Billing of dental services pertaining to functional analysis: Manual Structural Analysis

The further development of the scientific knowledge base of functional diagnostics also affects the sector of non-instrumental diagnostics. In this area, examinations are now scientifically established, which - unlike clinical functional analysis - examine the tissue of the masticatory system under loading. The various individual tests in Germany are summarized under the umbrella heading: "Manual Structural Analysis". The catalogue of service items contained in the updated German Dental Fee Schedule (GOZ) of 2012, however, hardly differs from the previous version of 1998. Dentists in Germany are required by the German Dentistry Act to practice dentistry according to the current state of science; yet this is not possible solely on the basis of the outdated content of the service items listed in the GOZ 2012. Instead, the legislator has incorporated into the GOZ 2012 the possibility of billing those dental services not listed as independent service items, according to the type, cost, and time input involved as well as the degree of difficulty of comparable services (termed "analogous services"). The present article describes the legal and scientific background as well as the consequences for implementation of the GOZ 2012 in daily clinical practice. Keywords: craniomandibular dysfunction (CMD), manual structural analysis, clinical functional analysis, manual medicine, Dental Fee Schedule (GOZ), analogous billing