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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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Recent changes in the Swiss coverage Lists and Ordinances

On March 4, 2020, the List of Analyses (AL/EA) and the Services Ordinance (KLV/OPre) were updated in Switzerland.

The List of Analyses, and all the changes, can be found here. The March update introduced the procedure code and the test for SARS-coronavirus-2 (code: 3565.00, tariff: CHF 180). The test will be reimbursed until the end of 2021. Furthermore, the graphical scheme of COVID-19 testing and reimbursement (criteria for testing, prescription, billing, payment) can be found in the “Documents” section of the link above.

The latest (and historical) Services Ordinances (KLV/OPre), including the version of March 4, 2020,  can be found here. No specific documents with the changes made were published.

On April 1, 2020, new updates are expected. This version of the Services Ordinance (KLV/OPre) is not published yet. Regarding the changes in the List of Analyses, they mostly concern the introduction of a dozen of new highly specialized biochemical analysis of metabolites for rare (orphan) congenital metabolic disease, whose tariffs range from CHF 60 to CHF 520. Other new tests are also included, together with some changes in the reimbursement conditions of the already reimbursed tests.

On April 1, 2020, the changes in the List of Medical Aids (MiGel/EMAp) are also occurring.  The April updates are not major; They mostly concern the amendments in the conditions and limitations for reimbursement of mostly respiratory therapy aids (substantial price reductions, probably related to the COVID-19 outbreak), but also to locomotion aids. The changes that regard the same type of medical aids will also occur in July 2020. All the changes and Lists of Medical Aids can be found here.

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