Alan Kelly (Tipperary, Labour)
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398. To ask the Minister for Health the reason the body with responsibility for the creation of surgical and medical procedure codes in private medicine have not kept them up to date and as a result have created additional costs and expenses for private medical subscribers; and if he will make a statement on the matter. [13911/18]

Simon Harris (Wicklow, Fine Gael)
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There is no specific body with responsibility for the creation of surgical and medical procedure codes in private medicine. Each of the commercial health insurers provide their own Schedule of Benefits, which outline the professional services provided by them for all medical, surgical and diagnostic procedures and tests for inpatient and day cases and include the relevant surgical procedural code which applies to each.

In public hospitals, Diagnosis Related Group (DRG) systems classify patients into distinct groupings that are clinically similar and consume similar health resources. The AR-DRG (Australian refined DRG) grouping system is used to group each hospital’s inpatient and daycase workload, including surgical and medical work, into approximately 1,050 DRGs. This system is overseen by the Healthcare Pricing Office within the HSE, and is used for the purposes of Activity Based Funding in public hospitals. The system is not used in private hospitals currently, and private health insurance claims in public hospitals are not made on this basis.