Coronary percutaneous revascularization procedures

Series
Coronary interventions
Status
Published
Date
Number of report
019

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Report presents summary of reimbursement situation for number of coronary percutaneous revascularization methods. Procedures, covered in the report include:

  • Percutaneous coronary balloon angioplasty (including plain and drug-coated balloons)
  • Percutaneous coronary angioplasty with stenting using bare metal, drug-eluting and bioresorbable stents
  • Mechanical thrombectomy
  • Mechanical atherectomy

Analysis is provided for three indications: stable angina, unstable angina and acute myocardial infarction.

Day case procedures are not considered in the report. 

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

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

6.1.    Overview of the reimbursement system
6.2.    Reimbursement for coronary percutaneous revascularization procedures
6.2.1.    Procedure coding
6.2.2.    Diagnosis coding
6.2.3.    Payment mechanism and reimbursement tariffs
6.2.4.    Policy considerations by the LBI-HTA
7.    Reimbursement analysis in Belgium
7.1.    Overview of the reimbursement system
7.2.    Reimbursement for coronary percutaneous revascularization procedures
7.2.1.    Procedure coding
7.2.2.    Payment mechanism and reimbursement tariffs
7.2.3.    Policy considerations 
7.2.4.    Health technology assessments by KCE 
8.    Reimbursement analysis in Denmark
8.1.    Overview of the reimbursement system
8.2.    Reimbursement for coronary percutaneous revascularization procedures
8.2.1.    Procedure coding 
8.2.2.    Diagnosis coding
8.2.3.    Payment mechanism and reimbursement tariffs
8.2.4.    Policy considerations 
9.    Reimbursement analysis in England
9.1.    Overview of the reimbursement system
9.2.    Reimbursement for coronary percutaneous revascularization procedures
9.2.1.    Procedure coding 
9.2.2.    Diagnosis coding
9.2.3.    Payment mechanism and reimbursement tariffs
9.2.4.    Policy considerations 
9.2.4.1.    Specifics of commissioning of the procedure
9.2.4.2.    Health technology assessments by NICE
10.    Reimbursement analysis in France
10.1.    Overview of the reimbursement system
10.2.    Reimbursement for coronary percutaneous revascularization procedures
10.2.1.    Procedure coding 
10.2.2.    Diagnosis coding
10.2.3.    Payment mechanism and reimbursement tariffs
10.2.4.    Policy considerations by HAS
11.    Reimbursement analysis in Germany
11.1.    Overview of the reimbursement system
11.2.    Reimbursement for coronary percutaneous revascularization procedures
11.2.1.    Procedure coding 
11.2.2.    Diagnosis coding
11.2.3.    Payment mechanism and reimbursement tariffs
11.2.4.    Policy considerations by G-BA
12.    Reimbursement analysis in Italy
12.1.    Overview of the reimbursement system
12.2.    Reimbursement for coronary percutaneous revascularization procedures
12.2.1.    Procedure coding at national level
12.2.2.    Procedure coding at regional level (Emilia-Romagna, Lombardy, Veneto regions)
12.2.3.    Diagnosis coding
12.2.4.    Payment mechanism and reimbursement tariffs at national level
12.2.5.    Payment mechanism and reimbursement tariffs at regional level
13.    Reimbursement analysis in the Netherlands
13.1.    Overview of the reimbursement system
13.2.    Reimbursement for coronary percutaneous revascularization procedures
13.2.1.    Procedure coding 
13.2.2.    Diagnosis coding
13.2.3.    Payment mechanism and reimbursement tariffs
13.2.4.    Policy considerations by Dutch Healthcare Institute (СIN)
14.    Reimbursement analysis in Norway
14.1.    Overview of the reimbursement system
14.2.    Reimbursement for coronary percutaneous revascularization procedures
14.2.1.    Procedure coding 
14.2.2.    Diagnosis coding
14.2.3.    Payment mechanism and reimbursement tariffs
14.2.4.    Policy considerations 
15.    Reimbursement analysis in Sweden
15.1.    Overview of the reimbursement system
15.2.    Reimbursement for coronary percutaneous revascularization procedures
15.2.1.    Procedure coding 
15.2.2.    Diagnosis coding
15.2.3.    Payment mechanism and reimbursement tariffs
15.2.4.    Policy considerations
16.    Reimbursement analysis in Switzerland
16.1.    Overview of the reimbursement system
16.2.    Reimbursement for coronary percutaneous revascularization procedures
16.2.1.    Procedure coding 
16.2.2.    Diagnosis coding
16.2.3.    Payment mechanism and reimbursement tariffs
16.2.4.    Policy considerations
17.    Disclaimer

30

Nov 2017

A 155-page reimbursement report covers coronary angioplasty (using a plain and drug-coated balloon, bare metal, drug-eluting and bioresorbable stents), mechanical thrombectomy and atherectomy in hospital settings. The analysis covers procedure coding, payment mechanism, reimbursement tariff and policy restrictions. The report provides an overview of reimbursement situation in 11 EU countries including Austria, Belgium, Denmark, England, France, Germany, Italy, the Netherlands, Norway, Sweden, and Switzerland.

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20

Nov 2017

Annual report from the Italian Society of Interventional Cardiology (GISE) shows increasing trends in procedural volume of percutaneous coronary interventions (PCI), transcatheter aortic valve implantations (TAVI), mitral clip implantations, closure of left atrial appendage (LAA) and patent foramen ovale (PFO).

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17

Oct 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 September 2017. They include knee and hip prostheses, therapeutic shoes, coronary stents, heart valves, peripheral stents, and balloons.

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03

Oct 2017

New procedure codes will be created for stem cell procedures, extracorporeal techniques (including hemodialysis and CO2 removal), surgical interventions, including growth-controlling spinal correction, transposition of peripheral nerve, interventions on veins, and percutaneous image-guided procedures (including code for pressure measurement in coronary arteries and additional code for drug-eluting balloon). Classification will be enabled from January 1, 2018.

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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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16

Aug 2017

In the second two weeks of July, the National Institute for Health and Care Excellence published one new (FebriDx for C-reactive protein and Myxovirus resistance protein A testing in primary care) and 3 updated Medtech Innovation Briefings, new Diagnostics Guidance for quantitative faecal immunochemical tests to guide referral for colorectal cancer in primary care and three new Interventional Procedures Guidance for laparoscopic insertion of a magnetic titanium ring for gastro-oesophageal reflux disease, transcatheter aortic valve implantation for aortic stenosis and hysteroscopic sterilisation by insertion of intrafallopian implants.

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03

Jul 2017

French National Authority for Health (HAS) released new decisions about add-on and medical aid reimbursement of 8 medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS). They include coronary stents, portable oxygen concentrators, Urolift device, spinal ganglion stimulator and insulin pumps.

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