Orthopedic procedures

On November 14, 2023, the Institute for the Hospital Remuneration System (InEK) published the DRG catalog (Fallpauschalen-Katalog) with the list of DRGs and additional reimbursement categories (ZEs) for 2024.

In November 2023, the National Institute for Health and Care Excellence (NICE) published four new Interventional Procedure Guidance (percutaneous thrombectomy for pulmonary embolism, percutaneous transarterial carotid artery stent placement for asymptomatic extracranial carotid stenosis, biodegradable subacromial spacer insertion for rotator cuff tears, extracorporeal carbon dioxide removal for acute respiratory failure) and one Health Technology Evaluation using early value assessment (virtual reality technologies for treating agoraphobia or agoraphobic avoidance). Also, five clinical guidelines were updated.

On November 16, 2023, the National Association of Statutory Health Insurance Physicians (KBV) informed that Annex 2 of the updated German Uniform Evaluation Standard (EBM) catalog, which is expected to be published on January 1, 2024, will be enriched with an additional 33 interventional procedures.

The updated German Uniform Evaluation Standard (EBM) catalog came into force on October 1, 2023. The EBM catalog (Einheitlicher Bewertungsmaßstab) regulates the reimbursement of services in the public outpatient sector in Germany and is updated once a quarter (four times a year). Among other changes, a new code for “Mawendo” and “Oviva Direkt für Adipositas” health apps were introduced in the catalog.

In September 2023, the Health Sciences Institute in Aragon (IACS) is working on several HTAs, including evaluations in diagnostic imaging, endocrine, IVD, neuromodulation, orthopedics, peripheral vascular, and some other fields.

Between late May and early September 2023, two more health apps were introduced in the Directory of digital health applications (DiGAs) at the Federal Office for Drugs and Medical Devices (BfArM) and thus became reimbursable. These apps can be prescribed by physicians and psychotherapists and will be reimbursed by health insurers. In total, 49 health apps are currently available in the DiGA Directory, and six health apps were delisted from the Directory.

In September 2023, the Galician Agency for Health Technology Assessment (AVALIA-T) is working on several HTAs, including the evaluations in the cardiovascular, e-health, endoscopy, extracorporeal treatment, ICU/OR, nephrology and urology, IVD, obstetrics and gynecology, orthopedics, peripheral vascular, pulmonary and airways, surgical procedures, and some other fields.

In August 2023, the Evaluation and Planning Service of the Canary Islands Health Service (SESCS) is working on several HTAs, including evaluations in the cardiovascular, endocrine, neurology and neurosurgery, orthopedics, surgical procedures, and some other fields.

On July 3, 2023, the document "Changes and innovations in the 2024 LKF model" (Änderungen und Neuerungen in den LKF-Modellen 2024) was published. The document summarizes the most significant changes and innovations in the LKF model for inpatient and outpatient care. The newly added procedure codes mainly concern endoscopic procedures, orthopedics, peripheral vascular, and pulmonary and airways fields.

On June 13, 2023, the Swedish Medical Technologies Product (MTP) Council recommended that all regions delay the introduction of robotic systems for knee, hip, and spine surgery until they have been evaluated as part of the Orderly introduction framework. For now, MTP Council recommends robotic systems in these indications only to be used in the context of research.

On April 20, 2023, the Dutch Healthcare Authority (NZa) published the first release of the DRG package for 2024 (RZ24a). Twenty-three new procedure codes, nine new supplementary payments, and thirteen new DRGs will be implemented across gynecology, pulmonary, extracorporeal treatments, and other technology groups.

OPCS-4 is the clinical coding classification of interventions and procedures undertaken within the NHS in England. It is updated every three years, reflecting current clinical practice to be used for statistical purposes and reimbursement. On April 1, 2023, a new version (OPCS-4.10) came into force. A total of 236 new four-character codes were introduced in multiple areas, including cardiovascular, endoscopy, ENT, gastrointestinal, urology, neurology, gynecology, breast reconstruction, and others.