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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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New DRGs in Swedish DRG system in 2019

06 Mar 2019

More than 50 new DRGs were introduced in the Swedish system in 2019, while two have been deleted. The changes affected nursing care, psychiatry, hospital and day case services of different major disease categories.

The following DRGs were introduced in hospital settings:

  • A89R/A89O Drug delivery intravascularly in diseases of the nervous system (MDC 01)
  • D89R/D89O Drug delivery intravascularly in respiratory diseases (MDC 04)
  • F89R/F89O Drug delivery intravascularly in digestive disorders (MDC 06)
  • H89R/H89O Intravascular drug delivery in muscular, skeletal and connective tissue disorders (MDC08)
  • M89R/M89O Drug delivery intravascularly in diseases of the kidney and urinary tract (MDC 11)
  • N89R/N89O Drug delivery intravascularly in male genitalia diseases (MDC12)
  • O89R/O89O Drug delivery intravascularly in women's genitalia diseases, primary care (MDC 13)
  • R89R/R89O Intravascular drug delivery in blood disorders, primary care (MDC 16)
  • R91R/R91O Drug delivery intravascularly in myeloproliferative diseases, primary care (MDC 17)
  • K89R/K89O Drug delivery intravascularly in mammary gland diseases, primary care (MDC 30)

Excluded DRGs:

  • DRG X72O Drug supply, other less resource-intensive
    • This DRG is removed because of a small outcome in this group and a low medical description value
  • DRG R01O Spleen Texture, Outpatient
    • This DRG is removed as the current procedure is not performed in an outpatient care

Split DRGs:

  • DRG E19O Percutaneous cardiovascular measures, outpatient care is eliminated and replaced by two new DRGs:
    • E17O Percutaneous ablation for cardiac arrhythmia, outpatient care
    • E22O Other percutaneous cardiovascular action, outpatient care
  • DRG A20N Implantation/replacement of nerve stimulator is removed and replaced by two new DRGs:
    • DRG A21N Insertion of intracranial and vagal nerve stimulation armor
    • DRG A22N Implantation/replacement of other nerve stimulation equipment
  • DRG O15O Operations on uterus and adnexa is removed and replaced by three new DRGs:
    • O16O Major surgery on uterus and adnexa for benign disease, outpatient care
    • O17O Other operations on the cervix and adnexa for benign disease, outpatient care
    • O18O Measures for in vitro fertilization, outpatient care

See full details in Swedish here.

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