Gastrointestinal endoscopy

In late October 2021, the Treatment Council (Behandlingsråd) published three topics chosen for developing the so-called major analyses (større analyser) in 2022. The selected topics include patient-centered diabetes technology, hand-held focused ultrasound in emergency medicine, and artificial intelligence as decision support for colonoscopy.

In late October 2021, the BfArM (Federal Institute for Drugs and Medical Devices) has published the final version of the 2022 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 March 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0175 and 0072 with changes to be implemented not later than May 01, 2021. Six new procedure codes related to gynecology, capsule endoscopy, and intracranial stereotactic radiotherapy were introduced. No changes were made in diagnostic test coding.

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.

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 gastrointestinal technologies. This post provides some key facts about the HTA, funding and innovation payment landscape for gastrointestinal devices in Europe.

The report presents a summary of reimbursement situation for diagnostic endoscopic procedures on the upper gastrointestinal tract for benign and malignant diseases in outpatient settings. The following procedures will be considered: esophagoscopy, gastroscopy, duodenoscopy. 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.

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.