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enforceability of NICHE BENEFITS - DGRV 2883/2003

A careful reading of DGRV 2883 3.10.2003 (that is linked to a recent note from the AO of Padua) allows you to single out the requirements that should have the cd "PERFORMANCE OF NICHE" to actually be performed, invoiced and paid :

A - performed by AO or AO Padova Verona
B - on request only cookbook Regional
C - contains criteria effectiveness and appropriateness
D - explicit indication indispensability
And - do not fall explicitly stated other benefits of tariff nomenclature
F - authorization ULSS opinion with reference to their doctors
G - direct billing between ASL, flow out of the compensation

Problems:
1 - not allowed out-tariff structures other than PD and AO AO VR (eg, tacrolimus)
2 - should be defined in each ULSS a path to collect the characteristics of effectiveness, appropriateness, and do not fall indispensability (criteria C, D, E)

click to resolution 2883

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assimilation performance - Emilia Romagna proposal 06/17/2003

Original Document Nomenclatore_indicazioni_di_applicazione.doc
Dimensions: 186862 bytes

17/06/2003

Protocollo N °. ASS/DIR/03 / 23669

Date 06/17/2003

Oggetto: Risposta ai quesiti ed indicazioni relative all’applicazione del Nomenclatore Tariffario regionale delle prestazioni specialistiche ambulatoriali posti dalle Aziende Sanitarie al “Gruppo regionale di lavoro per il controllo della qualità della codifica delle prestazioni”.

Con la presente, si inviano le risposte ad alcuni quesiti sollevati dalle Aziende sulla "corretta codifica delle prestazioni specialistiche ambulatoriali". In merito ai suddetti quesiti si ritiene di fornire le seguenti indicazioni:

... omission ...

1. Search anti-worm . anti-alpha fodrina , anti-citrulline , anticorpi anti-neuronali , steroidal anti- , anti-myelin , tests of intestinal permeability , permeability tests gastric , dosing of Helicobacter pylori CagA antigen , fecal elastase assay , dosage and dosing pepsinogeno1 pepsinogeno2 .

is asked to assimilate the services provided to other already existing nomenclature.

Per le prestazioni di cui sopra, si propongono le seguenti assimilazioni:

- " anticorpi anticitrullina " assimilata a " anticorpi anti antigeni nucleari estraibili ( ENA) "cod. 90.47.3 tariffa pari a euro 13,35;

- " anticorpi antineuronali " assimilata a " anticorpi antiorgano " cod. 90.52.5 tariffa pari a euro 14,50;

- " anticorpi anti-steroidali " assimilata a " anticorpi anti organo " cod. 90.52.5 tarifa pari a euro 14,50;

- "anti-myelin" corresponding to "anti MAG" cod. 90.51.3 fee of € 11.40;

- "dosage dosage pepsinogen pepsinogen 1 and 2" treated as "gastric parietal cell antibodies (PCA)" code. 90.48.1 fee of € 8.35;

- "fecal elastase" corresponding to "chymotrypsin (I)" code. 90.13.1 fee of € 5.40;

- "anti - GAD" assimilated to "antibodies antitransglutaminasi" code. 90.49.5 fee of € 11.40.

As for performance, anti-worm, anti-alpha fodrina, Helicobacter pylori CagA antigen assay, tests of intestinal permeability and gastric permeability test, given the low prevalence of the same and therefore the necessary information for a proper evaluation, it is not possible to propose any assimilation.

Franco Rossi

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Sample chapter for discussion: examination for urinary tract infection in the region of Veneto

• 90.93.6 ESAME COLTURALE DELL'URINA [URINOCULTURA] RICERCA COMPLETA MICROORGANISMIE RICERCA COMPLETA MICROORGANISMI E LIEVITI PATOGENI - SOSTITUISCE PREST. 90.94.2.Incluso: conta batterica e saggio di inibizione della crescita 11.35
• 90.87.1 BATTERI POTERE ANTIBATTERICO RESIDUO IN MATERIALI BIOLOGICIDIVERSI.Saggio di inibizione della crescita 4.65
• 91.11.7 URINOCULTURA SU TRE CAMPIONI - TEST DI STAMEY.Comprensiva di: ricercaTrichomonas. Clamidia, Micoplasma Escluso: massaggio prostatico 55.35
• 90.44.2 URINE CONTA DI ADDIS. 3.85
• 90.44.3 URINE ESAME CHIMICO FISICO E MICROSCOPICO. 2.3 URINE TEST PART
• 90.44.4 (Acetone quantity and glucose). 0.7

Questions propose:

1. because the Veneto is unique among the regions to associate Necessary outpatient urine culture and PAR test? (90.93.6)
2. the nomenclature is also used for the enhancement of benefits for patients admitted inside. It may be useful to have next to 90.93.6, 90.94.2 performance, simple urine culture, at least in these cases?
3. counts of Addis is a test obsolete?
4. latest technologies lend themselves to counting protocols like "urinary reflex", where the crop may follow the positive result a count of bacterial cells. The performance is appropriate in these cases, 90.93.6, 90.94.2, 90.44.2 or 90.44.3?
5. Stamey test is obsolete?
6. which method would be appropriate for the detection of chlamydia in the Stamey test? The rate is proportionate?

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Statement on outpatient care

original document on Parts tariff for the provision of outpatient specialist care: Updated 11/03/2005 rates.

• DGR 486 of 03/05/2004 (pdf 75KB)
• Annex No DGR 1 486 of 03/05/2004 (pdf 276KB)
• DGR 4304 of 29.12.2004 (pdf 78KB)
• DGR n. 61 del 21/01/2005 (pdf 65kb)
• Allegato alla DGR n. 61 (pdf 400KB)
• Allegato alla DGR n. 61 (csv 153KB)
• DGR n. 750 del 11/03/2005 (pdf 121KB)