New procedure codes in Belgian Nomenclature came into force in January and February 2020

The health benefit Nomenclature of the Belgian National Institute for Health and Disability Insurance (INAMI/RIZIV) includes the benefits (with specific hospital and ambulatory codes) that are reimbursed by the compulsory health care insurance, wholly or partially. The Nomenclature and its changes are published in the Belgian Official Gazette.

In late 2019, the Nomenclature was updated. The update brought changes regarding the creation of new codes, deletion of codes, modification of existing codes, and the addition of new reimbursement conditions.

The changes of the following articles of the Nomenclature come into force on January 1, 2020:

• Article 5 “Dental care, services”
• Article 6 “Dental care, application rules”
• Article 8 “Nursing”

Key changes in the dental care, services (5) article:

The following codes were added:

• 379536-379540 “Additional fee for incorporating a metal frame for a removable upper dental prosthesis” (before the 18th anniversary)
• 379551-379562 “Additional fee for incorporating a metal frame for a lower removable dental prosthesis” (before the 18th anniversary)
• 309536-309540 “Additional fee for incorporating a metal frame in a removable upper prosthesis” (after the 18th anniversary)
• 309551-309562 “Additional fee for incorporating a metal frame in a removable lower prosthesis” (after the 18th anniversary)
• 309573-309584 “Placing an osteo-integrated implant to support an upper prosthesis reinforced with a metal frame”
• 309595-309606 “Placing an osteo-integrated implant to support a prosthetic frame reinforced with a metal frame”
• 309610-309621 “Placing an abutment on an osteo-integrated implant and applying the corresponding anchors in a removable upper prosthesis reinforced with a metal frame”
• 309632-309643 “Placing an abutment on an osteo-integrated implant and applying the corresponding anchors in a removable lower prosthesis reinforced with a metal frame”
• 309654-309665 “Placing an alley between 2 osteo-integrated implants and fitting the corresponding anchors in a removable upper prosthesis reinforced with a metal frame, first connection”
• 309676-309680 “Placing an alley between 2 osteo-integrated implants and applying the corresponding anchorages in a removable lower prosthesis reinforced with a metal frame, first connection”
• 309691-309702 “Placing an alley between 2 osteo-integrated implants and applying the corresponding anchorages in a removable upper prosthesis reinforced with a metal frame, per additional connection”
• 309713-309724 “Placing an alley between 2 osteo-integrated implants and applying the corresponding anchorages in a removable lower prosthesis reinforced with a metal frame, per additional connection”
• 309735-309746 “Placing a complete bridge on a minimum of 4 implants in an edentate upper jaw or placing a bridge after reconstruction of the upper jaw by means of a free microvascular anastomosed tissue graft consisting of several tissues (soft tissue and / or bone and / or cartilage)”
• 309750-309761 “Placing a complete bridge on a minimum of 4 implants in an edentate lower jaw or placing a bridge after reconstruction of the lower jaw by means of a free microvascular anastomosed tissue graft consisting of several tissues (soft tissue and / or bone and / or cartilage)”

Key changes in the dental care, application rules (6) article:

• Minor modifications of reimbursement conditions were made
• New reimbursement conditions were added

Key changes in the nursing (8) article:

• New reimbursement conditions were added (minor changes)

The changes of the following articles of the Nomenclature come into force on February 1, 2020:

• Article 14 (h)  “Ophthalmology”
• Article 20 “Internal medicine”
• Article 22 “Physiotherapy”
• Article 23 “Application rules: physiotherapy”

Key changes in the ophthalmology (14 (h)) article:

The following codes were added:

• 248356-24836 “Two-dimensional optical coherence tomography using the laser of the eye or eyes with a minimum of 8 sections per eye, with written protocol, as part of an intravitreal injection treatment”
• 248371-248382 “Two-dimensional optical coherence tomography using the laser of the eye or eyes with a minimum of 8 sections per eye, with written protocol, as part of the follow-up of a drug treatment for glaucoma”
• 248393-248404 “Two-dimensional optical coherence tomography using the laser of the eye or eyes with a minimum of 8 sections per eye, with written protocol, as part of the diagnosis in young people under 16 of refractory amblyopia, neuropathy, retinopathy, uveitis, or congenital eye disease”
• 248430-248441 “Two-dimensional optical coherence tomography using the laser of the eye or eyes with a minimum of 8 sections per eye, with written protocol, as part of a vitreo-retinal intervention”
• 248452-248463 “Two-dimensional optical coherence tomography using the laser of the eye or eyes with a minimum of 8 sections per eye, with written protocol, as part of a preoperative examination for cataracts with an abnormal macula or papilla”

Conditions for reimbursement of these codes were added.

Key changes in the internal medicine (20) article:

• Several codes and reimbursement conditions were deleted

Key changes in the physiotherapy (22) article:

• Modifications of existing codes were made

Key changes in the application rules: physiotherapy (23) article:

• Conditions of reimbursement were added

See the full details here.

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