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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 reimbursement code for 2019-nCoV testing added to EBM catalog in Germany

On the 1st of February, 2020, the National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV-SV) have made the agreement for laboratory diagnostic clarification about the novel coronavirus. Afterwards, the statutory health insurance companies will cover the costs of the test for the novel coronavirus (2019-nCoV) if there are justified suspected cases.

Only risk groups are entitled to testing. According to the case definition of the Robert Koch Institute (RKI), these are people who have been in a risk area (e.g., in Wuhan, China) or have had contact with a person who has developed the coronavirus (2019-nCoV) associated disease and have symptoms such as fever or respiratory problems within 14 days.

The test itself may only be performed by specialists in laboratory medicine or microbiology and infection epidemiology. Fee order item (GOP) 32816 “Nucleic acid detection of the novel coronavirus (2019-nCoV) using RT-PCR including a confirmation test for reactivity in the search test (report of findings within 24 hours after submission of material)” with a tariff of €59.00 has been included in the EBM for billing. The health insurance companies provide additional funds for this.

The full details in German can be found here.

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