TARDOC

rudiments

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Outpatient packages -> eyes

Tardoc -> eyes

Fundamentals

• Any medical action must be able to be justified before the patient and the health insurer
  • Only a targeted investigation enables cost efficiency
• Only what was actually carried out is billed
• Only what is necessary is carried out or billed
  • Making a diagnosis
  • Exclude differential diagnoses
  • Legal protection for the examiner (medico-legal aspect)
• ONO billing blocks
  • To simplify and increase efficiency
  • Fewer TarDoc positions are lost
  • Blocks are designed in such a way that as many suitable and combinable positions as possible are included
    • must be adjusted in each case

Changeover times

• Change times once per sector per consultation
  
  • AR.00.0170 Functional diagnostics ophthalmology (e.g. perimetry, confocal microscopy, etc.)
  • AR.00.0210 Clinical ophthalmic diangostics (e.g. objective turbidity measurement, pupillometry, contrast sensitivity test, refraction determination with cycloplegia, determination of glare sensitivity)
  • AR.00.0220 Ophthalmic laser (e.g. YAG-KT, LIT, SLT, ALK, etc.)
  • AR.00.0230 Orthoptics/Neuroophthalmology (e.g. orthoptic status, follow-up, etc.)
  • AR.00.0240 Excimer laser (PTK, PRK)
  • AR.00.0250 Ophthalmic photography (e.g. cross-sectional, OCT, fundus images, topography, endothelial cells, aberrometry, etc.)
  • AR.05.0050 Change time Large ultrasound sector (e.g. pachymetry, sonography, biometry, etc.)
• The Luna® practice software from Hexabit® recognizes when changeover times should be mistakenly overcharged and issues an error message. Missed changeover times do not result in an error message.

What is included in an ophthalmological examination?

Standard search (minimum)

An ophthalmological examination is a legal act, i.e. the examining doctor must act to the best of his knowledge and belief and in the interests of the patient's health. This includes a minimum of measurements and tests.

• AA.00.0010 Consultation, first 5 min
  • AA.00.0020 every additional minute (including medical staff on medical advice +/- 15 minutes, must be adjusted in each case)
    
    • Maximum 15 times per consultation
• RC.00.0010 Subjective refraction determination (including subjective on an autorefractometer)
  
  • RC.00.0020 Advanced refraction determination, including any eyeglass ordination (for more precise subj. visual acuity assessment even if a prescription for glasses is not given)
  • RC.00.0030 examination of binocular vision by a specialist (stereo test+ 3 more tests e.g. Maddox, Worth, Wing)
• RC.05.0010 Applanation tonometry and stereoscopic papillary assessment
  
  • RC.40.0020 Split lamp examination of anterior eye sections, on both sides
• RC.25.0010 Schirmer test and/or fluorescence transmittance test, on both sides
• RC.70.0010 Biomicroscopy of the central fundus, one- and two-sided
• RC.70.0020 Supplement for a detailed investigation of fundus peripherals, per page
• RC.00.0080 Investigation of metamorphopsies using an Amsler network or similar methods, per page

Special Investigations

• RC.35.0170 Sectional images of the latter eye section, per side (e.g. OCT macula and RNFL)
  
  • AR.00.0250 Change time division ophthalmic photography
• RC.35.0100 Fundus recording on one side
  
  • AR.00.0250 Change time division ophthalmic photography
• RC.35.0110 Fundus images on both sides
• RC.55.0010 Cornea topography, per page
  
  • AR.00.0250 Change time division ophthalmic photography
• RC.00.0110 Objective turbidity measurement of refractive media, on both sides
• AR.00.0210 Wechseleit Division of Clinical Ophthalmic Diangostics

Discussion with patients and reports

• AA.00.0060 Preliminary and debriefing of diagnostic/therapeutic procedures per 1 minute (including relatives, debriefing up to 14 days post-operative)
  
  • maximum 60 times per 90 days
• AA.00.0070 Instructions for self-measurement and/or self-treatment by the doctor, per minute
  
  • maximum 15 times per consultation
  • maximum 30 times per 90 days

reports

Reports on consultations that include a doctor's report (e.g., emergency or urgency) cannot be billed additionally

Maximum 20 times per consultation

• AA.25.0010 Preparation of medical report for other doctor/therapist, per minute
• AA.25.0020 Preparation of medical report for patients or relatives, per minute
• AA.25.0030 Preparation of medical report for insurers, per minute
  
  • First report and insurer cannot be billed
  • The completion of ready-made questionnaires for insurers can only be billed if this results in a recommendation
• AA.25.0040 Preparation of a medical certificate in the absence of the patient, per minute
  
  • Maximum 1 time per certificate
• AA.25.0050 Medical reports are billed outside the KVG and must be agreed in advance with the payor or client.

Services provided in the absence of the patient

Can also be paid for meetings with anesthetists (also within the clinic)
‍Not billable if for a report that has already been billed

• AA.15.0010 Study of foreign files, per minute‍
  
  • Settle even for older internal practice files‍
• AA.15.0020 Information/inquiry from/to/from third parties, per minute‍
  
  • If more than 15 minutes, then document in the medical history‍
• AA.15.0060 Issuing prescriptions or prescriptions outside consultation/teleconsultation, per minute
• AA.15.0070 Referral to consultant doctors in the patient's absence, per minute
• AA.15.0090 Medical services on behalf of the insurer, per minute
  

Cornea examination

Irritating hair anesthesiometry is not included in TARDOC!

• RC.25.0010 Schirmer test and/or fluorescence permeability test, on both sides
• RC.55.0010 Cornea topography, on both sides (e.g. Pentacam®)
  
  • AR.00.0250 Change time Ophthalmic Photography Division
• RC.55.0020 corneal tomography
  
  • AR.00.0050 Changeover time Ophthalmic Photography Division
• GK.00.003 Sonography, pachymetry (e.g. Pentacam®)
  
  • AR.05.0050 Change time Ultrachall division large
• GK OCT anterior eye sections, per side
  • AR.00.0250 Change time Ophthalmic Photography Division
• RC.55.0030 Corneal endothelial mirror microscopy, per page
  
  • AR.00.0250 Change time Ophthalmic Photography Division
• RC.55.0040 Quantitative corneal morphometry, per page (counting and evaluating the shape of endothelial cells)‍
• RC.00.0110 Objective turbidity measurement of optical media (e.g. Pentacam®) ‍
  
  • AR.00.0210 Changeover time division Clinical Ophthalmic Diagnostics
• RC.40.0090 Pupillometry, double-sided
• AR.00.0210 Changeover time division Clinical Ophthalmic Diagnostics
• RC.55.0220 Aberrometry or wavefront measurement

lacrimal gland, lacrimal ducts

• 08.0610 Schirmer test and/or fluorescein permeability test (break-up time and outflow of tear fluid through the tear ducts)
• RC.25.0140 Determination of tear osmolarity, per page
  
  • 2 times per consultation
• RC.25.0030 Two-sided lacrimal flushing
  
  • 1 time per consultation
• RC.25.0040 Unilateral lacrimal tract probing
• RC.25.0060 Tear duct probing, on both sides
• RC.40.0030 Supplement for a small supply on the slit lamp
• RC.25.0070 Surgical treatment on the lacrimal spot (e.g. stretching, slit, stent, punctum plug
  
  • maximum 4 times per consultation

Cataract preliminary examination

• GK.00.0040 Ultrasound, complete biometry of the eye, on both sides (in the case of optical biometrics)‍
  
  • cannot be cumulated with GK.00.0020
  • AR.05.0050 Changeover time Ultrasound division large
• GK.00.00.20 Sonography, bulb length measurement, on both sides (e.g. ultrasound for mature cataracts) ‍
  
  • cannot be cumulated with GK.00.0040
  • AR.05.0050 Changeover time Ultrasound division large
• GK.00.0030 Pachymetry of the eyes, on both sides
  
  • AR.05.0050 Changeover time Ultrasound division large
• RC.00.0110 Objective turbidity measurement of refractive media, on both sides
  
  • AR.00.0210 Wechseleit Division of Clinical Ophthalmic Diangostics
• RC.00.0040 double-sided contrast sensitivity test (i.B. in case of present cataract)‍
  
  • AR.00.0210 Change period clinical ophthalmic diangostics
• RC.40.0110 Determination of sensitivity to glare, on both sides (usually in case of cataracts < 50 years for cost credit
  
  • AR.00.0210 Change period clinical ophthalmic diangostics
• RC.40.0090 Bilateral pupillometry (for documentation or scotopic, photopic for evaluation before implantation of multifocal IOLs)‍
  
  • AR.00.0210 Change period clinical ophthalmic diagnostics
• RC.55.0030 Corneal endothelial mirror microscopy, per page
  
  • AR.00.0250 Change time Ophthalmic Photography Division
  • RC.55.0040 Quantitative corneal morphometry, per page
• RC.55.0010 Korena topography, per page
  
  • AR.00.0250 Change time Ophthalmic Photography Division

glaucoma

• RC.05.0020 Ocular pressure curve, two-sided (applanation tonometry 3 times per day
  
  • maximum 1 time (cannot be cumulated with applanation tonometry)
• RC.40.0010 gonioscopy, per page
• RC.10.0330 Automatic static perimetry first eye, 55 points
• RC.10.0040 each additional program with 55 points
  
  • AR.00.0200 Changeover time Functional Diagnostics division
• GK.00.0030 Sonography, pachymetry, on both sides
  
  • AR.00.0250 Change time Ophthalmic Photography Division
• RC.35.0179 Cross-sectional image of the back of the eye, per side (Always carry out on both sides in case of glaucoma, check RNFL and adjust if necessary)‍
  
  • AR.00.0250 Change time Ophthalmic Photography Division
• RC.35.0100 Fundus images on both sides (Always do on both sides in case of glaucoma)‍
  
  • AR.00.0250 Change time Ophthalmic Photography Division

retinal

• RC.00.0080 Test using the Amsler test, per page (in case of abnormal biomicroscopy of the macula, always on both sides for side comparison)
  • AA.00.0070 Self-measurement instruction, per minute
• RC.70.0020 Supplement for detailed investigation of fundus peripherals, per page (even without mydriasis)
• RC.35.0110 Fundus receiver, both sides
  
  • AR.00.0250 Change time Ophthalmic Photography Division
• RC.35.0110 Fundus images on both sides (including red free, grayscale photography)‍
  
  • AR.00.0250 Change time Ophthalmic Photography Division
• RC.35.0120/RC.35.0130 Fundus panorama, one-sided/two-sided (including pseudo-colored Optomap®)
  
  • AR.00.0250 Change time Ophthalmic Photography Division
• RC.35.0170 Cross-sectional image of the latter eye sections, per side
  
  • AR.00.0250 Change time Ophthalmic Photography Division
• RC.35.0140 scanning laser angiography, per page (not cumulative with cross-sectional image or fluorescence angiography)‍
  
  • AR.00.0250 Change time Ophthalmic Photography Division
• RC.35.0050 Fluorescence angiography, per page (always on both sides, in case of retinal ischemia, neovascularization, leakage)‍
  
  • Can't be cumulated with scanning laser angiography (OCT-A)
• AR.00.0250 Change time Ophthalmic Photography Division
• AM.05.0010 Specialized non-medical monitoring after access/injection

Retinal treatments with an argon laser

• RC.70.0040 Retinal laser coagulation
  
  • AR.00.0220 Changeover time ophthalmic laser division
• RC.70.0110 Navigated laser coagulation of the mesh (e.g. pattern laser)
  
  • AR.00.0220 Changeover time ophthalmic laser division
• RC.40.0010 gonioscopy, per page
• AM.00.0010 Non-medical, non-specialized care/monitoring, per 15 minutes
  
  • maximum 8 times per consultation

Driving test (road traffic law)

• RC.10.0010 Manual kinetic perimetry, on both sides
• AA.25.0010 Medical report to general practitioner, per minute

Foreign body removal

• RC.30.0010 Foreign body removal (s) from conjunctiva by incision, per side
  
  • 2 times per consultation, 1 time per page
• RC.40.0030 Supplement for a small surgical treatment on the slit lamp, per side (e.g. epilation of zillions)
  
  • 2 times per consultation, 1 time per page
• RC.55.0050 Foreign body removal from cornea, possibly with drilling the grate
  
  • RC.55.0060 any further lesion
  • RC.55.0070 for children up to 7 years
• RC.55.0090 Abrasion of beads, 1 time per side

YAG capsulotomy

• RC.65.0010 capsulotomy/membranotomy/synechilysis with laser, per side
  
  • AR.00.0220 Change time division Ophthalmic Laser
  • 1 time per eye, 2 times per consultation
  • no cumulative limits (e.g. incoming fundus copy or sectional images of the retina)

emergency/urgency

Emergency rates (indication for consultation within 2 hours)

• AA.30.0010 Emergency rate A Monday to Friday 7 a.m. to 7 p.m., Saturday 7 a.m. to 12 p.m.
• AA.30.0020 Emergency package B Monday to Friday 7-22 p.m., Saturday 12-19 p.m., Sunday 7-19 p.m.

Emergency packages

• AA.30.0030 Emergency package C, Monday to Friday 7 a.m. to 7 p.m., Saturday 7 a.m. to 12 p.m.
• AA.30.0040 Emergency package D, Monday to Friday 19-22:00, Saturday 12-19:00, Sunday 7-19:00
  
  • AA30.0050 +25% surcharge on AL
• AA30.0050 Emergency package E, Monday to Friday 22-7 and Sunday 19-7
  
  • AA30.0070 50% surcharge on AL
• AA.30.0080 Emergency package F for telemedicine consultations Monday to Friday 19-22, Saturday 12-19, Sunday 7-19
  
  • AA.30.0090 25% surcharge
• AA.30.0100 Emergency rate G for telemedicine consultations Monday to Friday 22-7 p.m., Saturday and Sunday 7-7 p.m.
  
  • AA.30.0110 50% surcharge on AL

Blubus thread removal

• RC.55.0160 Removal of a keratoplasic suture or other prominent sutures on the bulb
• RC.40.0030 Supplement for a small surgical treatment on the slit lamp, per side

eyelid

• RC.50.0280 Eyelid suture removal, per eye
  
  • maximum 2 times per page
• RC.50.0270 Orbitofrontal eyelid status (measurement of eyelid pal/skin excess/eyelid muscle)

contact lenses

• RC.00.0100 contact lens adjustment, on both sides
• RC.45.0020 Initial adjustment of a therapeutic contact lens, per side
  

Hertel test

• RC.40.0040 Bilateral exophthalmometry

Color vision test

• RC.20.0020 Color vision check medium (Farnsworth 15) and large, per minute
  
  • maximum 20 times per consultation

Rinse in case of chemical burn

• Usually compensated for the emergency lump sum (no materials can be charged)

Neuro-ophthalmic status

• RC.15.0010 Neuroophthalmological status (cranial nerves II-VII cursory, field of vision, bulb motility, pupil motor skills, gaze motor skills)
  
  • maximum 1 time per consultation

myopia control

• GK.00.0020 Sonography, bulb length measurement on both sides
  
  • AR.05.0050 Changeover time Ultrasound division large
• RC.00.090 Refraction determination with cycloplegia, objective, per side
  
  • AR.00.0210 Changeover time division Clinical Ophthalmic Diagnostics

orthoptics

• RC.15.0030 Full orthoptic status, two-sided (vision, fixation, squint angle, stereopsis, convergence, fusion width)
  Physician service: Supervision, discussion with specialist
  
  • Orthoptics sector changeover time
• RC.15.0040 Orthoptic progress check/partial status (ONO short check in vision school)
• RC.15.0020 Therapeutic Orthoptics
  
  • maximum 1 time per consultation
• RC.00.090 Refraction determination with cycloplegia, objective, per side
  
  • AR.00.0210 Changeover time division Clinical Ophthalmic Diagnostics