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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 Swiss Federal Council has approved the new SwissDRG system for 2018

The further-developed tariff structure SwissDRG was approved by the Federal Council in Switzerland. The new tariff version for inpatient services will be effective from January 1st in 2018. The tariff structure SwissDRG defines how inpatient services in the acute care area of the hospitals and birthplaces are reimbursed within the framework of compulsory health care insurance in Switzerland.

Compared to the last version, the number of case groups in the new DRG catalog remains stable overall. The number of add-on payments (Zusatzentgelte, ZE) on the other hand has increased. These payments are used to for the additional reimbursement of especially costly services.

The following new add-on payments that are related to medical devices were included in the SwissDRG catalog for 2018:

  • ZE-2018-104.01 - Hemodialysis to remove proteins with a molecular mass up to 60,000, extended intermittently - 1,792.10 CHF
  • ZE-2018-109.01- ZE-2018-109.05 - Endoscopic insertion of bronchial valve(s), amount depending on number of valves - 2,128.40 to 10,642.00 CHF
  • ZE-2018-105 - Autogenic matrix-induced chondrocyte transplantation at the knee joint - 5,614.00 CHF
  • ZE-2018-107.01 - Proton therapy - 1,412.75 CHF
  • ZE-2018-108.01 - Externally delivered anesthesia service - 774.95 CHF

The SwissDRG catalog for 2018 in PDF and Excel versions is available here.

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