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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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Fifty-two new procedure 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 planning, insertion, and removal of high/low dose rate radioactive treatment (brachytherapy) into a prostate tumor,  open/laparoscopic repair of Spigelian hernia, and others. The codes are introduced with a recommended adoption date being the 1st of August 2020. The document also contains a list of textual changes in codes and unacceptable combinations. There were no changes to the CCSD Schedule of Diagnostic Tests.

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

  • Planning, insertion, and removal of high dose rate radioactive treatment (brachytherapy) into a prostate tumor (BT213)
  • Planning and insertion of low dose rate radioactive treatment (brachytherapy) into a prostate tumor (BT214)
  • Laparoscopic repair of Spigelian hernia +/- mesh (T2761)
  • Open repair of Spigelian hernia +/- mesh (T2762)
  • Minimally invasive Component Separation Technique (CST) repair for complex abdominal hernia +/- mesh (T2782)
  • Planning, insertion, and removal of a radioactive agent (brachytherapy) into the cervix or other female intra-pelvic tissue (BT343)
  • Planning, insertion, and removal of a radioactive agent (brachytherapy) into carcinoma of the esophagus, bronchus or stomach (BT261)
  • Planning, insertion, and removal of a radioactive agent (brachytherapy) into the vagina (BT283)
  • Planning, insertion, and removal of a radioactive agent (brachytherapy) into the rectal tumor (BT254)
  • Removal of port or valve from expandable breast prosthesis +/- image guidance (B3700)
  • And others

The full list of codes can be found here.

There were no changes to the CCSD Schedule of Diagnostic Tests. Link

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