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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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NHS Digital released HRG4+ 2021/22 Local Payment Grouper

On March 17, 2021, NHS Digital released HRG4+ 2021/22 Local Payment Grouper. In general, there were no significant changes in the HRG logic for 2021/22, and no new HRGs were introduced. Two new ICD-10 codes for COVID-19 were incorporated into the grouping logic in addition to three codes already included in the consultation grouper.

Furthermore, three new Main Speciality Codes (MSC) and 25 new Treatment Function Codes (TFC), which were introduced in April 2020, became mandatory to use in Grouper from April 2021.

The three new MSC codes are:

  • 107 Vascular Surgery
  • 200 Aviation and Space Medicine
  • 317 Allergy

The 25 new TFC codes are:

  • 109 Bariatric Surgery Service
  • 111Orthopaedic Service
  • 113 Endocrine Surgery Service
  • 115 Trauma Surgery Service
  • 145 Oral and Maxillofacial Surgery Service
  • 200 Aviation and Space Medicine Service
  • 230 Paediatric Clinical Pharmacology Service
  • 240 Paediatric Palliative Medicine Service
  • 250 Paediatric Hepatology Service
  • 270 Paediatric Emergency Medicine Service
  • 326 Acute Internal Medicine Service
  • 333 Rare Disease Service
  • 335 Inherited Metabolic Medicine Service
  • 347 Sleep Medicine Service
  • 348 Post COVID-19 Syndrome Service
  • 431 Orthogeriatric Medicine Service
  • 451 Special Care Dentistry Service
  • 461 Ophthalmic and Vision Science Service
  • 504 Community Sexual and Reproductive Health Service
  • 505 Fetal Medicine Service
  • 670 Urological Physiology Service
  • 673 Vascular Physiology Service
  • 675 Cardiac Physiology Service
  • 677 Gastrointestinal Physiology Service
  • 730 Neuropsychiatry Service

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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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