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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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CZ-DRG system updated in the Czech Republic

Earlier this year, the CZ-DRG v5 was released in the Czech Republic by the Central Institute of Health Information and Statistics (ÚZIS).

Key changes of the CZ-DRG v5 compared to CZ-DRG v4, revision 1, included:

  • The total amount of DRGs slightly decreased from 1792 to 1788 DRGs:
    • 72 new DRGs were introduced;
    • 76 DRGs were deleted;
  • There were changes in the DRG logic, including the addition/removal of procedure codes, DRG markers, and diagnosis codes as classification factors;
  • The list of highly specialized care centers was updated;
  • For some DRGs, the patient's age is now specifically outlined.

Some of the examples of newly added DRGs or DRG modifications with the removal of previous DRGs include:

  • DRG 08-M04-00 "Bloodless reduction of congenital hip deformities" was introduced;
  • DRG 05-I13-02 "Atrial or ventricular surgery with another procedure performed on another day or performed as an emergency procedure or in patients with CC=4" was introduced;
  • DRG 05-K18-01 "Infectious and inflammatory complications of artificial prostheses" and DRG 05-K18-02 "Other complications of artificial replacements" were introduced, while DRG 05-K18-00 "Complications of prosthetics" was deleted;
  • DRG 05-M07-01 changed its name to "Angioplasty of central and peripheral vessels with stent graft insertion". Previously, it was called "Angioplasty of peripheral vessels with the introduction of a stent graft";
  • DRG 15-M01-07 "Artificial pulmonary ventilation lasting 25-96 hours (2-4 days) in a newborn with a gestational age from 34 weeks" was introduced along with other DRGs for artificial pulmonary ventilation in newborns, and now the gestational age of newborns is considered instead of the birth weight;
  • DRG 19-M01-01 "Repeated implementation of non-invasive neurostimulation therapy for mental illness" and DRG 19-M01-02 "One-time procedure of non-invasive neurostimulation therapy for mental illness" were introduced. In contrast, DRG 19-M01-00 "Non-invasive neurostimulation therapy for mental illness" was deleted.

The CZ-DRG v5 was released in April 2022. Currently, it is being further updated to CZ-DRG v5, revision 1, which is expected to be valid from January 1, 2023. The consultation period, in which the interested parties could have submitted comments towards revision 1, was open in July 2022.

The full details in Czech can be found here and here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news).

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