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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 DRG changes in Sweden in 2020

MTRC has summarized the most important DRG changes in Sweden, which came in force in 2020.

The selection of the most significant changes is provided below:

Five new DRGs were added:

  • M23N “Central dialysis catheter (CVK) for Hemodialysis”
  • M24N “Arteriovenous (AV) fistula for hemodialysis”
  • M25N “Catheter for peritoneal dialysis”
  • M26O “Access measures for dialysis, outpatient care”
  • Z95N “Healthy person accompanying sick” (e.g. a healthy parent with an ill child or a close relative in care at the end of life)

Changes in DRG grouping logic:

  • Q60N “Newborn without serious problems”: case with main diagnosis Z76.3 “Healthy person accompanying sick” and age <1 year, i.e. healthy child with ill health guardians, e.g. newly delivered sick mother was previously grouped into several different neonatal DRGs with misleading description but will now be grouped into existing Q60N “Newborn without serious problems” as there are not enough cases for separate DRGs
  • M29A / C / E / O “Other kidney & urinary tract problems, ...”, M31A / C / E / O “Kidney failure, ...”: previous cases have been grouped in these DRGs with access measures for dialysis (CVK for hemodialysis, AV fistula for hemodialysis and catheter for peritoneal dialysis) but these are now grouped into the above-mentioned new DRGs
  • DRGs codes changes:
  • Y10R → L97R “Nurse visit in case of endocrine, nutrition and metabolic diseases, primary care”
  • Y12R → X96R “Nurse visit for vaccination, primary care”
  • Y13R → X97R “Nurse visit for blood pressure control, primary care”
  • R87O → X87O “Puncture biopsy bone and bone marrow, visit”

The full details in Swedish can be found here.

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