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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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DRG tariff system guide and the DRG tariffs for 2022 published in Denmark

In early December 2021, the Danish Health Authority (Sundhedsdatastyrelsen) has published DRG tariffs, as well as psychiatric and rehabilitation rates for 2022. Later on, in mid-December 2021, the DRG tariff system (Takstsystem) guide for 2022 was also published. Among other changes, seven new DRGs, specifically in ENT, endoscopy, obstetrics, and gynecology fields, were introduced.

The Danish Health Authority annually calculates the tariffs for hospital and outpatient care in the somatic and psychiatric areas. DRG tariffs express hospitals' average operating costs within each DRG group. The tariffs are calculated by linking the actual activity and costs.

As the DRG tariff reflects the average national cost, the costs incurred for each hospital can be above and below the tariff. This difference may be due, among other things, to differences in productivity, the composition of patients within the DRG group, or methodological differences in connection with the cost estimation of hospitals.

The DRG tariff system guide (Takstsystem) provides an overall description of billing rules, tariffs, and grouping logic (including the changes to be introduced in 2022). The most significant changes listed in the DRG tariff system guide for 2022 include the following:

  • The surcharge for the stay beyond the DRG trim point was established in the amount of 2,185 DKK;
  • The list of special services (Særydelsesliste), which can be covered by the region on top of the DRG tariffs, was not published. It is indicated that it will be provided at the beginning of 2022, when the DRG tariff system guide is expected to be updated.

Also, seven new DRGs were introduced, and twelve DRGs were deleted. Some examples of newly introduced DRGs are provided below:

  • 11MP26 Endoscopy and simple urinary tract procedures;
  • 03PR09 Auditory verbal therapy (AVT), patients aged 0-6 years;
  • 15MP18 Children 0-27 days, other.

The full details in Danish can be found here.

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