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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 updates in the Swiss coverage of health care services

17 Jul 2019

On June 6, 2019, the Swiss Federal Department of Home Affairs (FDHA) has changed the Services Ordinance (OPre/KLV). The changes in the articles of the Ordinance concern the following:

  • Chiropractic services
  • Vaccines
  • Minor adjustments regarding colorectal cancer screening
  • Benefits deliverable after miscarriage

The changes in annex 1 of the OPre/KLV (reimbursed services) concern the following:

  • Coverage of the percutaneous electroneuromodulation of the tibial nerve extended from July 1, 2019
  • Coverage of the transcatheter aortic valve implantation (TAVI) extended until June 30, 2020
  • Measures to preserve the fertility of adolescents and adults with cancer are covered since July 1, 2019
  • Osteodensitometry using double energy X-ray absorption (DEXA) is now covered for more conditions
  • Positron emission tomography (PET/CT) is now covered for more conditions
    • Under evaluation, until December 31, 2019, usage of PET/CT in the case of the «mass effect» indication, according to the clinical guidelines relating to the FDG-PET dated 28 April 2011 of the SSMN, chapter 2.0
    • Under evaluation, until June 30, 2020, usage of PET/CT for the preoperative localization of parathyroid adenomas in cases of primary hyperparathyroidism after conventional negative or inconclusive imaging (scintigraphy with sestamibi or -SPECT / TC)

More information can be seen in Italian (change to German or French in the top-right corner) here.

Furthermore, the suggestion to update the Health Insurance Law (LAMal/KVG) has been published on June 21, 2019. The changes concern the measures to be taken that would enhance the quality of the care delivered and its effectiveness. The details can be seen in Italian here.

The List of Analyses has also been updated. The changes mostly relate to the denomination of the services. Four (4) new tests were added. The latest version is valid since July 1, 2019, and it can be seen in Italian (change to German or French in the top-right corner)  here.

In addition, the List of Medical aids and Equipment has also had some changes. On their website, the changes coming on force on July 1, 2019, and October 1, 2019, have been published. Not much was changed; most changes regard the text of the Ordinance itself. Full details can be seen in Italian (change to German or French in the top-right corner) here.

Finally, the second notification for the clinical coders of this year has been published. It mostly concerns the changes in the coding of sepsis and other minor changes. The full details can be seen in Italian (change to German or French in the top-right corner) here.

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