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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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Release of provisional OPS procedure catalogue for 2018 in Germany by DIMDI

Procedures that can be reimbursed through the statutory health insurance in Germany are assigned a code listed in a catalogue called OPS (Operationen- und Prozedurenschlüssel). The catalogue is updated annually and procedural codes are maintained and developed by the German Institute of Medical Documentation and Information (DIMDI). Actors in the German healthcare system can submit applications for new procedures to be included in the catalogue. Applications must be developed in cooperation with the German Medical Society and submitted to DIMDI by the deadline of February 28th of each year.

In the next step, DIMDI reviews the applications for new procedure codes using a defined policy framework and consults with OPS-Working Group and authorized experts.

The preliminary version of the procedure catalogue for the coming year is published in the middle of August. This gives medical software developers time to update DRG grouping software and make necessary adaptions and hospital staff can be trained on the coding of the new procedures. DIMDI considers additional change requests by software developers or the Ministry of Health (BMG) before the final version of the catalogue becomes effective on January 1st of the subsequent year.

MTRC will report about new procedures and other changes included in the catalogue after the release of the official version in the beginning of 2018.

See a provisional version of the procedure catalogue for 2018 here.

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