Renal denervation

Procedure coding

The procedure coding for percutaneous renal artery denervation varies between European countries.

The procedure is specifically coded in some countries (England, Germany, and countries of the Nordic region). For example, in Denmark, a specific SKS code KPCW10A “Percutaneous transluminal denervation of a. renalis” exists to cover renal denervation. 

Procedure codes can specify the type of energy used (e.g., radiofrequency or ultrasound). For example, there is a specific OPCS code for radiofrequency renal denervation in England – code L43.6 “Percutaneous transluminal radiofrequency denervation of renal artery”.

In other countries (Italy and most countries of Eastern Europe), the procedure is not coded, or nonspecific procedure codes for periarterial sympathectomy can be used to describe percutaneous denervation of the renal artery. 

Policy considerations

Percutaneous renal artery denervation can be subject to specific policies from payers or national decision-makers in the countries where such frameworks exist. 

For example, in 2017, the Dutch Healthcare Institute (ZIN) published a Position on renal denervation in treatment-resistant essential hypertension, which concluded that the procedure cannot be reimbursed under basic health insurance because it has not shown a clinically relevant effect compared to the standard treatment.

Future challenges 

Due to complicated history of the method, it is expected that the procedure will be re-introduced into payment systems of European countries. This will require coverage/funding decisions in the countries, where such frameworks exist and creation of reimbursement in the countries, where it is currently lacking.