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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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Instruction with the amendments for diagnosis coding of infected wounds was published by the Swedish National Board of Health and Welfare

At the beginning of March, 2018, the National Board of Health and Welfare (Socialtyrelsen) has published the instruction with the amendments for diagnosis coding of infected wounds. The National Board of Health and Welfare (Socialtyrelsen) decided to implement further clarifications:

  • Surgical wound infections (the skin); cellulitis and abscesses of skin and subcutaneous tissues:
    • L02 “Cutaneous abscess, furuncle and carbuncle of face” (skin suppuration, baldness):
      • Description of infection of the superficial layers of skin
    • L03 “Cellulitis” (inflammation of subcutaneous adipose tissue):
      • Description of the inflammation of the skin and subcutaneous layers, including abscess
    • L08.9 “Local infection of skin and subcutaneous tissue, unspecified”:
      • This code should only be used in case of unknown anatomical site of the infection
  • Ulcerations/Chronic wounds:
    • Codes listed above can be used for the description of ulcerations or chronic wounds, however, the following additional codes can be used to clarify the diagnosis:
      • B95 “Streptococcus, group A, as the cause of diseases classified to other chapters” and B96 “Mycoplasma pneumoniae [M. pneumoniae] as the cause of diseases classified to other chapters” - for the description of infectious agents
    • An exception for the coding of ulcerations is precancerous leg ulcers (varicose veins). In these cases, the use of I83.0 “Varicose veins of lower extremities with ulcer” is needed in addition to the wounds coding
  • Post-traumatic Infectious:
    • The diagnosis code T79.3 “Post-traumatic wound infection, not elsewhere classified” should be used as a primary diagnosis code in combination with the codes for skin infections mentioned above and other additional codes according to the exact situation
  • Postoperative wound infections:
    • Typically, the postoperative wound infections are the complications of surgery, which are encoded via the diagnosis codes T80 – T88, however, the varicose veins is an exception, which should be coded via I83.0 “Varicose veins of lower extremities with ulcer”
    • Additional codes should be used in combination with the diagnosis codes T80 – T88 to reflect the specificity of conditions
  • Postoperative wound infections as natural consequences of the disease:
    • In case of intestinal perforation with generalized peritonitis, T-codes should not be used, instead, it is recommended to use codes Y83, Y84

See full description of instruction with the coding examples in Swedish here.

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