Billing of analyzing the dynamic movement patterns of the mandible

The functional analysis of mandibular movement patterns based on electronic records (electronic axiography or condylography) is not covered by the 2012 revision of the German Dental Fee Schedule (GOZ). The only change from GOZ 1988 is that the old service item 806 was renumbered 8060 and limited to the application of mechanical recording systems. The description was otherwise left unchanged. A separate service item, 8065, was added with a similar description, but intended to cover the use of electronic registration systems. Apart from the distinction between mechanical and electronic recording systems, both services thus remain almost unchanged in the revised GOZ 2012 compared to the GOZ 1988. Furthermore, the descriptions of both service items unequivocally limit the scope of the items to the movement record intended for programming articulators. This is sufficient and useful for restorative applications. However, the methods for the functional evaluation of mandibular movement patterns that have arisen in recent years are not reflected in these two items. At the same time, however, these methods are well founded in the scientific literature and have now also been described in the Guideline (S2k) "Instrumental Functional Analysis in Dentistry"1. Dentists in Germany are required by law to practice dentistry according to the current state of the art, but they cannot do so based solely on the service items listed in the GOZ. § 6.1 of GOZ 2012 therefore explicitly stipulates that those dental services not listed as independent service items can be billed according to the type, cost, and time input involved and the degree of difficulty of comparable services (referred to as "analogous services"). With reference to the example of functional mandibular movement analysis, the present article describes the legal and technical background of the GOZ items as well as the consequences for their implementation in clinical practice. Keywords: temporomandibular dysfunction (TMD), analysis of mandibular movements, recording of mandibular movement, clinical functional analysis, Dental Fee Schedule (GOZ), analogous billing