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Health economic modeling for medical technologies in Europe

Early and comprehensive economic models to determine economic value proposition and inform healthcare decision-makers

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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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New procedure and diagnostic codes added to the private reimbursement schedule in England

In April 2023, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 189 and 085 with changes to be implemented no later than June 15, 2023.

Eighteen new procedure codes were implemented in cardiovascular, endocrine, endoscopy, gastrointestinal, interventional radiology, neuromodulation, peripheral vascular, robotic surgery, men's health, and general surgery fields. Some examples of newly added codes are provided below:

  • K5761 Pulsed Field Ablation (PFA) of paroxysmal atrial fibrillation (including mapping);
  • B1802 Robot assisted radical thymectomy;
  • M7072 Transperineal micro invasive laser ablation for lower urinary tract symptoms caused by benign prostatic hyperplasia;
  • L2730 Endovascular insertion of stent graft for thoracic TEVAR.

Eight new codes for in-vitro diagnostics were introduced. Some examples are provided below:

  • 8006A Faecal Antitrypsin;
  • 0005O HMG-CoA Reductase Antibodies;
  • 2999G SCMD Multi Gene Panel 5.

See more information 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). Contact us to get a free, three-month, no-obligation trial.