New DRG system in Austria for 2018 came into effect

The LKF (Leistungsorientierte Krankenanstaltenfinanzierung) system is a performance-oriented financing system in Austria. It is comparable to common Diagnosis Related Group (DRG) systems. The LKF catalogue includes procedures that are obligatory to be performed in inpatient settings and such that can be performed as ambulatory services optionally. An updated version of the catalogue is released by the Federal Ministry of Health and Women (BMGF) annually and comes into effect on January 1st of each calendar year. The system is used for the reimbursement as well as the documentation and cost data collection of inpatient and day case services.

Each DRG in Austria is associated with points (cost weight) that are multiplied by a monetary base rate to determine the reimbursement tariff. The base rate differs between states and even hospitals within states regions and hospitals. The changes regarding new procedures and procedure codes made in the LKF system for 2018 compared to 2017 are listed below.

Changes in DRGs for inpatient treatments:

• MEL05.07 Interventions on spleen, liver, duodenum and pancreas
  • Adding of procedure “HL031 - Enucleation, resection of superficial single liver lesions – open” (4,937 points)
  • Adding of procedure “HL032 - segment resection, enucleation, resection of multilocular liver lesions - open"
  • Adding of procedure “HL041 - enucleation, resection of superficial single liver lesions - laparoscopic" (4,937 points)
  • Adding of procedure " HL042 - segment resection, enucleation, resection of multi-locular liver lesions - laparoscopic"
• MEL08.08 Thoracoscopic interventions
  • Adding of procedure „GF025 – Switch from thoracoscopic to open surgery“ (5,978 – 8,625 points)
• MEL12.03 Transuteral resection of the prostate
  • Adding of procedure "JG015 - Photoselective laser vaporization of the prostate” to the filter (3,511 points)
• MEL22.14 Other, additional or accompanying oncological therapy - monoclonal antibodies
  • Adding of procedure "XA071 - Oncological Therapy - monoclonal antibody daratumumab 16mg / kg body weight" (5,501 – 8,000 points)
  • Adding of procedure "XA072 - oncological therapy - monoclonal antibody elotuzumab 10mg / kg body weight" (2,501 – 3,750 points)
  • "XA079 - oncological Therapy - monoclonal antibody olaratumab 15mg / kg body weight” (2,501 – 3,750 points)
  • Adding of procedure “XA115 - oncological therapy - mono-clonal antibody Necitumumab 800mg. (400 – 1,500 points)

• 2.1.5 MEL22.27 Oncological Immunotherapy (new procedure group)
  • The new procedure "XA035 - Oncological Therapy - Oncolytic Viral Immune Therapy: Talimogen laherparepvec, 1ml" (3,511 points) leads to the new procedure group “MEL22.27 Oncological Immunotherapy”

Changes in DRGs for the day case procedures:

• AMG21.26 Oncological Immunotherapy (new procedure group)
  • The new procedure "XA035 - Oncological Therapy - Oncolytic Viral Immune Therapy: Talimogen laherparepvec, 1ml" (2,477 points) leads to the new procedure group “AMG21.26 Oncological Immunotherapy”
• APG01.31 Transcranial Magnetic Stimulation (new procedure group)
  • The new procedures "AM650 - Repetitive Transcranial Magnetic Stimulation - Planning" and "AM660 - Repetitive Transcranial Magnetic Stimulation - Therapy" lead to the new group “APG01.31 “Transcranial Magnetic Stimulation"
• APG07.11 Outpatient procedures in the gastointestinal tract
  • The new procedure "HK511 - treatment of simple anal diseases” (81 points) replaces the previous two services "EH510 - sclerosis/leaflet of hemorrhoids" and "HK510 - treatment of simple anal diseases"

The LKF system is available here. More details about the changes made since the last LKF version can be viewed here.

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