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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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Three new procedure codes were added to private reimbursement schedule in England in July

The Clinical Coding and Schedule Development (CCSD) develops and maintains procedural and diagnostics nomenclature for private payers in England. Once codes are added to the Schedule, a private insurance company can develop reimbursement tariff for these procedures and tests.

The CCSD Group has approved the following procedure codes for publication to the CCSD Schedule in July:

  • Video-assisted anal fistula treatment (H5580)
  • Infracoccygeal sacropexy using mesh to repair uterine prolapse +/- ureterolysis (Q5460)
  • Infracoccygeal sacropexy using mesh to repair vaginal vault prolapse +/- ureterolysis (P2453)

The following requests have been declined or withdrawn:

  • CCSD declined requests for laying open of low anal fistula (fistulotomy) +/- insertion of stitch, +/- video assistance, (including sigmoidoscopy) and Laying open of high anal fistula (fistulotomy) +/- insertion of stitch, +/- video assistance (including sigmoidoscopy) due to implementation of new code for Video-assisted anal fistula treatment (VAAFT)

There were no changes to CCSD Diagnostic Schedule in July.

See full information here.

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