[ICPM-independent documentation of new reimbursement forms--method and 1995 results].

Abstract

The structural health care law (known as the Gesundheitsstrukturgesetz or GSG) of the Federal Republic of Germany has been enacted to replace the covering cost prices by various forms of payment. On the basis of the Godesberg Diagnosis and Therapy Catalogue, a new system has been developed that assesses all new implications of the care benefit law. With the help of intelligent plausibility tests, a particular case (PC) or a special rate (SR) is suggested. The documentation system works without ICPM numbers. The conversion of diagnosis and therapies to ICD-10/ICPM numbers is possible. The results of the first half of 1995 and the second half of 1995 show that only two-fifths of operations can be assessed with PC or SR. Neither emphasis on certain operations nor the more differentiated illnesses are recognised as extra costs by the GSG regulations. Complete and correct documentation is achieved by a strict and stratified control system.