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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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Fifteen new procedure and one diagnostic code added to private reimbursement schedule in England

The Clinical Coding and Schedule Development (CCSD) group develops and maintains procedural and diagnostics nomenclature for private payers in England. New procedure codes concern removal of pectus bar, open surgical correction of pectus deformity of the chest wall, intradermal injection into the scalp, nerve and neurolytic root block with or without image guidance, facet joint injection with or without image guidance and diagnostic code for gustatory testing. The codes are introduced with a recommended adoption date being the 1st of May 2020. The documents also contain a list of textual changes in codes, unacceptable combinations, and inactivated codes.

The CCSD Group approved the following procedure codes for publication to the CCSD Schedule in December 2019 with a recommended adoption date being the 1st of May 2020:

  • Removal of pectus bar (including bilateral) (T0213)
  • Minimally invasive pectus bar placement for pectus excavatum (including bilateral) (T0214)
  • Open surgical correction of pectus deformity of chest wall (or other congenital defect thereof) (T0215)
  • Intradermal injection into scalp (for alopecia) (S5211)
  • Nerve Root Block +/- Image Guidance (Bilateral) CERVICAL (A5753)
  • Nerve Root Block +/- Image Guidance (Bilateral) THORACIC (A5754)
  • Nerve Root Block +/- Image Guidance (Bilateral) LUMBAR (A5755)
  • Nerve Root Block +/- Image Guidance (Bilateral) CAUDAL (A5756)
  • Neurolytic Root Block +/- Image Guidance (Bilateral) CERVICAL (A5763)
  • Neurolytic Root Block +/- Image Guidance (Bilateral) THORACIC (A5764)
  • Neurolytic Root Block +/- Image Guidance (Bilateral) LUMBAR (A5765)
  • Neurolytic Root Block +/- Image Guidance (Bilateral) CAUDAL (A5766)
  • Facet joint injection +/- Image Guidance (Bilateral) CERVICAL (A5773)
  • Facet joint injection +/- Image Guidance (Bilateral) THORACIC (A5774)
  • Facet joint injection +/- Image Guidance (Bilateral) LUMBAR (A5775)

 

See the full details here.

The CCSD Group approved the following diagnostic codes for publication to the CCSD Schedule in December 2019 with a recommended adoption date being the 1st of May 2020:

  • Gustatory testing - for patients reporting primary disturbances of salt/sweet/sour/bitter sensations (MI053)

See the full details here.

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