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Evidence gap analysis

Strategic analysis of the sufficiency of evidence to obtain reimbursement and HTA approval in Europe and recommendations about evidence generation

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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

On June 13, 2024, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 196 and 092 with changes to be implemented no later than August 8, 2024. 

Five new procedure codes were added concerning endoscopy, ENT, orthopedics, and spine field, as well as seven new codes for in vitro diagnostic tests were introduced. Some examples of newly added procedural and diagnostic codes are provided below:

  • E1490 Insertion of biodegradable stent into paranasal sinus (frontal);
  • V4020 Spinal stabilisation (without fusion) by implantation of a posterior arthroplasty system;
  • 3030G Circulating tumour DNA profile (Guardant360);
  • 0056G ClonoSEQ.

See the full details here.

This news is just one of about 300 market access news collected by our team in the premium subscription service Market Access Monitor every week from more than 80 organizations. Access our paid service to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Access is organized as an online Database and email alert formats. Contact us to get a free, three-month, no-obligation trial.