Orthopedic procedures

Since 2019, several low-cost and simple procedures in Belgium have been reimbursed not via individual INAMI fees but APR-DRG groups. This funding system is called “Low Variability Care”. On January 26, 2022, the list of APR-DRG groups and corresponding reimbursement amounts for 2022 was published.

In December 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 0181 and 0078 with changes to be implemented no later than February 01, 2022. Seven new procedure codes and four new diagnostic codes were introduced.

On December 16, 2021, the Federal Joint Committee (G-BA) announced the start of the procedure concerning a co-funded study in accordance with §137e of the Social Code Book V (SGB V) for a low-intensity pulsed ultrasound for the treatment of pseudarthroses.

In mid-December 2021, the Danish Health Data Agency (Sundhedsstyrelsen) published the Health Care Classification System (Sundheds-væsenets Klassifikations System, SKS). The most significant changes include: 41 new diagnosis codes and 21 procedure codes were added. The newly added procedure codes concern mainly spine area and orthopedic procedures.

On December 17, 2021, NHS Digital released HRG4+ Consultation Grouper for 2022/23. This release is used to support the NHS England and Improvement consultation process for the 2022/23 National Tariff Payment System. In general, there are significant changes in base HRG design. A total of 120 new HRGs were created, multiple HRGs were removed, and the grouping logic was updated significantly. This Consultation Grouper will be superseded by the 2022/23 Local Payment Grouper in March 2022, for use from April 01, 2022.

In November 2021, the National Institute for Health Research (NIHR) in England released three MedTech-related reports in its Health Technology Assessment (HTA) Journal, which concerned delivery for preterm birth, thoracolumbar fracture, and knee replacement. HTA Journal publishes research reports on the effectiveness, costs, and broader impact of health technologies for those who use, manage, and provide care in the NHS and informs National Institute for Health and Care Excellence (NICE) guidance.

The HTA body of the Tuscany Regional Healthcare issues two types of documents: HTA forms and motivational forms. With a regional decree 20520 of November 22, 2021, Tuscany Regional Healthcare has published assessments of seventeen medical devices of various therapeutic areas, including devices belonging to neurology, as well as gastrointestinal, urology, cardiovascular, orthopedics, peripheral vascular, and other fields of care.

In late November 2021, the INeK (Institute for the Hospital Remuneration System) has published the DRG catalog (Fallpauschalen-Katalog) with the list of DRGs and add-on reimbursement categories (ZEs) for 2022. Seven new DRGs and seventeen ZE categories were added to the catalog in 2022.

In early October 2021, three 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, 23 health apps are now available at the DiGA Directory.

In late September 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0179 and 0076 with changes to be implemented no later than January 01, 2022. Four new procedure codes related to gynecology, robotic surgery in the pulmonology area, and orthopedics, and four new diagnostic codes were introduced.

In September 2021, the National Institute for Health and Care Excellence (NICE) published three new Interventional Procedure Guidance on transapical transcatheter mitral valve-in-valve implantation for a failed surgically implanted mitral valve bioprosthesis, transapical transcatheter mitral valve-in-ring (TMVIR) after failed annuloplasty for mitral valve repair, and lateral elbow resurfacing for arthritis

In August 2021, the National Institute for Health and Care Excellence (NICE) published three new Interventional Procedure Guidance (magnetic resonance therapy for knee osteoarthritis, laparoscopic removal of uterine fibroids with power morcellation, hysteroscopic mechanical tissue removal for uterine fibroids), and six new Medtech Innovation Briefings (PLASMA system with button electrode, Immunoscore, MMprofiler, Patient Status Engine, lung texture analysis, Colli-Pee). Also, five clinical guidelines were published.