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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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The Norwegian Directorate of Health has released 2018 version Norwegian Classification of medical, surgical and radiological procedure codes (NCSP, NCMP, NCRP) applicable since January 1, 2018

03 Oct 2017

In Norway, there are specific classifications for medical (NCMP), surgical (NCSP) and radiological (NCRP) procedures. Classifications are required for coding of use of procedures and for grouping together with diagnosis code to obtain diagnosis-related group (DRG), which is partly used for funding of hospital and out-patient specialist care in Norway.

Procedural classifications are updated annually by the Norwegian Directorate of Health.

The following updates have been made for 2018:

  • 15 new codes for medical procedures have been added to the Norwegian Classification of medical procedures (NCMP) for 2018, including new codes for stem cell procedures and blood exchange techniques:
    • Haploidentical transplantation of stem cells from blood (RAGG60) and from bone marrow (RAGG65): a modified form of stem cell transplant, in which donors for a haploidentical transplant need be only a 50 percent match to the recipient;
    • Transfusion of irradiated erythrocytes (REGG15) and irradiated platelets (RTGG15): a blood component obtained by irradiating for preventing transfusion-related GvHD; labor intensive procedures interesting for national statistics;
    • Plasmapheresis with plasma (RPGD20) or albumin (RPGD25) as replacement fluid: new codes clarify the type of replacement fluid used;
    • Intermittent hemodialysis / hemodiafiltration in acute (RXGD20) and chronic conditions (RXGD25): codes should be used for intermittent dialysis needs in acute and suspected transient conditions and in patients with long-term dialysis treatment, respectively;
    • Extracorporeal removal of CO2 by hemofiltration (RXGD40);
    • Intraarterial tumor treatment (WBOC03): ATC code for the drug used and image guidance are additionally coded.
  • 28 new codes for surgical procedures (Norwegian Classification of surgical procedures, NCSP) have been added for 2018, including:
    • Transposition of peripheral nerve with coaptation to achieve motor (ACC61) and sensitive (ACC61) function;
    • Growth-controlling spinal correction (NAT37- NAT39);
    • Interventions on veins, including endophlebectomy (PHE40, PHE41), autotransplantation of venous segments with functional flap (PHK00, PHK01), Construction of a new venous flap (PHN40, PHN41);
    • Delayed skin closure of wounds following surgical procedure (QAG31, QBG31, QCG31, QDG31, QXG31).
  • 32 new codes for radiological procedures (Norwegian Classification of radiological procedures, NCRP) have been added for 2018, including:
    • Percutaneous insertion of tunneled pleura catheters under US-guidance (GAD15K);
    • Percutaneous insertion of tunneled peritoneal catheter under CT (JAD15A) or US-guidance (JAD15K);
    • Percutaneous sclerosis of renal cyst under US-guidance (KAO10K);
    • Percutaneous thrombectomy or embolectomy of a. Mesenterica superior (PCE30B);
    • Injection of therapeutic substance into different visceral arteries (PCI20B, PCI30B, PCI40B, PCI50B, PCI55B, PCI99B): code includes injection of particles or foam or other substance,  ATC code should be listed to specify drug used;
    • Insertion of bifurcated stent graft in the abdominal and iliac arteries, with openings (PCZ13B) or branches (PCZ14B) for visceral arteries;
    • Percutaneous occlusion of a. Epigastrica inferior (PDY51B);
    • Endovascular thrombectomy or embolectomy of lower limb arteries (PEE10B, PFE10B, PFE20B, PFE30B);
    • Endovascular injection of thrombolytic agent in extraanatomic bypass (PGT87B);
    • Percutaneous occlusion of the perforants on the legs (PHY14C) and the thighs (PHY15C);
    • Percutaneous occlusion of v. spermatica (PHY41C);
    • Endovascular balloon dilatation in AV fistula (PYP90B);
    • Endovascular Selective Optical Coherent Tomography (OCT) of coronary artery or coronary artery bypass (SFN0GX);
    • Endovascular measurement of blood pressure gradient in coronary artery or coronary artery bypass with drug injection (SFN0HX);
    • Additional codes for simultaneous endovascular diagnostic arterial (ZTX0CB) and venous (ZTX0CC) blood pressure measurement;
    • Additional code drug-eluting balloon (ZTX0EJ).

See full information in Norwegian here.

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