Heart surgeons and cardiologists sometimes implant or remove a heart rhythm monitor. There are specific procedure codes for this intervention: 039698 "Insertion of a subcutaneously placed heart rate monitor" and 039699 "Removal of a subcutaneously placed heart rate monitor". However, in the current version of the Dutch DRG package, these procedures cannot be reimbursed when performed by the specialist with the cardiopulmonary surgery profile.
On April 29, 2021, the Dutch Healthcare Authority (NZa) published the first release of the DRG package for the 2022 (RZ22a). Since 2022, a diagnosis of cardiac rhythm monitor implantation for medical specialty "Cardiopulmonary surgery" (0328_2290) will be implemented. In combination with procedure codes for insertion and removal of subcutaneously placed heart rate monitor, it will drive the allocation to four new DRGs under the DRG group 099899 "Cardiovascular system - Other heart diseases / acute rheumatism (including (sub) acute rheumatoid arthritis) / chronic rheumatic heart disease".
The following new DRGs will be implemented for adult patients:
- 099899121 "Surgical placement of a heart rhythm monitor during hospital admission for (research into) a disease of the heart";
- 099899122 "Surgical placement of a heart rate monitor at (research into) a disease of heart";
- 099899123 "Removal of a heart rhythm monitor during hospital admission for (research into) a disease of the heart";
- 099899124 "Removal of a heart rhythm monitor in case for (research into) a disease of the heart".
All DRGs have a tariff negotiated locally between providers and insurers. The effective date of the release is January 1, 2022.
The full details in Dutch can be found 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).
Not ready for a subscription service? Subscribe to our free-of-charge newsletter delivered every second week to get updates about key reimbursement developments in Europe (10-12 news every two weeks).