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

13

May 2022

In April 2022, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 0183 and 0080 with changes to be implemented no later than June 14, 2022.

Eleven new procedure codes were added:

  • F4306 Transoral robotic horizontal supra-glottic laryngectomy (as sole procedure);
  • F4308 Transoral robotic mucosectomy for microscopic primary tumor (as sole procedure);
  • Y3811 Removal of indwelling pleural catheter;
  • V4282 Revision correction of adult degenerative or adult idiopathic scoliosis including decompression +/- fusion (including spinal cord monitoring);
  • A5430 Image-guided transforaminal injection of fibrin sealant;
  • B2818 Mastectomy and immediate reconstruction of breast using expandable prosthesis and acellular dermal matrix (ADM) - unilateral;
  • B2819 Mastectomy and immediate reconstruction of breast using expandable prosthesis and acellular dermal matrix (ADM) – bilateral;
  • B2994 Reconstruction of breast using stacked flap (including delayed reconstruction) not elsewhere classified - unilateral (2 flaps);
  • B2995 Reconstruction of breast using stacked flap (including delayed reconstruction) not elsewhere classified - bilateral (2 flaps per breast);
  • T9021 Sentinel node mapping +/- sampling with magnetic lymphatic tracer for breast cancer;
  • W9047 Autologous protein solution injection.

The following diagnostic imaging codes were introduced:

  • IM379 Dynamic ultrasound of the thorax and ribs;
  • IM380 US Doppler (not otherwise specified) unilateral;
  • IM381 US Doppler (not otherwise specified) bilateral.

The following in-vitro diagnostic codes were introduced:

  • 5940B Indirect Immunofluorescence for blistering skin conditions;
  • 5941B Hepatitis E RNA;
  • 5942B Parechovirus PCR;
  • 9003G Invitae breast cancer STAT panel;
  • 9004G Invitae prostate cancer panel;
  • 9005G Invitae colorectal cancer panel.

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.

Not ready for a subscription service? Subscribe to our free-of-charge newsletter delivered every second week to get updates about key reimbursement developments in Europe (10-12 news every two weeks).

The latest related news

05

Dec 2022

On November 17, 2022, the Ministry of Health and Prevention published the Order in the Official Journal of the French Republic on the extension of the national newborn screening by laboratory diagnostics to seven more diseases (inborn errors of metabolism).

Read more

02

Dec 2022

On November 15, 2022, a new body called “Organization for Outpatient Physician Tariffs AG (OAAT)” was founded under the leadership of the Bernese government councillor. It involves all tariff partners (associations of health insurers curafutura and santésuisse, as well as the association of hospitals H+, the association of physicians FMH, and medical tariff commission MTK/CTM), who have joined forces in order to reach the goal of improving the outpatient reimbursement system.

Read more

01

Dec 2022

In November 2022, NHS Accelerated Access Collaborative decided not to add new technologies to MedTech Funding Mandate (MTFM) in 2023/24. Instead, Integrated Care Systems (ICSs) are asked to prioritize the appropriate adoption of currently supported technologies where this has not yet occurred. The MTFM supports eleven NICE-approved and cost-saving devices, diagnostics, and digital products, making them mandatory for implementation and funding.

Read more

30

Nov 2022

In November 2022, the National Board of Health and Welfare released the Swedish version of the NordDRG system to come into force in January 2023, including the list of DRG codes, names, and cost-weights. A total of 77 new DRGs will be implemented. Key new DRGs were introduced in cardiovascular, gastrointestinal, and endoscopy fields, also for breast reconstruction and bone-anchored hearing implants.

Read more

28

Nov 2022

The new version of the classification of procedure codes (CCAM v.71), applicable from December 03, 2022, was published in France. Several changes were introduced, including the creation of four new codes related to ENT, pulmonary and airways, and interventional radiology areas. Also, the modification of tariffs for 50 dental procedure codes will enter into force on January 01, 2023.

Read more