Abrechnung der chirurgischen Therapie des Lipödems

Handchirurgie · Mikrochirurgie · Plastische Chirurgie, vol. 55, pp. 315–323

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).

Authors 6

1. Melodi Motamedi corresponding

   Sana Kliniken AG

   Affiliation as printed

   Plastische und Ästhetische Chirurgie, Handchirurgie, Sana Klinikum Hameln-Pyrmont, Hameln, Germany

2. Matthias Gensior
   Affiliation as printed

   CG Lympha, Fachklinik für Operative Lymphologie, Köln, Germany

3. Mojtaba Ghods

   Klinikum Ernst von Bergmann

   Affiliation as printed

   Plastic and Reconstructive, Hand and Micro Surgery, Ernst von Bergmann Hospital, Potsdam, Germany

   Plastic and Reconstructive, Hand and Micro Surgery, Ernst von Bergmann Hospital, Potsdam, Germany

4. Anja Miriam Boos Aachen Hand Surgery—Burn Center Department of Plastic Surgery

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Plastic Surgery, Hand Surgery - Burn Center, University Hospital RWTH Aachen, Aachen, Germany

   Department of Plastic Surgery, Hand Surgery - Burn Center, University Hospital RWTH Aachen, Aachen, Germany

5. Philipp Kruppa

   Klinikum Ernst von Bergmann

   Affiliation as printed

   Plastic and Reconstructive, Hand and Micro Surgery, Ernst von Bergmann Hospital, Potsdam, Germany

   Plastic and Reconstructive, Hand and Micro Surgery, Ernst von Bergmann Hospital, Potsdam, Germany

6. Sixtus Allert

   Sana Kliniken AG

   Affiliation as printed

   Plastische und Ästhetische Chirurgie, Handchirurgie, Sana Klinikum Hameln-Pyrmont, Hameln, Germany