Service text
„Vollständige körperliche Untersuchung mindestens eines der folgenden Organsysteme: das gesamte Hautorgan, die Stütz- und Bewegungsorgane, alle Brustorgane, alle Bauchorgane, der gesamte weibliche Genitaltrakt (gegebenenfalls einschließlich Nieren und ableitende Harnwege) - gegebenenfalls einschließlich Dokumentation -“Not alongside — per the Gebührenverzeichnis (22)
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 7 is the counterpart to number 6 for the large organ systems: skin organ, musculoskeletal system, chest organs, abdominal organs, female genital tract. Here too, the regulation itself defines what counts as complete. 160 points give 9,33 € at the base rate and 21,45 € at the 2.3× multiplier.
GOÄ number 7 in the regulation's own words
The line between number 6 and number 7 does not run along effort, but along the list in the wording itself. Number 7 names the entire skin organ, the musculoskeletal system, all chest organs, all abdominal organs, and the entire female genital tract — the latter including the kidneys and urinary tract where applicable.
The accompanying provision spells out each system: for the skin organ, inspection of the entire skin, skin appendages and visible mucous membranes, where applicable including a test of dermographism and examination with a glass spatula; for the musculoskeletal system, inspection, palpation and an orienting functional test of the joints and spine including a reflex check; for the chest organs, auscultation and percussion of heart and lungs plus blood pressure measurement.
For the abdominal organs, the regulation calls for palpation, percussion and auscultation, including a palpatory check of the hernial orifices and renal beds. Read the list and there is nothing to add and nothing to leave out: completeness is defined, not left to judgement.
The sentences below are quoted here exactly as they stand in the Gebührenverzeichnis (fee schedule) — some as a general provision for Section B, some directly under number 7. The German wording is the binding legal text; the words after the dash are a working translation for orientation only, not a substitute for the original.
- „Die vollständige körperliche Untersuchung eines Organsystems nach der Leistung nach Nummer 7 beinhaltet insbesondere: bei dem Hautorgan: Inspektion der gesamten Haut, Hautanhangsgebilde und sichtbaren Schleimhäute, gegebenenfalls einschließlich Prüfung des Dermographismus und Untersuchung mittels Glasspatel.“ — a complete physical examination of an organ system under number 7 includes in particular, for the skin organ: inspection of the entire skin, skin appendages and visible mucous membranes, where applicable including a test of dermographism and examination with a glass spatula.
- „bei den Stütz- und Bewegungsorganen: Inspektion, Palpation und orientierende Funktionsprüfung der Gelenke und der Wirbelsäule einschließlich Prüfung der Reflexe.“ — for the musculoskeletal system: inspection, palpation and an orienting functional test of the joints and spine, including a reflex check.
- „bei den Brustorganen: Auskultation und Perkussion von Herz und Lunge sowie Blutdruckmessung.“ — for the chest organs: auscultation and percussion of heart and lungs, plus blood pressure measurement.
- „bei den Bauchorganen: Palpation, Perkussion und Auskultation der Bauchorgane einschließlich palpatorischer Prüfung der Bruchpforten und der Nierenlager.“ — for the abdominal organs: palpation, percussion and auscultation of the abdominal organs, including a palpatory check of the hernial orifices and renal beds.
- „Die Leistung nach Nummer 7 ist neben den Leistungen nach den Nummern 5, 6 und/oder 8 nicht berechnungsfähig.“ — number 7 may not be billed alongside numbers 5, 6 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, the services under numbers 600, 601, 1203, 1204, 1228, 1240, 1400, 1401 and 1414 may not be billed.
The multiplier (Steigerungssatz) for number 7
Section B: from the base multiplier up to 3.5×, with the usual range running up to 2.3×.
Under § 5 Abs. 2, the fee within that range is set at fair discretion, weighing the difficulty and the effort of the individual service and the circumstances of its performance; the difficulty can also lie in the difficulty of the underlying medical case.
Above the 2.3× multiplier, § 12 Abs. 3 requires a written justification tied to the individual service, to be explained further on request.
What the record must contain for number 7
As with number 6, the wording names documentation as included where applicable. It is therefore not an add-on, but part of what the fee already covers.
The practical difference from number 6 is volume: the abdominal organs or the musculoskeletal system produce a series of individual findings that all belong in the same entry. In a full consultation, that is exactly where something tends to get lost — not the striking finding, but the unremarkable one that later shows the examination actually happened.
§ 630f BGB requires the essential measures and their results to be recorded. A normal finding is still a result.
Frequently asked questions
What is the difference between number 6 and number 7?
The list of organ systems in the wording. Number 6 names the eye sections, ENT region, stomatognathic system, kidneys and urinary tract, and the vascular status; number 7 names the skin organ, musculoskeletal system, chest organs, abdominal organs and the female genital tract.
Is blood pressure measurement part of number 7?
For the chest organs, the general provision names auscultation and percussion of heart and lungs, plus blood pressure measurement, as part of the complete examination of that organ system.
What does number 7 cost at the 2.3× multiplier?
160 points give 9,33 € at the base rate, 21,45 € at 2.3× and 32,64 € at 3.5×.
How often may number 7 be billed on the same day?
The general provision for Section B allows billing more than once on the same day only where the nature of the case required it; the time each service was performed must then be stated on the invoice, and the repeated billing must be justified on request. Alongside numbers 5, 6 and/or 8, number 7 may not be billed on the same day at all.
When does number 7 need a justification?
In two cases, both from the regulation itself: above the 2.3× multiplier, § 12 Abs. 3 requires a written justification tied to the individual service, to be explained further on request; and where the number is billed more than once on the same day, the general provision for Section B requires a justification on request. Both presuppose that the record carries the reason.