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

It is also possible to add analysis in Czech Republic, Finland, Hungary, Romania, Russia and Turkey.

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
 

16

May 2022

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in April 2022. Thirty recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular and peripheral vascular, orthopedic, neurovascular, and neuromodulation and other devices, as well as medical aids.

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20

Apr 2022

In mid-March 2022, the Danish Health Data Agency (Sundhedsstyrelsen) published an update of the Health Care Classification System (Sundheds-væsenets Klassifikations System, SKS). The most significant changes include: ten new diagnosis codes, two procedure codes, and 143 additional codes (Tillægskoder) were added. The newly added procedure codes concern gastrointestinal and peripheral vascular procedures.

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15

Apr 2022

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in March 2022. More than 15 recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular and peripheral vascular, orthopedic, and neurovascular devices, as well as medical aids.

Read more

07

Apr 2022

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in February 2022. More than 25 recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration of devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular and peripheral vascular, orthopedic, neurovascular, and neuromodulation devices, as well as breast implants and medical aids. Except for this, CNEDiMTS published two negative opinions concerning transitional coverage of devices.

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24

Mar 2022

The HTA body of the Tuscany Regional Healthcare issues two types of documents: HTA forms and motivational forms. With a regional decree 2472 of February 10, 2022, Tuscany Regional Healthcare has published assessments of five medical devices of various therapeutic areas, such as cardiovascular and peripheral vascular areas.

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