Peripheral Angioplasty

Procedure coding   

Typically, procedure coding for peripheral angioplasty is well established in European countries.

The coding for peripheral angioplasty may differ depending on the anatomical site of intervention (for example, in France and countries of the Nordic region) or the number of treated vessels (for example, in England, Germany, and Italy). 

In some countries, procedure coding is complex, involving multiple codes depending on the type, number of inserted stents, and the number of treated vessels. For example, in Switzerland, a combination of CHOP codes for percutaneous angioplasty or atherectomy of other non-coronary vessel, along with insertion of a stent or drug-coated balloon, and multiple supplementary codes to specify the type (bare metal stent, drug-eluting stent, etc.), the number of inserted stents (ranging from one to six), and the number of treated vessels (from one to four or more) is used to describe the procedure. 

In other countries, the number of procedure codes for PCI is limited. For example, in the Netherlands, the procedure is described via a single code for percutaneous angioplasty of non-coronary peripheral vessels (code 033672).

Policy considerations

Peripheral angioplasty, both with and without stenting, is a well-established technology unlikely to be subject to specific policies from payers or national decision-makers in countries where such frameworks exist. 

Future challenges 

Peripheral angioplasty, with or without stent placement, is widely reimbursed and funded across most European countries. However, the introduction of newer peripheral stents and balloons – featuring novel designs, functionalities, or distinct cost profiles – often necessitates creating specific procedure codes and adjusting existing payment mechanisms. Robust evidence demonstrating clinical efficacy and cost-effectiveness is essential for adopting these innovative technologies to ensure appropriate reimbursement.