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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 preliminary version of the DRG manual for 2022 published in France

On February 15, 2022, the preliminary version of the DRG manual for 2022 was published in France. Introduced changes (new DRGs, change of DRG logic) concern surgical procedures on the breast, interventions for malignant skin tumors, interventions of excision and grafting on the skin and subcutaneous tissue, spondyloplasties.

Introduced changes are described in Volume 1 of the DRG manual.

Considering the heaviness of certain procedures and improved description of concomitant procedures, such as the positioning of markers and the various procedures of simultaneous reconstruction, DRGs for breast reconstructions and other interventions on the breast were changed. Seven new DRGs are introduced instead:

  • 09C16 Total mastectomies with complex reconstructions;
  • 09C17 Isolated complex reconstructions;
  • 09C18 Major interventions for malignant breast tumor with prosthetic reconstruction;
  • 09C19 Major interventions for malignant breast tumor;
  • 09C20 Other interventions for malignant breast tumor;
  • 09C21 Major interventions excluding malignant breast tumor;
  • 09C22 Other interventions excluding malignant breast tumor.

New DRGs are introduced for spondyloplasty and other transcutaneous interventions on the spine:

  • 08K05 Spondyloplasties;
  • 08K06 Other interventional procedures on the spine, stays of less than 2 nights.

The full details about other changes in French can be found here.

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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