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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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News from SwissDRG in January 2020

On the 30th of January 2020, the entity managing the DRG system in Switzerland, SwissDRG, has published the data collection guideline and excel module for data collection for SwissDRG 2020 (2019 data). The hospitals can send the data March 1 – May 15, 2020. See further details in Italian (change the language to German or French in the top-right corner) here.

One day later, SwissDRG has published an explanation about the codification of “Aortic stent graft (stent prosthesis).” Starting from January 1, 2020, in the SwissDRG version 9.0 (2020/2020), there will be changes regarding the CHOP 2020 codes “Endovascular implantation of stent grafts (stent prosthesis) in the abdominal / thoracic / thoracoabdominal aorta, …” (codes from 39.71.21 to -.25;  from 39.73.31 to -.35; from 39.73.41 to -.45).

As a consequence, if stent grafts are implanted in the abdominal aorta (CHOP codes 39.71.21 to -.25), the CHOP code 39.71.09 “Endovascular implantation of the stent graft (stent prosthesis) in the abdominal aorta, other” must be added. If stent grafts are implanted in the thoracic aorta (CHOP codes 39.73.31 to -.35), or in the thoracoabdominal aorta (CHOP codes 39.73.41 to -.45), the CHOP code 39.73.09 “Endovascular implantation of stent graft (prosthesis) stent) in the thoracic and thoracoabdominal aorta, other” must be added.

These additional codes are required in order to ensure the correct allocation of the new CHOP 2020 codes for “aortic stent grafts” in the Grouper. See the news in Italian (change the language to German or French in the top-right corner) here.

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