Atherectomy for peripheral artery disease

Series
Peripheral vascular interventions
Status
Published
Date
Number of report
011

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Report presents summary of the reimbursement situation in Europe for atherectomy.

Analysis covers iliac, femoral and popliteal arteries.

Analysis is provided for admitted and day case hospital care.

The following clinical scenarios are considered:

  • Percutaneous transluminal atherectomy as stand-alone procedure
  • Percutaneous transluminal atherectomy in combination with plain balloon angioplasty
  • Percutaneous transluminal atherectomy in combination with insertion of bare metal stent
  • Percutaneous transluminal atherectomy in combination with plain balloon angioplasty and insertion of bare metal stent

Report includes essential information about reimbursement and national funding for atherectomy, including:

  • Brief overview of reimbursement system for medical devices
  • Procedure coding for technology
  • Diagnosis coding
  • Payment mechanism for technology
  • Reimbursement tariffs for technology
  • Restrictions in indications or scenarios for use of technology
  • Policy considerations by payers and policy-makers about technology

Reimbursement information is provided for the following geographies:

  • Austria
  • Belgium
  • Denmark
  • England (UK)
  • France
  • Germany
  • Italy
  • Netherlands
  • Norway
  • Sweden
  • Switzerland

Manufacturers of the atherectomy systems include:

  • Boston Scientific (Jetstream, Rotablator System)
  • Cardiovascular Systems (Diamondback Orbital Atherectomy System)
  • Medtronic (HawkOne directional atherectomy system, TurboHawk plaque excision system, SilverHawk plaque excision system)
  • Philips Volcano (Phoenix atherectomy system)
  • Spectranetics (Turbo-Power Laser Atherectomy Catheter, Turbo-Elite laser atherectomy catheter, Turbo-Tandem Laser Guide Catheter with Laser Atherectomy Catheter)

If you are interested in other reimbursement reports in the peripheral artery field, please, visit report-specific pages for:

Table of content

1.    Introduction and summary
2.
    Executive summary table
3.    Contents
4.    Methodology
5.    Reimbursement analysis in Austria

5.1.    Overview of the reimbursement system
5.2.    Reimbursement for percutaneous atherectomy
5.2.1.    Procedure coding
5.2.1.1.    Coding of atherectomy
5.2.1.2.    Coding of atherectomy in combination with angioplasty and insertion of stent
5.2.2.    Diagnosis coding
5.2.3.    Payment mechanism and reimbursement tariffs
5.2.3.1.    Reimbursement of atherectomy
5.2.3.2.    Reimbursement of atherectomy in combination with angioplasty and insertion of stent
6.    Reimbursement analysis in Belgium
6.1.    Overview of the reimbursement system
6.2.    Reimbursement for percutaneous atherectomy
6.2.1.    Procedure and material coding 
6.2.1.1.    Procedure and material coding of percutaneous transluminal atherectomy
6.2.1.2.    Procedure and material coding for surgical endarterectomy
6.2.2.    Payment mechanism and reimbursement tariffs
7.    Reimbursement analysis in Denmark
7.1.    Overview of the reimbursement system
7.2.    Reimbursement for percutaneous atherectomy
7.2.1.    Procedure coding 
7.2.2.    Diagnosis coding
7.2.3.    Payment mechanism and reimbursement tariffs
8.    Reimbursement analysis in England
8.1.    Overview of the reimbursement system
8.2.    Reimbursement for percutaneous atherectomy
8.2.1.    Procedure coding 
8.2.1.1.    Coding of atherectomy
8.2.1.2.    Coding of angioplasty and insertion of stent
8.2.2.    Diagnosis coding
8.2.3.    Payment mechanism and reimbursement tariffs
8.2.3.1.    Reimbursement for atherectomy
8.2.3.2.    Reimbursement for atherectomy in combination with angioplasty
8.2.3.3.    Reimbursement for atherectomy in combination with angioplasty with insertion of stent
8.2.4.    Policy considerations 
8.2.4.1.    Health technology assessment of percutaneous atherectomy by the National Institute for Health and Care Excellence 
8.2.4.2.    Commissioning of percutaneous atherectomy
9.    Reimbursement analysis in France
9.1.    Overview of the reimbursement system
9.2.    Reimbursement for percutaneous atherectomy
10.    Reimbursement analysis in Germany
10.1.    Overview of the reimbursement system
10.2.    Reimbursement for percutaneous atherectomy
10.2.1.    Procedure coding 
10.2.1.1.    Coding of atherectomy
10.2.1.2.    Coding of atherectomy in combination with angioplasty and insertion of stent
10.2.2.    Diagnosis coding
10.2.3.    Payment mechanism and reimbursement tariffs in hospital setting
10.2.3.1.    Reimbursement for atherectomy
10.2.3.2.    Reimbursement for atherectomy in combination with angioplasty and insertion of stent 
10.2.4.    Payment mechanism and reimbursement tariffs in day case setting
10.2.5.    Policy considerations
11.    Reimbursement analysis in Italy
11.1.    Overview of the reimbursement system
11.2.    Reimbursement for percutaneous atherectomy
11.2.1.    Procedure coding 
11.2.1.1.    Coding of atherectomy
11.2.1.2.    Coding of atherectomy in combination with angioplasty and insertion of stent
11.2.2.    Diagnosis coding
11.2.3.    Payment mechanism and reimbursement tariffs 
11.2.3.1.    Reimbursement for atherectomy
11.2.3.2.    Reimbursement for atherectomy in combination with angioplasty and insertion of stent 
12.    Reimbursement analysis in the Netherlands
12.1.    Overview of the reimbursement system
12.2.    Reimbursement for percutaneous atherectomy
12.2.1.    Procedure coding
12.2.1.1.    Coding of atherectomy
12.2.1.2.    Coding of atherectomy in combination with angioplasty and insertion of stent
12.2.2.    Material coding
12.2.3.    Diagnosis coding
12.2.4.    Payment mechanism and reimbursement tariffs
12.2.4.1.    Reimbursement for atherectomy
12.2.4.2.    Reimbursement for atherectomy in combination with angioplasty
12.2.4.3.    Reimbursement for atherectomy in combination with angioplasty with insertion of stent
12.2.5.    Policy considerations
12.2.6.    Health technology assessment by National Healthcare Institute
13.    Reimbursement analysis in Norway
13.1.    Overview of the reimbursement system
13.2.    Reimbursement for percutaneous atherectomy
13.2.1.    Procedure coding 
13.2.2.    Diagnosis coding
13.2.3.    Payment mechanism and reimbursement tariffs 
13.2.3.1.    Reimbursement using procedure codes for “other image-guided interventions”
13.2.3.2.    Reimbursement for surgical endarterectomy
14.    Reimbursement analysis in Sweden
14.1.    Overview of the reimbursement system
14.2.    Reimbursement for percutaneous atherectomy
14.2.1.    Procedure coding 
14.2.2.    Diagnosis coding
14.2.3.    Payment mechanism and reimbursement tariffs 
15.    Reimbursement analysis in Switzerland
15.1.    Overview of the reimbursement system
15.2.    Reimbursement for percutaneous atherectomy
15.2.1.    Procedure coding 
15.2.1.1.    Coding of atherectomy
15.2.1.2.    Coding of atherectomy in combination with angioplasty and insertion of stent
15.2.2.    Diagnosis coding
15.2.3.    Payment mechanism and reimbursement tariffs in hospital setting
15.2.3.1.    Reimbursement for atherectomy
15.2.3.2.    Reimbursement for atherectomy in combination with angioplasty with insertion of stent
15.2.4.    Payment mechanism and reimbursement tariffs in day case
15.2.4.1.    Reimbursement for atherectomy
15.2.4.2.    Reimbursement for atherectomy in combination with angioplasty with insertion of stent
15.2.5.    Policy considerations 
16.    Disclaimer
 

24

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Nov 2017

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Nov 2017

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23

Oct 2017

On 13th of October of 2017, the Ministry of Health of Poland commissioned Agency of Health Technology Assessment and Tariff Systems (AOTMiT) to assess the benefit of angioplasty of arteries of lower extremities (femoral and popliteal) with drug-eluting balloons.

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17

Oct 2017

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28

Sep 2017

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06

Sep 2017

French National Authority for Health (HAS) released new decisions about add-on and medical aid reimbursement of medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in August 2017. They include different types of stents and stent-grafts for multiple indications (coronary, peripheral vascular), mechanical thrombectomy devices for stroke, medical devices applied for treatment of ulcer of venous origin, remote monitoring for Implantable Cardioverter Defibrillator Systems (ICDS).

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04

Sep 2017

There is an ongoing process to change the structure of add-on reimbursement for peripheral vascular stents in France. In July 2017 CNEDiMTS issued additional clarifications about proposed reimbursement requirements for stents and stent-grafts. Read about proposed changes in our post.

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14

Jul 2017

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08

Jun 2017

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10

May 2017

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08

May 2017

Ministerial decree to enlist Medtronic's IN.PACT Admiral for the LPPR title V for add-on reimbursement was published on 6th of May 2017 in the Official Journal of French Republic. This is not only the first peripheral DCB on the List, but one of the first invasive non-implantable devices to get add-on reimbursement in France.

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01

May 2017

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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