Endoscopic procedures

In late September 2020, the Austrian version of the DRG system (LKF) 2021 model with the relevant supplementary documents was published in Austria. For 2021, the main changes include the addition of sixteen new procedure codes and the introduction of two new procedure codes for billing in the day-case settings, update of cases flat rates, and adjustments of the cases daily component calculation.

In mid-August 2020, the German Federal Institute for Drugs and Medical Devices (BfArM) published the preliminary 2021 version of OPS procedure coding nomenclature. Numerous content updates and new procedure codes inclusion concern the chapters 1 “Diagnostic measures,” 5 “Operations,” and 8 “Non-operative therapeutic measures.” The list of new endoscopy-related procedure codes added under the respective OPS sub-chapters of chapters 1 and 5 is provided below:

The revised EBM (German Uniform Evaluation Standard) catalog came into force on July 1, 2020. MTRC has compiled the selection of the most significant changes.

The German Society for Neurology (DGN) has released a new version of the S1 guideline "Diagnostics and therapy of neurogenic bladder disorders." It is valid until January 2025.

The report presents a summary of the reimbursement situation for a number of therapeutic endoscopic procedures on esophagus in Europe, including: endoscopic mucosal resection of lesion of esophagus; endoscopic submucosal resection of lesion of esophagus; endoscopic radiofrequency ablation of lesion of esophagus; endoscopic injection sclerotherapy to varices of esophagus; endoscopic balloon dilation of esophagus; endoscopic insertion of stent into esophagus. 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. It is also possible to add analysis in the Czech Republic, Finland, Hungary, Romania, Russia and Turkey.

MTRC has developed three reports on the key market access topics, including innovation funding, health technology assessment and funding frameworks for medical devices. These reports help to understand the relevance of these frameworks to certain types of medical technologies, including endoscopy technologies. This post provides some key facts about the HTA, funding and innovation payment landscape for endoscopy devices in Europe.

In Sweden, the Priority Council of Skåne Region prepares and presents suggestions for new methods, routines, and treatments, to be included in the healthcare system. In August 2019, the HTA report for endoscopic procedures in dysphagia was released. The analysis showed that fiberoptic endoscopic evaluation of swallowing and videofluoroscopy are clinically well-established procedures that have good and equal coherence between different assessors and in repeated assessments.

In April 2019, the National Institute for Health and Care Excellence published two new interventional procedure guidance for endoscopic ablation for an anal fistula and a pilonidal sinus, and two new MedTech innovation briefings for urine test for detecting bladder cancer in people with symptoms associated with malignancy and imaging software designed to help clinicians to diagnose and stage liver disease.

The report presents a summary of reimbursement situation for diagnostic endoscopic procedures on the lower gastrointestinal tract for benign and malignant diseases in outpatient settings. The following procedures will be considered: colonoscopy, rectoscopy, anoscopy. 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.

With a regional decree of March 7, 2019, Tuscany Regional Healthcare has published assessments of seventeen medical devices belonging to various therapeutic areas.

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.

At the beginning of December 2018, the HTA entity of the Region of Tuscany has released a list of the upcoming assessments of the medical devices. Assessments include among others Impella ventricular assist device from Abiomed, Endocuff Vision colonoscope from Olympus, VascuFlex® Multi-LOC multiple stent delivery system from B Braun.