Interpretatieregels betreffende de nomenclatuur van de geneeskundige verstrekkingen - (interpretatieregel 8), de 10 mai 2021
Artikel M.
Interpretatieregels betreffende de nomenclatuur van de geneeskundige verstrekkingen
"INTERPRETATIEREGEL 8
VRAAG
Hoe dient de compressiebroek (verstrekking 769716) geteld te worden in kader van de bepalingen rond hernieuwingstermijnen en maximaal aantal therapeutisch elastische beenkousen per periode ?
ANTWOORD
In art. 27 § 12bis 4. a) staat i.v.m. hernieuwingstermijnen van therapeutisch elastische beenkousen het volgende vermeld:
"Hernieuwingstermijnen van de therapeutische elastische beenkousen van subgroep 1: de rechthebbende heeft per kalender jaar recht op maximaal vier therapeutische elastische beenkousen van subgroep 1 per behandeld been.".
In art 27 § 12 bis 4. c):
"Binnen het kalenderjaar kunnen de compressiebroek (code 769716) en een nomenclatuurcode uit de groep van de panty's (AT en Mono-AT: codes 769414 tot en met 769694) niet gecumuleerd worden."
De compressiebroek is één van de koustypes die vallen onder de rubriek "therapeutisch elastische beenkousen van subgroep 1 lymfoedeem".
Bijgevolg dient de compressiebroek meegeteld te worden als één van de 4 verstrekkingen therapeutisch elastische beenkousen die binnen de hernieuwingstermijn per behandeld been vergoedbaar zijn.
Dus als compressiebroek wordt afgeleverd en beide benen worden behandeld, dan zijn zowel voor links als rechts nog 3 andere therapeutisch elastische beenkousen vergoedbaar, waarbij wel rekening dient gehouden te worden met de...
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