D Surgical services – "3000"

General provisions Part D

The primary wound care (e.g. cleaning the wound, smoothing the bone, cutting, tamponing, wound closure without additional flap formation, possibly fixing a plastic wound dressing) is part of the services according to Section D and cannot be calculated separately.
The creation of operational access is part of the services according to Section D and is not separately billable.
Bone replacement materials as well as materials for promoting blood coagulation or tissue regeneration (e.g. membranes) and for closing superficial bleeding in hemorrhagic diathesis or, if this is necessary to protect important anatomical structures (e.g. nerves), as well as atraumatic suture material or only explant milling cutters that can be used are separately billable.

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Even within the scope of an operation, there are almost always different combinations when it comes to additional procedures.

Many operations can also be carried out in different ways, e.g. shortening a root tip with a rotating (rotating) cutter ("drill") can be performed or with special surgical ultrasound machines or even with lasers.

The BZÄK expresses itself somewhat misleadingly in its comment if it formulates it "Wound care measures that are performed for wound healing that is as uncomplicated as possible are compensated with the fee for the corresponding number". We think you can misunderstand as follows can: "Many accompanying services, even more advanced surgical procedures themselves (e.g. lasers) should aim to improve wound healing, so they are always to be paid for as a basic fee and not to be additionally charged or used to increase the factor."

That the Dental Association could not have meant this is clear again from their comments on the individual service positions, but has provided a possible unfortunate quote here. What she probably meant: For a wound to heal well, it must be cared for correctly, e.g. with a seam closure. The suture fastener in the basal simple form is included in the surgical performance position.

However, the following also applies: included in a service

is the literal procedure,
is whatever is required to perform this performance,
is the simple (basal), average performance level.

The principle of individual service reimbursement is to avoid that only basic medicine is made by rewarding additional work. Without money, the work would not be sustainable, the practice would suffer financial wreckage.

Wound care measures that are performed for wound healing that is as uncomplicated as possible are compensated with the fee for the corresponding number.

The simple removal and, if necessary, fixation of the wound edges is included in the respective service.

Tissue glue, atraumatic sutures, membranes and single-use explantation cutters can be calculated separately.

Disposable explants are those that are used up after use at the end of treatment.

When using a surgical microscope and / or a laser, surcharges are calculated according to numbers 0110 and 0120.

The general provisions before Section D are revised in order to clarify some application questions that have so far been controversial in the application of the GOZ and to differentiate the separately billable materials from the materials paid for with the fees.

A wound care measure is always a private service if the main service is a private service or has been agreed as such.

The guiding principle applies: "The main service turns the ancillary service into a private service".

Was e.g. an operation on a large molar tooth was agreed as a private benefit because the operation was no longer indicated according to the cash register guidelines or because the operation was performed with the laser or ultrasound tools, then the additional measure, such as a plastic cover or a roller cover is a private benefit.