Inside Diagnostics New RIZIV/INAMI nomenclature provides further clarity and fair compensation for EGFR mutation detection
In 2012 a request was made to RIZIV/INAMI to assign a specific code for the detection of EGFR mutation in non-small cell lung cancer (NSCLC) patients. As this request was not granted, laboratories were obliged to use the generic code for detection of genetic mutations in solid tumors to obtain partial reimbursement. However on June 18th a new and specific code was voted in parliament for EGFR-mutation detection, as per royal decree.
As of August 1st 2017, this newly introduced 589831-589842 reimbursement code covers EGFR mutation detection in the context of therapeutic choice for non-squamous NSCLC patients. This provision may be used once per diagnostic cycle, but is renewed in the case of a relapse after one year. As for the previous RIZIV/INAMI code, laboratories requesting reimbursement should either be ISO 15189 certified and be in possession of EGFR test specific accreditation, or obtain accreditation within 2 years. In addition to the formalisation of the reimbursement process for EGFR-mutation detection, reimbursement has also increased from €127,75 to €340,67.
In conclusion, this new decree should facilitate the reimbursement process and contribute to more transparent and fairer compensation for screening EGFR mutation in NSCLC patients.
Rudy Hovelinck
Diagnostics Manager AstraZeneca
NS ID BE-1375-RD10/2017-LB
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About the Author
Rudy Hovelinck obtained a scientific degree first in biochemistry at Ghent University and later in Molecular Biology at the ULB. Initially exploring the academic world in diverse fields as genetics, protein chemistry and virology, he soon realised that bridging scientific knowledge to the medical world was a more meaningful way of spending his professional life. This journey started in the field of pathology biomarker testing, introducing HER2 IHC and ISH testing for patient therapy selection and continued in the field of molecular oncology. Today at AstraZeneca he works as a diagnostics manager. In this role he is passionately contributing to the successful introduction of novel biomarkers and support current testing strategies for patient selection. In his own time he enjoys travelling with his family exploring the world and spending time close to nature. Specialties: Oncology, Anatomic Pathology, Biomarker Development, Medical Devices.