Service text
„Ultraschalluntersuchung eines Organs“Not alongside — per the Gebührenverzeichnis (1)
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 410 is the ultrasound examination of an organ, valued at 200 points. That gives 11,66 € at the single rate and 26,81 € at the 2.3-fold rate. What matters about this number is less the amount than the question of what counts as an organ: the Allgemeine Bestimmungen expressly extend the term to the intestine, to joints as functional units, and to muscle groups, lymph nodes and vessels of a body region. Which organ was examined has to appear on the invoice.
The service text of Number 410
The service text names neither a particular organ nor a body region — what counts as the organ examined in a given case is left open here. That is exactly what the Allgemeine Bestimmungen regulate, and in some detail.
They extend the concept of an organ beyond the anatomically defined organs: the intestine counts, as do joints treated as functional units, and muscle groups, lymph nodes and vessels of a body region. The organ, in this sense, is the body region examined, whether only vessels, only lymph nodes, or both together with soft tissue are looked at.
Where more than one such organ is examined in the same session, the further organ falls under Number 420 — this page deals only with Number 410 itself. Numbers 410 to 418 may never be billed alongside each other in any case.
The sentences below stand exactly like this in the Gebührenverzeichnis, as Allgemeine Bestimmungen to the sonographic services. They are quoted here in German, word for word rather than summarized, because the German wording is what is legally binding — a paraphrase of the sentence that defines what counts as an organ, or the sentence that excludes numbers from each other, would be a claim of its own. The English text after each dash is a working translation, not a substitute for the statutory wording.
- „Das untersuchte Organ ist in der Rechnung anzugeben.“ — The organ examined has to be stated on the invoice.
- „Als Organe im Sinne der Leistungen nach den Nummern 410 und 420 gelten neben den anatomisch definierten Organen auch der Darm, Gelenke als Funktionseinheiten sowie Muskelgruppen, Lymphknoten und/oder Gefäße einer Körperregion. Als Organ gilt die jeweils untersuchte Körperregion unabhängig davon, ob nur Gefäße oder nur Lymphknoten oder Gefäße und Lymphknoten bzw. Weichteile untersucht werden. Die Darstellung des Darms gilt als eine Organuntersuchung unabhängig davon, ob der gesamte Darm, mehrere Darmabschnitte oder nur ein einziger Darmabschnitt untersucht werden.“ — For the purposes of Numbers 410 and 420, organs also include, besides the anatomically defined organs, the intestine, joints as functional units, and muscle groups, lymph nodes and/or vessels of a body region. The organ is the body region examined in each case, regardless of whether only vessels, only lymph nodes, or vessels and lymph nodes or soft tissue are examined. Imaging the intestine counts as one organ examination regardless of whether the whole intestine, several segments of the intestine, or only a single segment is examined.
- „Die Zuschläge bzw. Leistungen nach den Nummern 401 bis 418 sowie 422 bis 424 sind je Sitzung jeweils nur einmal berechnungsfähig.“ — The surcharges or services under Numbers 401 to 418 and 422 to 424 may each be billed only once per session.
- „Die Zuschläge bzw. Leistungen nach den Nummern 410 bis 418 sind nicht nebeneinander berechnungsfähig.“ — The surcharges or services under Numbers 410 to 418 may not be billed alongside each other.
- „Mit den Gebühren für die Zuschläge bzw. Leistungen nach den Nummern 401 bis 424 ist die erforderliche Bilddokumentation abgegolten.“ — The fees for the surcharges or services under Numbers 401 to 424 already cover the required image documentation.
- „Neben der Leistung nach Nummer 435 sind für die Dauer der stationären intensivmedizinischen Überwachung und Behandlung Leistungen nach den Abschnitten C III und M sowie die Leistungen nach den Nummern 1 bis 56, 61 bis 96, 200 bis 211, 247, 250 bis 268, 270 bis 286a, 288 bis 298, 401 bis 424, 427 bis 433, 483 bis 485, 488 bis 490, 500, 501, 505, 600 bis 609, 634 bis 648, 650 bis 657, 659 bis 661, 665 bis 672, 1529 bis 1532, 1728 bis 1733 und 3055 nicht berechnungsfähig. Diese Leistungen dürfen auch nicht anstelle der Leistung nach Nummer 435 berechnet werden.“ — Alongside the service under Number 435, services under Sections C III and M, and under Numbers 1 to 56, 61 to 96, 200 to 211, 247, 250 to 268, 270 to 286a, 288 to 298, 401 to 424, 427 to 433, 483 to 485, 488 to 490, 500, 501, 505, 600 to 609, 634 to 648, 650 to 657, 659 to 661, 665 to 672, 1529 to 1532, 1728 to 1733 and 3055 are not billable for the duration of inpatient intensive-care monitoring and treatment. These services may also not be billed in place of the service under Number 435.
The multiplier for Number 410
Number 410 stands in Abschnitt C, so it falls within the ordinary fee range: from the single rate up to the 3.5-fold rate, with the 2.3-fold rate as the span within which, under § 5 Abs. 2 Satz 4 GOÄ, a fee is as a rule assessed.
Above the 2.3-fold rate, § 12 Abs. 3 GOÄ requires a written justification tied to the particular service, comprehensible and traceable for the person liable to pay. The criteria for that, under § 5 Abs. 2, are the difficulty and the time taken for the particular service and the circumstances of how it was performed.
With a sonographic service, the difficulty often lies exactly in what the service text leaves open: which organ, over what extent, and under what conditions it was examined. Criteria already accounted for in the service description are left out of consideration.
What the record has to carry for Number 410
The treatment record is independent of the fee schedule — § 630f BGB requires it in immediate temporal connection with the treatment, whether billed privately or through statutory insurance. For Number 410, two duties meet at one point: the provision requires the organ examined on the invoice, and that same detail belongs in the record regardless.
Where the extended concept of an organ applies — the intestine, a group of joints treated as a functional unit, muscle groups, lymph nodes or vessels of a body region — only the record establishes which region was actually meant, and whether more than one organ in the sense of the provision was examined in the same session. An invoice that names the organ but documents it nowhere stands on thin ground.
The same applies to a justification above the usual rate: its content can only come from the record of the examination itself. A record created while the appointment is happening is exactly the basis from which such a justification can be traced.
Frequently asked questions
What counts as an organ under Number 410?
Besides the anatomically defined organs, this includes the intestine, joints as functional units, and muscle groups, lymph nodes and/or vessels of a body region. The organ, in each case, is the body region examined, regardless of whether only vessels, only lymph nodes, or both together with soft tissue are examined.
May Numbers 410 to 418 be billed alongside each other?
No. The Allgemeine Bestimmungen state expressly that the surcharges or services under Numbers 410 to 418 may not be billed alongside each other. A further organ examined in the same session falls instead under Number 420.
What does Number 410 cost at the 2.3-fold rate?
200 points times the point value of 5,82873 Cent give 11,66 € at the single rate; 2.3 times that is 26,81 €, and 3.5 times is 40,80 €. Rounding is to the cent, under § 5 Abs. 1 Satz 4 GOÄ.