Skip to main content
See details

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.
See details

Five new procedure and nine diagnostic codes were added to private reimbursement schedule in England in May

The Clinical Coding and Schedule Development (CCSD) develops and maintains procedural and diagnostics nomenclature for private payers in England. Once codes are added to the Schedule, private insurance company can develop reimbursement tariff for these procedures and tests.

The CCSD Group has approved the following procedure codes for publication to the CCSD Schedule in May:

  • Minimally invasive sacroiliac joint stabilisation surgery for chronic sacroiliac pain under image guidance (W7720);
  • Irreversible electroporation of prostate cancer (M7180);
  • Medial Branch Block (under x-ray control) - 1 to 2 levels (A5752);
  • Medial Branch Block (under x-ray control) - 3 to 4 levels (A5762);
  • Medial Branch Block (under x-ray control) - 5 to 6 levels (A5772).

The narrative for the following two procedure codes has been changed:

  • Diagnostic nasolaryngopharyngoscopy +/- biopsy as sole procedure (E2500);
  • Mobilisation of the lumbar/thoracic vessels to provide spinal surgical access (by vascular surgeon) as sole procedure (V3345).

 The following requests have been declined or withdrawn:

  • CCSD declined inactivation of code for “Percutaneous chemical ablation of tumour - Ultrasound guided” (XR962), because this code is still required;
  • "Delayed" was added to the narrative of ”Secondary repair of tendon (including graft, transfer and/or prosthesis) (not otherwise specified)” (T6800) and ”Secondary repair of Achilles tendon with tendon or fascial graft”  (T6822), because some patients don't have the repair done for several weeks or even months;
  • Code for “Ceramic on ceramic hip resurfacing arthroplasty” (W3715c) has been declined, application of code W3715 was recommended;
  • Request for coding of Diphencyprone Topical Immunotherapy for warts and verucca has been declined as this is not a procedure.

The CCSD Group has approved the following diagnostic codes for publication to the CCSD Schedule in May:

  • Point shear wave elastography (PSWE) (MI046);
  • PD-L1 marker (5005B);
  • Mycoplasma genus PCR (5006B);
  • DNA RET protein gene test (5007T);
  • Residual leukaemic testing (5008B);
  • Mitotane level (5009B);
  • CMV-CISH (5010T);
  • CISH or chromogenic in situ hybridization (5011T);
  • Globin panel (5012B).

See full information here

Subscribe to our newsletter delivered every second week not to miss important reimbursement information.