[Settlement of the surgical treatment of lipoedema].

IF 0.4 4区 医学 Q4 SURGERY
Melodi Motamedi, Matthias H L Gensior, Mojtaba Ghods, Anja M Boos, Philipp Kruppa, Sixtus Allert
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引用次数: 0

Abstract

The billing of lipoedema treatment in Germany has come to be heterogeneous. This is due to the decision of the Federal Joint Committee ("Gemeinsamer Bundesausschuss", G-BA) to acknowledge lipoedema stage III as a treatment to be paid by the statutory health insurance funds ("Gesetzliche Krankenversicherung", GKV) until the completion of the trial study "LipLeg" at the end of 2024. Based on this decision, inpatient and outpatient surgical treatment of stage III lipoedema can be billed to the GKV, while the reimbursement of costs for surgical treatment of the other two stages remains a case-by-case decision of the GKV and is currently often rejected. Therefore, treatment costs are often paid by patients themselves. The question of the correct settlement of lipoedema treatment repeatedly arises in the context of legal disputes, which, in turn, repeatedly faces experts and courts with a major challenge. In the following article, the Task Force Lipoedema of the German Society for Plastic, Reconstructive and Aesthetic Surgery presents an overview of the various billing modalities and presents a proposal for the correct billing of lipoedema within the framework of the German medical fee schedule ("Gebührenordnung für Ärzte", GOÄ).

[脂肪水肿手术治疗的解决]。
在德国,脂水肿治疗的账单是不同的。这是由于联邦联合委员会("Gemeinsamer Bundesausschuss", G-BA)决定承认脂肪水肿第三阶段是由法定健康保险基金("Gesetzliche Krankenversicherung", GKV)支付的治疗,直到2024年底完成"LipLeg"试验研究。基于这一决定,III期脂肪水肿的住院和门诊手术治疗可以向GKV收费,而其他两个阶段的手术治疗费用的报销仍由GKV根据具体情况决定,目前经常被拒绝。因此,治疗费用往往由患者自己支付。正确解决脂水肿治疗的问题在法律纠纷的背景下一再出现,这反过来又一再使专家和法院面临重大挑战。在下面的文章中,德国整形、重建和美容外科学会的脂肪水肿特别工作组概述了各种计费方式,并提出了在德国医疗收费表(" geb hrenordnung f Ärzte", GOÄ)框架内正确计费脂肪水肿的建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.00
自引率
16.70%
发文量
85
审稿时长
6-12 weeks
期刊介绍: In Originalarbeiten und Fallberichten finden Sie die neuesten Informationen über: Diagnostik Verfahrenswahl state of the art / neueste Techniken rekonstruktive Verfahren Behandlung infolge von Traumata oder OP Bewertung der Ergebnisse Klinische Forschung Interessante Darstellung der neuesten Erkenntnisse in Originalarbeiten und Fallberichten. Exzellent veranschaulicht durch ein klares Layout und reiche Bebilderung. Überzeugen Sie sich selbst! Organschaften Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie, Deutschen Gesellschaft für Handchirurgie und Österreichischen Gesellschaft für Handchirurgie Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße Organ der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen
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