Capsule endoscopy

Series
Procedures on gastrointestinal tract
Status
Published
Date
Number of report
052

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The report presents a summary of reimbursement situation for capsule endoscopy in ambulatory settings.

Indications include gastrointestinal bleeding, Crohn's disease, malignant neoplasm of small intestine and celiac disease.

The only reimbursement within public / statutory health insurance systems is considered.

Report includes essential information about reimbursement and national funding, 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 capsule endoscopy system include:

  • CapsoVision Inc. (CapsoCam Plus, Capso Retrieve, CapsoAccess, CapsoView)
  • Check Cap (Check-cap)
  • Chongqing Jinshan Science & Technolgy (Group) Co. Ltd. (OMOM)
  • IntroMedic Co. Ltd. (MicroCam Regular, Green, Navi)
  • Medtronic (PillCam)
  • Olympus Corporation (EndoCapsule)
  • RF System lab. (Sayaka)

Table of content is not available at the moment. Report is still ongoing.

05

Apr 2021

The Danish Health Authority (Sundhedsstyrelsen) updates the Health Care Classification System (Sundheds-væsenets Klassifikations System, SKS) quarterly. It publishes the results on its website two weeks before the implementation, while the files with the changes are sent to the hospital systems. Most of the newly introduced procedure codes concern the gastrointestinal field.

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23

Mar 2021

In March 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0175 and 0072 with changes to be implemented not later than May 01, 2021. Six new procedure codes related to gynecology, capsule endoscopy, and intracranial stereotactic radiotherapy were introduced. No changes were made in diagnostic test coding.

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16

Oct 2020

In late September 2020, the Austrian version of the DRG system (LKF) 2021 model with the relevant supplementary documents was published in Austria. For 2021, the main changes include the addition of sixteen new procedure codes and the introduction of two new procedure codes for billing in the day-case settings, update of cases flat rates, and adjustments of the cases daily component calculation.

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23

Sep 2020

In mid-August 2020, the German Federal Institute for Drugs and Medical Devices (BfArM) published the preliminary 2021 version of OPS procedure coding nomenclature. Numerous content updates and new procedure codes inclusion concern the chapters 1 “Diagnostic measures,” 5 “Operations,” and 8 “Non-operative therapeutic measures.” The list of new endoscopy-related procedure codes added under the respective OPS sub-chapters of chapters 1 and 5 is provided below:

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27

Jul 2020

The revised EBM (German Uniform Evaluation Standard) catalog came into force on July 1, 2020. MTRC has compiled the selection of the most significant changes.

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