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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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Swiss Medical Tariff Commission recommendations about knee Autologous Chondrocyte Implantation

In December 2019, the Swiss Medical Tariff Commission (MTK/CTM) has published their recommendations regarding the knee Autologous Chondrocyte Implantation (ACI). The CTM recommends covering the costs of the implant for knee ACI until the end of 2024, according to their document “Indications and contraindications for knee ACI (version of the 10th of December 2019)", after individual examination.

The CTM recommends covering of the cost of implant in the following indications:

  • Isolated lesion of knee cartilage in stage III-IV, according to the Outerbridge or ICRS classification
  • Documented size of the lesion on MRI or arthroscopy is 2-6 cm2 lesion
  • Preserved subchondral bone lamella (osteochondral defects with bone lesion up to 2 mm deep; in case of deeper defects, a previous bone reconstruction is required)
  • Structure of the surrounding cartilage (cartilaginous shoulder) is intact around the lesion, for anchoring the membrane
  • Localization: medial and lateral femoral condyle, trochlea, patella
  •  Corresponding articular surfaces intact (lesions up to the II degree of the Outerbridge classification of the corresponding articular surfaces are allowed)
  • Free mobility of the joint
  • Ligamentous stability
  • Only patients who are done growing
  • Age: up to 55 years

It is also advised to provide the collected data to the international register of the German orthopedic and traumatology federation (DOGU) here.

The Swiss military insurance has already accepted these recommendations.

See the contraindications and the whole news here.

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