Reimbursement

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 April 1, 2023, an updated version of the Health Care Classification System (SKS) came into force. The Danish Health Data Authority quarterly updates the SKS system, which includes coding for procedures, diagnoses, and other coding (e.g., administrative, pharmaceuticals). In the current version, eight new surgical procedure codes, one medical procedure code, multiple codes for regional anesthesia, one code for diagnostic imaging, one for nuclear medicine, and several additional codes were implemented.

In March 2023, the National Institute for Health and Disability Insurance (INAMI-RIZIV) updated the List of reimbursable devices and Nominative lists to take effect on April 1, 2023. Eight new codes for intracardiac transcatheter pacing systems with the corresponding conditions of reimbursement were added to the List, and two devices (Micra VR and Micra AV) were registered on the list of brands connected to that new codes.

In the middle of March 2023, the updated version of the intra-DRG list was published. Changes include the introduction of several devices for thrombo-aspiration into the list and the deletion of a few devices from the list.

In late March 2023, NHS England released the 2023/25 NHS Payment Scheme (NHSPS) to come into force on April 1, 2023. NHSPS has been set for two years, replacing the National Tariff Payment System (published annually). The NHSPS specifies payment conditions for NHS-funded secondary care.

In late March 2023, the Norwegian Directorate of e-Health released an updated version of the National Laboratory code (NLK) system and associated tariffs for state and private laboratories to be implemented no later than May 1, 2023. Twenty-one new codes were added, 122 codes were changed, and one code was terminated.

In late March 2023, NHS England released an annual update of HRG4+ Local Payment Grouper for 2023/24, to come into effect on April 1, 2023. No new HRGs were added. The HRG design has been updated to accommodate the latest version of procedure coding classification (OPCS-4.10).

In March 2023, two 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 sickness funds.

On March 22, 2022, the entity managing the DRG system in Switzerland, SwissDRG, announced that they will be accepting applications for changes in the DRG system from June 5, 2023, until July 17, 2023. The results of the DRG applications made in 2023 will be reflected in the 2025 version of SwissDRG.

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.

A new preeclampsia screening algorithm has been evaluated within the "New Method" framework since 2021. The algorithm helps to predict the risk of preeclampsia in the first trimester based on several parameters, including ultrasound examination and measurement of the Placenta Growth Factor (PIGF). In March 2023, the Decision Forum for "New Method" was held and commissioned to perform the implementation study of a new screening algorithm at St. Olav's Hospital.

On March 1, 2023, Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) updated three Articles of the Nomenclature related to in-vitro diagnostics. Twelve new codes concerning clinical biology, molecular biology for infections, and genetics were implemented.