Service text
„Vollständige körperliche Untersuchung mindestens eines der folgenden Organsysteme: alle Augenabschnitte, der gesamte HNO-Bereich, das stomatognathe System, die Nieren und ableitenden Harnwege (bei Männern auch gegebenenfalls einschließlich der männlichen Geschlechtsorgane) oder Untersuchung zur Erhebung eines vollständigen Gefäßstatus - gegebenenfalls einschließlich Dokumentation -“Not alongside — per the Gebührenverzeichnis (25)
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 6 values the complete physical examination of at least one of five organ systems named in the service text — and the ordinance itself says what it means by completeness, organ system by organ system. 100 points give 5,83 € at the single rate and 13,41 € at the 2.3-fold rate.
The service text of Number 6
Number 6 is one of the few numbers in the Gebührenverzeichnis that supplies its own interpretation. The service text names the organ systems, and a following provision spells out for each one what the complete examination „insbesondere beinhaltet“ — in particular consists of: for the eyes, bilateral inspection of the external eye and examination of the anterior and middle segments plus the fundus; for the ENT area, inspection of the nose, the nasal interior, the throat, both ears, both external ear canals and eardrums, together with laryngoscopy; and so on.
The vascular status stands in the service text as its own alternative alongside the organ systems, not as one of them. The related provision describes it as palpation and, where applicable, auscultation of the arteries at both wrists, elbow creases, armpits, the backs of both feet, ankles, backs of the knees and groins, as well as the palpable arteries of the neck and head, plus inspection and, where applicable, palpation of the superficial leg and neck veins.
„Mindestens eines“ — at least one — is why the number does not multiply when two of the named systems were examined: the service text is fully satisfied by the first one.
The sentences below stand exactly like this in the Gebührenverzeichnis — some as an Allgemeine Bestimmung to Abschnitt B, some directly under Number 6. 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.
- „Die vollständige körperliche Untersuchung eines Organsystem nach der Leistung nach Nummer 6 beinhaltet insbesondere: bei den Augen: beidseitige Inspektion des äußeren Auges, beidseitige Untersuchung der vorderen und mittleren Augenabschnitte sowie des Augenhintergrunds.“ — The complete physical examination of an organ system under the service in Number 6 in particular includes: for the eyes, bilateral inspection of the external eye and bilateral examination of the anterior and middle segments of the eye and of the fundus.
- „bei dem HNO-Bereich: Inspektion der Nase, des Naseninnern, des Rachens, beider Ohren, beider äußerer Gehörgänge und beider Trommelfelle, Spiegelung des Kehlkopfs.“ — for the ENT area: inspection of the nose, the nasal interior, the throat, both ears, both external ear canals and both eardrums, plus laryngoscopy.
- „bei dem stomatognathen System: Inspektion der Mundhöhle, Inspektion und Palpation der Zunge und beider Kiefergelenke sowie vollständiger Zahnstatus.“ — for the stomatognathic system: inspection of the oral cavity, inspection and palpation of the tongue and both temporomandibular joints, and a complete dental status.
- „bei den Nieren und ableitenden Harnwegen: Palpation der Nierenlager und des Unterbauchs, Inspektion des äußeren Genitale sowie Digitaluntersuchung des Enddarms, bei Männern zusätzlich Digitaluntersuchung der Prostata, Prüfung der Bruchpforten sowie Inspektion und Palpation der Hoden und Nebenhoden.“ — for the kidneys and urinary tract: palpation of the renal areas and lower abdomen, inspection of the external genitalia and a digital rectal examination; for men, additionally a digital examination of the prostate, checking the hernial orifices, and inspection and palpation of the testes and epididymides.
- „Die Leistung nach Nummer 6 ist neben den Leistungen nach den Nummern 5, 7 und/oder 8 nicht berechnungsfähig.“ — The service under Number 6 may not be billed alongside services under Numbers 5, 7 and/or 8.
- „Die Leistungen nach den Nummern 1, 3, 5, 6, 7 und/oder 8 können an demselben Tag nur dann mehr als einmal berechnet werden, wenn dies durch die Beschaffenheit des Krankheitsfalls geboten war. Bei mehrmaliger Berechnung ist die jeweilige Uhrzeit der Leistungserbringung in der Rechnung anzugeben. Bei den Leistungen nach den Nummern 1, 5, 6, 7 und/oder 8 ist eine mehrmalige Berechnung an demselben Tag auf Verlangen, bei der Leistung nach Nummer 3 generell zu begründen.“ — Services under Numbers 1, 3, 5, 6, 7 and/or 8 may be billed more than once on the same day only where the nature of the case required it. Where billed more than once, the time each service was performed must be stated on the invoice. For services under Numbers 1, 5, 6, 7 and/or 8, billing more than once on the same day must be justified on request; for the service under Number 3, always.
- „Neben einer Leistung nach Nummer 5, 6, 7 oder 8 sind die Leistungen nach den Nummern 600, 601, 1203, 1204, 1228, 1240, 1400, 1401 und 1414 nicht berechnungsfähig.“ — Alongside a service under Number 5, 6, 7 or 8, services under Numbers 600, 601, 1203, 1204, 1228, 1240, 1400, 1401 and 1414 may not be billed.
The multiplier for Number 6
Abschnitt B, so single rate up to the 3.5-fold rate, with the 2.3-fold rate as the usual span.
§ 5 Abs. 2 Satz 3 GOÄ is especially tangible here: criteria already accounted for in the service description are left out of consideration. That the examination has to be complete stands in the service text itself, and so it is already reflected in the point count.
Above the 2.3-fold rate, § 12 Abs. 3 GOÄ requires a written, traceable justification tied to the particular service.
What the record has to carry for Number 6
„Gegebenenfalls einschließlich Dokumentation“ — where applicable including documentation — stands in the service text itself. The record is therefore part of the service and not separately billable alongside it — and it is also what later shows which organ system was examined.
Because the ordinance lists completeness organ system by organ system, the record is the place where that completeness has to show up. An entry that names the system examined and carries the finding for it answers the question; an entry that says only „examination“ does not.
For the practice that means nothing other than what § 630f BGB requires anyway: the significant measures and their results, recorded promptly. The fee schedule adds no second duty to that — it only makes the first one visible.
Frequently asked questions
Which organ systems does Number 6 name?
All sections of the eye, the entire ENT area, the stomatognathic system, the kidneys and urinary tract — for men, where applicable including the male genital organs — or, as an alternative, the examination to establish a complete vascular status.
Is Number 6 billable twice if two organ systems were examined?
The service text requires the complete examination of „mindestens eines“ — at least one — of the named organ systems. For billing more than once on the same day, the Allgemeine Bestimmung to Abschnitt B applies: only where the nature of the case required it, and then with the time on the invoice.
What does Number 6 cost?
100 points give 5,83 € at the single rate, 13,41 € at the 2.3-fold rate and 20,40 € at the 3.5-fold rate.