Orthopedic procedures

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.

On March 2, 2023, the decision of the National Union of Health Insurance Funds relating to the update of the CCAM Nomenclature of procedure codes was published in the Official Journal of the French Republic. Changes include registration of new procedure codes, modification and removal of some existing codes. Newly introduced codes concern cardiovascular procedures, interventional radiology, orthopedics, peripheral vascular procedures, and others.

In January-February 2023, Health Technology Wales published sixteen Medtech-related Topic Exploration Reports (TER), including stereotactic radiosurgery, percutaneous implantation of pulmonary artery pressure sensors, ambulatory patch ECG devices, and others; however, Health Technology Wales will not proceed with full appraisals on these topics. No Guidance was released for Medtech in January-February 2023.

Surgery for rotator cuff tears has been evaluated within the "New Method" framework since 2020. In January 2023, the method assessment phase was completed, and the National Institute of Public Health (NIPH) report was published. As the recommendations from HTA are now available, the Decision Forum needs to make a coverage decision regarding the method.

On January 1, 2023, the annual update of the Finnish NordDRG system came into force. There are 947 DRGs in the 2023 DRG system, compared to 930 DRGs in 2022. Among other changes, 34 new DRGs were introduced, including the DRGs in the cardiovascular, endocrine, endoscopy, gastrointestinal, obstetrics and gynecology, orthopedics, peripheral vascular, surgical procedures, and some other fields.

On December 19, 2022, the Dutch Healthcare Authority (NZa) issued a draft release of the DRG package for 2024, including new procedure codes, new diagnosis codes, and several new DRGs. These changes concern pulmonary, gynecology, ENT, orthopedics, and other technology groups.

In December 2022, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletin 187 with changes to be implemented in procedural classification no later than February 8, 2023. Five new procedure codes were introduced concerning orthopedic, surgical procedures, and men’s health. No changes were made to the diagnostic schedule.

In December 2022, NHS England published an update of the Specialized Services Policy Pipeline (as of December 6, 2022). No new MedTech-related Clinical Commissioning Policies were added to the work program, and three new policies were published in the period from September 6, 2022, to December 6, 2022. The status of ongoing policies was updated as well.

On December 1, 2022, the Swiss Federal Office of Public Health published the changes that will occur to the Services Ordinance (KLV/OPre), which determines coverage of medical services in Switzerland. The updates will enter into force on January 1, 2023, and they relate to the list of explicitly evaluated services (Annex 1 of KLV/OPre), outpatient-before-hospital services (Annex 1a), List of Tools and Appliances(Annex 2), and List of Analyses (Annex 3).

In November 2022, NHS Digital published a final summary of core changes from OPCS-4.9 to OPCS-4.10 to be introduced from April 01, 2023. OPCS-4 is a statistical classification for clinical coding of interventions and procedures undertaken within the NHS. It is updated every three years. A total of 236 new four-character codes will be implemented in OPCS-4.10. Key changes concern cardiovascular, gastrointestinal, endoscopy, ENT, nephrology and urology, neurology and neurosurgery, obstetrics and gynecology, orthopedic, and breast surgery fields.