Service text
„Erhebung der Fremdanamnese über einen Kranken und/oder Unterweisung und Führung der Bezugsperson(en) - im Zusammenhang mit der Behandlung eines Kranken -“Not alongside — per the Gebührenverzeichnis (16)
Numbers the fee schedule names together with this one in an exclusion sentence. Open a chip for the wording, in German, and where it stands; about a particular case the sentence says only what it says.
Number 4 values the conversation that is not held with the patient themselves: taking the external history and instructing and guiding the reference persons, in connection with the treatment. 220 points give 12,82 € at the single rate and 29,49 € at the 2.3-fold rate. The ordinance allows it only once per treatment case.
The service text of Number 4
The bracketed plural in the official text is part of the wording; the service does not presuppose any particular number of reference persons.
The „und/oder“ separates two things that often run together in practice: the conversation in which a relative reports what the practice cannot learn from the patient directly, and the conversation in which that same relative is instructed how to handle the treatment.
The closing phrase „im Zusammenhang mit der Behandlung eines Kranken“ — in connection with the treatment of a patient — is this number's boundary. It does not value a conversation that stands on its own, but one that belongs to an ongoing course of treatment.
The sentences below stand exactly like this in the Gebührenverzeichnis — some as an Allgemeine Bestimmung to Abschnitt B, some directly under Number 4. They are quoted here in German, word for word rather than summarized, because the German wording is what is legally binding: the sentence that excludes two numbers from each other is exactly the sentence that matters, and a paraphrase of it would be a claim of its own. The English text after each dash is a working translation, not a substitute for the statutory wording.
- „Als Behandlungsfall gilt für die Behandlung derselben Erkrankung der Zeitraum eines Monats nach der jeweils ersten Inanspruchnahme des Arztes.“ — For treatment of the same illness, the treatment case is the period of one month after the patient's first attendance.
- „Die Leistung nach Nummer 4 ist im Behandlungsfall nur einmal berechnungsfähig.“ — The service under Number 4 may be billed only once per treatment case.
- „Die Leistung nach Nummer 4 ist neben den Leistungen nach den Nummern 30, 34, 801, 806, 807, 816, 817 und/oder 835 nicht berechnungsfähig.“ — The service under Number 4 may not be billed alongside services under Numbers 30, 34, 801, 806, 807, 816, 817 and/or 835.
- „Neben der Leistung nach Nummer 15 ist die Leistung nach Nummer 4 im Behandlungsfall nicht berechnungsfähig.“ — Alongside the service under Number 15, the service under Number 4 may not be billed within the same treatment case.
- „Anstelle oder neben der Visite im Krankenhaus sind die Leistungen nach den Nummern 1, 3, 4, 5, 6, 7, 8 und/oder 15 nicht berechnungsfähig.“ — Instead of or alongside a hospital visit, services under Numbers 1, 3, 4, 5, 6, 7, 8 and/or 15 may not be billed.
The multiplier for Number 4
Number 4 stands in Abschnitt B and so falls within the range from the single rate up to the 3.5-fold rate, with the 2.3-fold rate as the usual span under § 5 Abs. 2 Satz 4 GOÄ.
§ 5 Abs. 2 Satz 3 GOÄ is the sentence that is easy to overlook for this number: criteria already accounted for in the service description are left out of consideration. That a conversation with a relative takes more effort than a short consultation is already reflected in the point count.
Above the 2.3-fold rate, § 12 Abs. 3 GOÄ applies: the justification must be in writing, tied to the particular service, and comprehensible and traceable for the person liable to pay; on request, it has to be explained further.
What the record has to carry for Number 4
Recording the external history in the file means documenting statements about one person that another person made. For the record that means two things: it has to stay clear who said what, and it has to stay clear that this is a third-party statement and not the practitioner's own finding.
Because the number may be billed only once per treatment case, a question of timing also hangs on the record: the treatment case runs from the patient's first attendance for the same illness, and whether a service still falls within that period can only be answered from a dated record.
Whoever has instructed a reference person has explained something to them that they are meant to apply later. What exactly was explained belongs in the record — not because of the fee schedule, but because § 630f BGB requires the significant measures and their results, and an instruction session is such a measure.
Frequently asked questions
May Number 4 be billed alongside Number 15?
No. The Allgemeine Bestimmungen say expressly that, alongside the service under Number 15, the service under Number 4 may not be billed within the same treatment case.
How often may Number 4 be billed?
Only once per treatment case. Under the Allgemeine Bestimmungen to Abschnitt B, the treatment case is the period of one month after the patient's first attendance for the same illness.
What does Number 4 cost?
220 points, with the point value of 5,82873 Cent, give a single standard fee of 12,82 €. 2.3 times that is 29,49 €, and 3.5 times is 44,88 €.