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Reimbursement summary for angioplasty of arteries of lower extremities

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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2023 Swedish NordDRG system released

In November 2022, the National Board of Health and Welfare released the Swedish version of the NordDRG system to come into force in January 2023, including the list of DRG codes, names, and cost-weights. A total of 77 new DRGs will be implemented. To obtain DRG tariffs, DRG cost-weights must be multiplied by the base tariff estimated at 68,358 SEK in 2023

In the cardiovascular field, a total of 12 new DRGs will be introduced. Some DRG roots received more complication splits, while others received fewer. Some examples are provided below:

  • One new DRG, E04O, “Operation on heart valves, outpatient care”, is added, while two are removed: E05O “, Operation on heart valves, outpatient care”, and E04A “, Operation on heart valves, very complicated or with several complications”;
  • Two new DRGs, E17E, “Percutaneous ablation for cardiac arrhythmia, not complicated” and E17C “, Percutaneous ablation for cardiac arrhythmia, complicated”, will be introduced, while one DRG E17N “, Percutaneous ablation for cardiac arrhythmia” removed.

Some gastrointestinal endoscopic DRGs were divided into complicated/not complicated based on using general anesthesia or not. For example:

  • New DRGs F71P, “Colonoscopy, complicated, outpatient”, and F71Q “, Colonoscopy, not complicated, outpatient”, will replace abolished DRG F71O “, Colonoscopy, outpatient”.

Four new DRGs will be implemented for bone-anchored hearing implants, including the following:

  • C11N “Insertion of a bone-anchored hearing implant/hearing aid”;
  • C85P “Upgrade/connection of transcutaneous bone-anchored hearing implant, complicated”.

New DRGs will also be introduced for breast reconstruction.

See more information in Swedish here and here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). First EU issues of both newsletters are available for download free-of-charge.

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