In-vitro diagnostic tests

In December 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 0181 and 0078 with changes to be implemented no later than February 01, 2022. Seven new procedure codes and four new diagnostic codes were introduced.

In late December 2021, five new in-vitro diagnostics tests, including one test for COVID-19 spike protein antibodies determination, were added to the Laboratory Test Nomenclature (Laboratoriotutkimusnimikkeistö) in Finland.

The Council for Choices in Health Care in Finland (PALKO) has initiated the development of recommendations concerning companion diagnostic tests. The respective preparations were completed in November 2021.

In 2015, the Federal Office for Public Health launched an HTA program intending to reassess the benefits already reimbursed by compulsory health insurance. The following ongoing re-evaluations are in progress: multigene expression tests in breast cancer, cardiac catheterization for coronary artery disease, invasive procedures for coronary artery disease, removal of osteosynthesis materials, etc.

In November 2021, the National Institute for Health and Care Excellence (NICE) published two new Interventional Procedure Guidance (percutaneous implantation of pulmonary artery pressure sensors in chronic heart failure and coronary sinus narrowing device implantation for refractory angina), one new Medical Technologies Guidance (Synergo for non-muscle-invasive bladder cancer), one new Diagnostic Guidance (SeHCAT for diagnosing bile acid diarrhea), and four new Medtech Innovation Briefings (clonoSEQ for minimal residual disease, CerebAir for continuous EEG monitoring, 24/7 EEG SubQ for epilepsy, Paige Prostate for prostate cancer). Also, three new clinical guidelines were published, and six were updated.

On November 23, 2021, 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 January 01, 2021. NLK system has been used for activity-based reimbursement by the Norwegian Health Economics Administration (Helfo) in outpatient settings since 2018. Thirty new codes were added in medical biochemistry, immunology and transfusiology, and clinical pharmacology areas.

On November 18, 2021, Swedish Medical Technologies Product (MTP) Council recommended the use of gene expression analysis (Prosigna and OncotypeDX) for decision-making on the adjuvant breast cancer treatment. The technologies have been under evaluation within the Orderly introduction framework since 2020.

In late November 2021, the INeK (Institute for the Hospital Remuneration System) has published the DRG catalog (Fallpauschalen-Katalog) with the list of DRGs and add-on reimbursement categories (ZEs) for 2022. Seven new DRGs and seventeen ZE categories were added to the catalog in 2022.

In November 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0180 and 0077 with changes to be implemented no later than February 01, 2022. Four new procedure codes related to neurology, spinal procedures, cancer pharmacotherapy, and ophthalmology, and three new diagnostic codes were introduced.

In October 2021, the Scottish Health Technology Group released two Innovative Medical Technology Overviews for e-health technologies. The topics were asynchronous digital dermatology appointment service (DDAS) and the Dxcover™ Brain Cancer Liquid Biopsy. Regarding DDAS, the authors concluded that the Scottish health boards should provide more data to allow for further performance and economic analyses of the DDAS. Regarding Dxcover™, the SHTG concluded that it was cost-effective, but further work to confirm its accuracy, effectiveness, safety, and cost-effectiveness is required.

In November 2021, the National Board of Health and Welfare released an annual update of the Swedish procedure coding classification (Classification of Health Care Measures, KVÅ) that will come into force in January 2022. KVÅ includes two parts – medical procedures (KMÅ) and surgical procedures (KKÅ) divided into chapters based on anatomical principles. In 2022, six new surgical procedure codes will be introduced. Furthermore, structural changes will be made in Chapter V "Operations on the aorta, peripheral vessels, and lymphatic system," introducing two new sub-chapters with 318 new codes. A total of 53 new medical procedure codes (KMÅ) will be added.

In late October 2021, the BfArM (Federal Institute for Drugs and Medical Devices) has published the final version of the 2022 OPS procedure coding classification. The OPS, together with the ICD-10-GM (International Statistical Classification of Diseases and Related Health Problems, 10th revision, German Modification), forms the basis for the reimbursement systems in outpatient and inpatient care.