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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 procedure and diagnostic codes added to the private reimbursement schedule in England

In April 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 0176 and 0073 with changes to be implemented not later than August 01, 2021.

Two new procedure codes for High-Intensity Focused Ultrasound of the prostate were introduced:

  • M6771 Focal High Intensity Focused Ultrasound of the prostate (including cystoscopy);
  • M6772 Total gland High Intensity Focused Ultrasound of the prostate (including cystoscopy).

Two new procedure codes related to breast surgery were introduced:

  • B2761 Skin/nipple sparing mastectomy (including axillary node biopsy) – bilateral;
  • B2927 Reconstruction of breast using fixed prosthesis and acellular dermal matrix (ADM) (including delayed reconstruction) – bilateral.

One new diagnostic code, 3024G "myChoice CDx", was introduced. myChoice® CDx is a next-generation sequencing-based test detecting deleterious or suspected deleterious mutations in BRCA1, BRCA2 genes, and Genomic Instability Score. This test is used in ovarian cancer patients with positive homologous recombination deficiency (HRD) status to identify who is eligible for treatment with the targeted therapy.

See the full details here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). First EU issues of both newsletters are available for download free-of-charge.

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