgent emergency requirements
      • an expanded list of potential immediate help conditions for stays over 5 hours (as in 2019)
      • department stays under 5 hours and outpatient contacts are fully equated. This provides the same treatment of outpatient contacts and the shortest department stays
    • Clinical neurophysiology services (tariffs 702-702g for public outpatient clinics, as well as tariffs 721 and 722 for private outpatient clinics) will be transferred to stakeholder financing (ISF). The activity will mainly be included in pre-existing DRG 801X based on tariffs 702c-702g, 720a-c and 721-726
    • The length of stay trim point is shortened for DRG 809R “Other light therapy”
    • As the correction of coding for the tattoo on medical indication was made, the DRG logic was amended correspondingly, so that the procedure will still be grouped to the DRG 809T “Minor skin procedure”.

The full details in Norwegian can be found here.

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