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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 final version of the 2024 OPS procedure coding classification released in Germany

On October 26, 2023, the BfArM (Federal Institute for Drugs and Medical Devices) published the final version of the 2024 OPS procedure coding classification. The OPS, together with the ICD-10-GM (International Statistical Classification of Diseases and Related Health Problems, 10th revision, German Modification), forms the basis for the reimbursement systems in outpatient and inpatient care in Germany.

One hundred sixty (160) proposals submitted by representatives of professional societies, associations of health insurance companies, and healthcare institutions were incorporated in the OPS 2024.

Numerous content updates and new procedure codes inclusion mainly concern chapters 5 “Operations” and 8 “Non-operative therapeutic measures”. The examples of newly introduced codes per technology group are provided below:

Cardiovascular

  • 8-835.e0 Ablative measures in cardiac arrhythmias: Use of guidance: Use of endoscopy, endovascular;
  • 8-835.e1 Ablative measures in cardiac arrhythmias: Use of guidance: Use of magnetic resonance imaging;
  • 8-83d.a Other percutaneous transluminal vascular interventions on the heart and coronary vessels: Intracoronary hyperoxemic therapy.

Extracorporeal treatments

  • 8-821.50 Adsorption and related procedures: C-reactive protein apheresis [CRP apheresis]: With reusable and regenerable adsorber, first-time use;
  • 8-821.51 Adsorption and related procedures: C-reactive protein apheresis [CRP apheresis]: With reusable and regenerable adsorber, further application;
  • 8-858.0 Extracorporeal liver replacement therapy [liver dialysis]: Without individualized pH control to compensate for acidosis;
  • 8-858.1 Extracorporeal liver replacement therapy [liver dialysis]: With individualized pH control to compensate for acidosis.

Gastrointestinal

  • 1-999.50 Additional information on diagnostic measures: Diagnostic use of a single-use endoscope: Single-use duodenoscope;
  • 1-999.51 Additional information on diagnostic measures: Diagnostic use of a single-use endoscope: Single-use gastroscope;
  • 5-447.e** Revision after gastric resection: Reduction of an anastomosis;
  • 8-123.00 Replacement and removal of a gastrostomy catheter: Replacement: Without jejunal probe;
  • 8-123.01 Replacement and removal of a gastrostomy catheter: Replacement: With jejunal probe;
  • 8-123.0x Replacement and removal of a gastrostomy catheter: Replacement: Other.

The full details in German can be found here. The 2024 version of the OPS classification can be found here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Contact us to get a free, three-month, no-obligation trial.