Anhang zu Anlage 4 zum Vertrag über die Hausarztzentrierte Versorgung nach 73 b SGB V

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1 Anhang zu Anlage 4 zum Vertrag über die Hausarztzentrierte Versorgung nach 7 b SGB V lfd. Nr Indikationsgruppe Abrechnungsausschluss Alkohol- oder Drogenabhängigkeit F0., F., F., F., F4., F5., F6., F8., F9. Alkohol- oder drogeninduzierte Psychose F0., F0.4, F0.5, F0.6, F0.7, F0.8, F0.9, F., F.4, F.5, F.6, F.7, F.8, F.9, F., F.4, F.5, F.6, F.7, F.8, F.9, F., F.4, F.5, F.6, F.7, F.8, F.9, F4., F4.4, F4.5, F4.6, F4.7, F4.8, F4.9, F5., F5.4, F5.5, F5.6, F5.7, F5.8, F5.9, F6., F6.4, F6.5, F6.6, F6.7, F6.8, F6.9, F8., F8.4, F8.5, F8.6, F8.7, F8.8, F8.9, F9., F9.4, F9.5, F9.6, F9.7, F9.8, F9.9 Andere angeborene Herzfehler Q.0, Q., Q.0, Q., Q., Q., Q.4, Q.5, Q.6, Q.8, Q.9, Q.0, Q., Q., Q., Q.4, Q.8, Q.9, Q5., Q5., Q5., Q5.4, Q89. 4 Andere Neubildungen C00.0, C00., C00., C00., C00.4, C00.5, C00.6, C00.8, C00.9, C45.7, C45.9, C5.0, C5., C5., C5.8, C5.9, C5, C5.0, C5., C5.8, C5.9, C54.0, C54., C54., C54., C54.8, C54.9, C55, C57.7, C57.8, C57.9, C60.0, C60., C60., C60.8, C60.9, C6.0, C6., C6.9, C6.0, C6., C6., C6.7, C6.8, C6.9, C64, C65, C69.0, C69., C69., C69., C69.4, C69.5, C69.6, C69.8, C69.9, C76.0, C76., C76., C76., C76.4, C76.5, C76.7, C76.8, D7.0, D7., D7., D7., D7.4, D7.5, D7.6, D7.7, D7.9, D8.0, D8., D8., D8., D8.4, D8.5, D8.6, D9.0, D9., D9., D9.7, D9.9, D40.0, D40., D40.7, D40.9, D4.0, D4., D4., D4., D4.4, D4.7, D4.9, D44.0, D44., D44., D44.6, D44.7, D44.8, D44.9, D47.0, D47., D47., D47., D47.7, D47.9, D48.0, D48., D48., D48., D48.4, D48.5, D48.6, D48.7, D48.9, L94.5, Q85.0, Q85., Q85.8, Q Andere schwerwiegende bösartige Neubildungen C5.0, C5., C5., C5., C5.4, C5.5, C5.8, C5.9, C47.0, C47., C47., C47., C47.4, C47.5, C47.6, C47.8, C47.9, C49.0, C49., C49., C49., C49.4, C49.5, C49.6, C49.8, C49.9, C70.0, C70., C70.9, C7.0, C7., C7., C7., C7.4, C7.5, C7.6, C7.7, C7.8, C7.9, C7.0, C7., C7., C7., C7.4, C7.5, C7.8, C7.9, C74.0, C74., C74.9, C75., C75., C75. 6 Angina pectoris / Z. n. altem Myokardinfarkt I0., I0.8, I0.9, I5., I5.0, I5., I5., I5.9 7 Atherosklerose mit Ulkus oder Gangrän I70., I Atherosklerose, arterielles Aneurysma und sonstige, nicht näher bezeichneten Krankheiten der Arterien und Arteriolen I70.0, I70., I70., I70.0, I70., I70., I70.5, I70.8, I70.9, I7.0, I7., I7., I7.4, I7.8, I7.9, I77.8, I Aufmerksamkeits-Defizit-Syndrom F90.0, F90., F90.8, F Bipolare affektive Störungen, Anorexia nervosa, Bulimie F0.0, F0., F0., F0.8, F0.9, F.0, F., F., F., F.4, F.5, F.6, F.7, F.8, F.9, F4.0, F4.8, F4.9, F50.0, F50., F50., F50. Bösartige Neubildung des Dünndarms, Peritoneums, Gallenblase, Leber, Pankreas C7.0, C7., C7., C7., C7.8, C7.9, C.0, C., C., C., C.4, C.7, C.9, C, C4.0, C4., C4.8, C4.9, C5.0, C5., C5., C5., C5.4, C5.7, C5.8, C5.9, C45., C48.0, C48., C48., C48.8 Chronisch entzündliche Darmerkrankungen K50.0, K50., K50.8, K50.9, K5.0, K5., K5., K5., K5.4, K5.5, K5.8, K5.9 BA- Pauschale

2 Anhang zu Anlage 4 zum Vertrag über die Hausarztzentrierte Versorgung nach 7 b SGB V Chronische Hepatitis B8.0, B8., B8., B8.8, B8.9, K7.0, K7., K7., K7.8, K7.9, B6., B6.9, B7.0, B7., B7., B7.8 4 Chronische obstruktive Bronchitis / Emphysem J4.0, J4., J4., J4.8, J4.9, J44.0, J44.00, J44.0, J44.0, J44.0, J44.09, J44., J44.0, J44., J44., J44., J44.9, J44.8, J44.80, J44.8, J44.8, J44.8, J44.89, J44.9, J44.90, J44.9, J44.9, J44.9, J44.99, J45.0, J45., J45.8, J45.9, J98., J98. 5 Delir und Enzephalopathie F05.0, F05.8, F05.9, F06.0, F06., F06., F06., F06.4, G9, G9.4, K7.7, K7.7, K7.7, K7.7, K7.74, K Depression F.0, F., F., F., F.0, F., F., F., F.4, F4. 7 Depressive Episoden (nicht näher bezeichnet) F.8, F.9, F.8, F.9, F8.0, F8., F8.8, F9, F4. 8 Diabetes mit peripheren zirkulatorischen Manifestationen oder Ketoazidose E0.5, E0.50, E0.5, E.5, E.50, E.5, E.5, E.50, E.5, E.5, E.50, E.5, E4.5, E4.50, E4.5 9 Diabetes mit renalen oder multiplen Manifestationen E0., E0.0, E0., E0.7, E0.70, E0.7, E., E.0, E., E.7, E.70, E.7, E., E.0, E., E.7, E.70, E.7, E., E.0, E., E.7, E.70, E.7, E4., E4.0, E4., E4.7, E4.70, E4.7 0 Diabetes mit sonstigen Komplikationen E0., E0.0, E0., E0.4, E0.40, E0.4, E0.6, E0.60, E0.6, E0.8, E0.80, E0.8, E., E.0, E., E.4, E.40, E.4, E.6, E.60, E.6, E.8, E.80, E.8, E., E.0, E., E.4, E.40, E.4, E.6, E.60, E.6, E.8, E.80, E.8, E., E.0, E., E.4, E.40, E.4, E.6, E.60, E.6, E.8, E.80, E.8, E4., E4.0, E4., E4.4, E4.40, E4.4, E4.6, E4.60, E4.6, E4.8, E4.80, E4.8, G59.0, G6. Diabetes ohne oder mit nicht näher bezeichneten Komplikationen E0.9, E0.90, E0.9, E.9, E.90, E.9, E.9, E.90, E.9, E.9, E.90, E.9, E4.9, E4.90, E4.9, O4.0, O4., O4., O4., O4.4, O4.9 Dialysestatus N8.0, N8.84, Z49.0, Z49., Z49., Z99. Diplegie der oberen Extremitäten, Monoplegie und andere Lähmungen G80., G80.4, G80.8, G80.9, G8.0, G8., G8., G8., G8.8, G8.88, G8.9 4 Enzündung / Nekrose von Knochen / Gelenken / Muskeln A54.4, A66.6, M00.0, M00.00, M00.0, M00.0, M00.0, M00.04, M00.05, M00.06, M00.07, M00.08, M00.09, M00., M00.0, M00., M00., M00., M00.4, M00.5, M00.6, M00.7, M00.8, M00.9, M00., M00.0, M00., M00., M00., M00.4, M00.5, M00.6, M00.7, M00.8, M00.9, M00.8, M00.80, M00.8, M00.8, M00.8, M00.84, M00.85, M00.86, M00.87, M00.88, M00.89, M00.9, M00.90, M00.9, M00.9, M00.9, M00.94, M00.95, M00.96, M00.97, M00.98, M00.99, M0.0, M0.00, M0.0, M0.0, M0.0, M0.04, M0.05, M0.06, M0.07, M0.08, M0.09, M0., M0.0, M0., M0., M0., M0.4, M0.5, M0.6, M0.7, M0.8, M0.9, M0.4, M0.40, M0.4, M0.4, M0.4, M0.44, M0.45, M0.46, M0.47, M0.48, M0.49, M0.5, M0.50, M0.5, M0.5, M0.5, M0.54, M0.55, M0.56, M0.57, M0.58, M0.59, M0.6, M0.60, M0.6, M0.6, M0.6, M0.64, M0.65, M0.66, M0.67, M0.68, M0.69, M0.8, M0.80, M0.8, M0.8, M0.8, M0.84, M0.85, M0.86, M0.87, M0.88, M0.89, M0., M0.0, M0., M0., M0., M0.4, M0.5, M0.6, Nicht abrechenbar, wenn Diabetes mit peripheren zirkulatorischen Manifestationen oder Ketoazidose, Diabetes mit renalen oder multiplen Manifestationen, Diabetes mit sonstigen Komplikationen

3 Anhang zu Anlage 4 zum Vertrag über die Hausarztzentrierte Versorgung nach 7 b SGB V M0.7, M0.8, M0.9, M0.0, M0.00, M0.0, M0.0, M0.0, M0.04, M0.05, M0.06, M0.07, M0.08, M0.09, M0., M0.0, M0., M0., M0., M0.4, M0.5, M0.6, M0.7, M0.8, M0.9, M46., M46.0, M46., M46., M46., M46.4, M46.5, M46.6, M46.7, M46.8, M46.9, M86.0, M86.00, M86.0, M86.0, M86.0, M86.04, M86.05, M86.06, M86.07, M86.08, M86.09, M86., M86.0, M86., M86., M86., M86.4, M86.5, M86.6, M86.7, M86.8, M86.9, M86., M86.0, M86., M86., M86., M86.4, M86.5, M86.6, M86.7, M86.8, M86.9, M86., M86.0, M86., M86., M86., M86.4, M86.5, M86.6, M86.7, M86.8, M86.9, M86.4, M86.40, M86.4, M86.4, M86.4, M86.44, M86.45, M86.46, M86.47, M86.48, M86.49, M86.5, M86.50, M86.5, M86.5, M86.5, M86.54, M86.55, M86.56, M86.57, M86.58, M86.59, M86.6, M86.60, M86.6, M86.6, M86.6, M86.64, M86.65, M86.66, M86.67, M86.68, M86.69, M86.8, M86.80, M86.8, M86.8, M86.8, M86.84, M86.85, M86.86, M86.87, M86.88, M86.89, M86.9, M86.90, M86.9, M86.9, M86.9, M86.94, M86.95, M86.96, M86.97, M86.98, M86.99, M87.0, M87.00, M87.0, M87.0, M87.0, M87.04, M87.05, M87.06, M87.07, M87.08, M87.09, M87., M87.0, M87., M87., M87., M87.4, M87.5, M87.6, M87.7, M87.8, M87.9, M87., M87.0, M87., M87., M87., M87.4, M87.5, M87.6, M87.7, M87.8, M87.9, M87.8, M87.80, M87.8, M87.8, M87.8, M87.84, M87.85, M87.86, M87.87, M87.88, M87.89, M87.9, M87.90, M87.9, M87.9, M87.9, M87.94, M87.95, M87.96, M87.97, M87.98, M87.99, M90., M90.0, M90., M90., M90., M90.4, M90.5, M90.6, M90.7, M90.8, M90.9, M90.4, M90.40, M90.4, M90.4, M90.4, M90.44, M90.45, M90.46, M90.47, M90.48, M90.49, M90.5, M90.50, M90.5, M90.5, M90.5, M90.54, M90.55, M90.56, M90.57, M90.58, M Epilepsie G40.0, G40.00, G40.0, G40.0, G40.08, G40.09, G40., G40., G40., G40.4, G40.5, G40.6, G40.7, G40.8, G40.9, G4.0, G4., G4., G4.8, G4.9 6 Erkrankungen / Verletzungen des Rückenmarks G.0, G., G., G., G.8, G.9, G.0, G., G., G.8, G.0, G8.4, G8.40, G8.4, G8.49, G90., G95.0, G95., G95., G95.8, G95.80, G95.8, G95.8, G95.8, G95.84, G95.85, G95.88, G95.9, G99., Q00.0, Q00., Q00., Q0.0, Q0., Q0., Q0.8, Q0.9, Q0, Q0.0, Q0., Q0.8, Q0.9, Q04.0, Q04., Q04., Q04., Q04.4, Q04.5, Q04.6, Q04.8, Q04.9, Q05.0, Q05., Q05., Q05., Q05.4, Q05.5, Q05.6, Q05.7, Q05.8, Q05.9, Q06.0, Q06., Q06., Q06., Q06.4, Q06.8, Q06.9, Q07.0, Q07.8, Q07.9, T9. 7 Erworbene Erkrankungen der Herzklappen und rheumatische Herzerkrankungen I05.0, I05., I05., I05.8, I05.9, I06.0, I06., I06., I06.8, I06.9, I07.0, I07., I07., I07.8, I07.9, I08.0, I08., I08., I08., I08.8, I08.9, I4.0, I4., I4., I4.8, I4.80, I4.88, I4.9, I5.0, I5., I5., I5.8, I5.9, I6.0, I6., I6., I6.8, I6.9, I7.0, I7., I7., I7.8, I7.9, I8, I9.0, I9., I9., I9., I9.4, I9.8 8 Hämophilie D66, D67 9 Hautulkus (ohne Dekubitalulzera) L97, L Hemiplegie / Hemiparese G80., G8.0, G8., G8.9 Herzinsuffizienz I.0, I.00, I.0, I.0, I.00, I.0, I., I.0, I., I5.5, I7.0, I7., I7., I7.0, I7.8, I7.8, I7.9, I8.0, I8., I8.8, I8.9, I4.0, I4., I4., I4.8, I4.0, I4., I4., I4., I4.4, I4.5, I4.6, I4.7, I4.8, I4.80, I4.88, I4.9, I4.0, I4., I4., I4.8, I50.0, I50.00, I50.0, I50., I50., I50., I50., I50.4, I50.9, I50.9, I5.4, I5.5 HIV/AIDS B0, B, B, B.0, B.8, B4, U60., U60., U60., U60.9, U6., U6., U6., U6.9, U85, Z Hypertensive Herz- und Nierenerkrankung oder Enzephalopathie I.9, I.90, I.9, I.9, I.90, I.9 4 Hypertonie bzw. Hypertensive Herzerkrankung

4 Anhang zu Anlage 4 zum Vertrag über die Hausarztzentrierte Versorgung nach 7 b SGB V I.9, I.90, I.9, I0.0, I0.00, I0.0, I0., I0.0, I0., I0.9, I0.90, I0.9, I5.0, I5.00, I5.0, I5., I5.0, I5., I5., I5.0, I5., I5.8, I5.80, I5.8, I5.9, I5.90, I5.9 5 Infektionen durch opportunistische Erreger A.0, B5.0, B5., B5., B5.8, B5.9, B7., B7.7, B7.8, B4 B44.0, B44., B44., B44.7, B44.8, B44.9, B45.0, B45., B45., B45.7 B45.8, B45.9, B46.0, B46., B46., B46.4, B46.5, B46.8, B59 6 Koma, Hirnödem / hypoxische Hirnschäden G9.0, G9., G9., G9.8, G9.9, G9., G9.5, G9.6, G Koronare Herzkrankheit / andere chronischischämische Erkrankungen des Herzens I5.0, I5., I5.0, I5., I5., I5., I5.4, I5.5, I5.6, I5.9, I5., I5.4, I5.6, I5.8, I5.9 8 Leberzirrhose K70., K70., K70.4, K7.7, K74.0, K74., K74., K74., K74.4, K74.5, K Lungenmetastasen und Metastasen der Verdauungsorgane C78.0, C78., C78., C78., C78.4, C78.5, C78.6, C78.7, C Lymphknotenmetastasen C77.0, C77., C77., C77., C77.4, C77.5, C77.8, C Metastasten sonstiger Lokalisation, Kaposi-Sarkom C46.0, C46., C46., C46., C46.7, C46.8, C46.9, C79.0, C79., C79., C79., C79.4, C79.5, C79.6, C79.7, C79.8, C79.8, C79.8, C79.8, C79.84, C Morbus Alzheimer, normotensiver Hydrozephalus G0.0, G0., G0.8, G0.9, G.0, G., G.9, G.8, G9., G9.0, G9., G9.9, G9.7, G94.0, G94., G94. 4 Morbus Parkinson und Chorea Huntington G0, G0.0, G0.00, G0.0, G0., G0.0, G0., G0., G0.0, G0., G0.9, G0.90, G0.9, G.0, G., G., G., G.8, G.9, G, G.0, G., G., G.8, G.9, G4.0, G4., G4., G4., G4.4, G4.5, G4.8, G4.9, G5.0, G5., G5., G5., G5.4, G5.5, G5.6, G5.8, G5.9, G6 44 Mukoviszidose E84.0, E84., E84.8, E84.80, E84.87, E84.88, E Multiple Sklerose G5.0, G5., G5.0, G5., G5., G5.0, G5., G5., G5.0, G5., G5.9, G6.0, G6., G6.8, G6.9, G7.0, G7., G7., G7.5, G7.8, G Multiples Myelom, akute lymphatische Leukämie C90.0, C90.00, C90.0, C90., C90.0, C90., C90., C90.0, C90., C9.0, C9.00, C9.0, C9.0, C9.00, C9.0, C94.0, C94.00, C94.0, C94., C94.0, C94., C95.0, C95.00, C Muskeldystrophie G7.0, G7. 48 Myelodysplastisches Syndrom und andere schwerwiegende hämatologische Erkrankungen D46., D46., D46., D46.4, D46.7, D46.9, D59.0, D59., D59., D59., D59.4, D59.5, D59.6, D59.8, D59.9, D64.0, D64., D64., D Myeloische Leukämie C9.0, C9.00, C9.0, C9., C9.0, C9., C9., C9.0, C9., C9., C9.0, C9., C9.4, C9.40, C9.4, C9.5, C9.50, C9.5, C9.7, C9.70, C9.7, C9.9, C9.90, C9.9, C9., C9.0, C9., C9., C9.0, C9., C9.7, C9.70, C9.7, C9.9, C9.90, C9.9, C94., C94.0, C94., C94., C94.0, C94., C94.4, C94.40, C94.4, C94.7, C94.70, C Näher bezeichnete Arrhythmien I47.0, I47., I47., I48.0, I48.00, I48.0, I48.09, I48., I48.0, I48., I Nephritis A98.5, N00.0, N00., N00., N00., N00.4, N00.5, N00.6, N00.7, N00.8, N00.9, N0.0, N0., N0., N0., N0.4, N0.5, N0.6, 4

5 Anhang zu Anlage 4 zum Vertrag über die Hausarztzentrierte Versorgung nach 7 b SGB V N0.7, N0.8, N0.9, N0.0, N0., N0., N0., N0.4, N0.5, N0.6, N0.7, N0.8, N0.9, N04.0, N04., N04., N04., N04.4, N04.5, N04.6, N04.7, N04.8, N04.9, N05.0, N05., N05., N05., N05.4, N05.5, N05.6, N05.7, N05.8, N05.9, N06., N06., N06.4, N06.5, N06.7, N07.0, N07., N07., N07., N07.4, N07.5, N07.6, N07.7, N07.8, N07.9, N08.0, N08., N08., N08., N08.4, N08.5, N08.8, N0, N.0, N., N.8, N.9, N, N5.0, N5.8, N5.9, N6.0, N6., N6., N6., N6.4, N6.8 5 Neurogene Blase N.0, N., N., N.8, N.80, N.8, N.8, N.88, N.9 5 Nicht näher spezifizierte Spätfolgen zerebrovaskulärer Erkrankungen G09, I69.0, I69., I69., I69., I69.4, I Nicht postmenopausale Osteoporose M8., M8.0, M8., M8., M8., M8.4, M8.5, M8.6, M8.7, M8.8, M8.9, M8.4, M8.40, M8.4, M8.4, M8.4, M8.44, M8.45, M8.46, M8.47, M8.48, M8.49, M8.5, M8.50, M8.5, M8.5, M8.5, M8.54, M8.55, M8.56, M8.57, M8.58, M8.59, M8.6, M8.60, M8.6, M8.6, M8.6, M8.64, M8.65, M8.66, M8.67, M8.68, M8.69, M8.8, M8.80, M8.8, M8.8, M8.8, M8.84, M8.85, M8.86, M8.87, M8.88, M8.89, M8.9, M8.90, M8.9, M8.9, M8.9, M8.94, M8.95, M8.96, M8.97, M8.98, M8.99, M8.0, M8.00, M8.0, M8.0, M8.0, M8.04, M8.05, M8.06, M8.07, M8.08, M8.09, M8., M8.0, M8., M8., M8., M8.4, M8.5, M8.6, M8.7, M8.8, M8.9, M8.8, M8.80, M8.8, M8.8, M8.8, M8.84, M8.85, M8.86, M8.87, M8.88, M Nierenfunktionsstörung N4.0, N4., N4., N4., N4.4, N5.0, N5., N5.8, N5.9, N6, N7.0, N7., N Nierenversagen I.0, I.00, I.0, I., I.0, I., N8.8, N8.80, N8.8, N8.8, N8.8, N8.89, N8.9, N9, Q6. 57 Non-Hodgkin-Lymphom, Morbus Hodgkin, chronisch lymphatische Leukämie C8.0, C8., C8., C8., C8.7, C8.9, C8.0, C8., C8., C8.7, C8.9, C8.0, C8., C8., C8., C8.4, C8.5, C8.6, C8.7, C8.8, C8.9, C84.0, C84., C84., C84., C84.4, C84.5, C85.0, C85., C85.7, C85.9, C88.0, C88.00, C88.0, C88., C88.0, C88., C88., C88.0, C88., C88., C88.0, C88., C88.7, C88.70, C88.7, C88.9, C88.90, C88.9, C9., C9.0, C9., C9., C9.0, C9., C9., C9.0, C9., C9.4, C9.40, C9.4, C9.5, C9.50, C9.5, C9.7, C9.70, C9.7, C9.9, C9.90, C9.9, C95., C95.0, C95., C95., C95.0, C95., C95.7, C95.70, C95.7, C95.8, C95.9, C95.90, C95.9, C96.0, C96., C96., C96., C96.7, C Ösophagitis, Reflux und andere Erkrankungen der Speiseröhre (ohne Ulkus und Blutung) K0, K.0, K.9, K.0, K., K., K.4, K.5, K.7, K.8, K.9, K., K.8 59 Osteoarthritis der Hüfte oder des Knies M6.0, M6., M6., M6., M6.4, M6.5, M6.6, M6.7, M6.9, M7.0, M7., M7., M7., M7.4, M7.5, M7.9, M9.05, M9.5, M9.85, M Pathologische Fraktur des Humerus, der Schulter, der Tibia oder Fibula M80.0, M80.0, M80.06, M80., M80., M80.6, M80., M80., M80.6, M80., M80., M80.6, M80.4, M80.4, M80.46, M80.5, M80.5, M80.56, M80.8, M80.8, M80.86, M80.9, M80.9, M80.96, M84.4, M84.46, M90.7, M Periphere Gefäßerkrankungen I7.9, I77.0, I77., I77., I77., I77.4, I77.5, I77.6, I79. 6 Polyneuropathie G60.0, G60., G60., G60., G60.8, G60.9, G6.0, G6., G6.8, G6.9, G6.0, G6., G6., G6.8, G6.80, G6.88, G6.9, G6.0, G6., G6., G6.4, G6.5, G6.6, G6.8, G64, G7., G7., G7.8, G7.9, G7.0, G7., G7., G7., G7.4, G7.8, G7.80, G7.88, G7.9, G7.4, G7.5, G7.6, G7.7 6 Postmenopausale Osteoporose 5

6 Anhang zu Anlage 4 zum Vertrag über die Hausarztzentrierte Versorgung nach 7 b SGB V M8.0, M8.00, M8.0, M8.0, M8.0, M8.04, M8.05, M8.06, M8.07, M8.08, M8.09, M8., M8.0, M8., M8., M8., M8.4, M8.5, M8.6, M8.7, M8.8, M8.9, M8., M8.0, M8., M8., M8., M8.4, M8.5, M8.6, M8.7, M8.8, M Quadriplegie, andere ausgeprägte Lähmungen G.0, G., G., G.8, G.9, G80.0, G8., G8.0, G8., G8., G8., G8.9, G8.4, G8.40, G8.4, G8.4, G8.4, G8.49, G8.5, G8.50, G8.5, G8.5, G8.5, G8.59, G8.60, G8.6, G8.6, G Querschnittslähmung G04., G.4, G80., G8.0, G8.00, G8.0, G8.0, G8.0, G8.09, G8., G8.0, G8., G8., G8., G8.9, G8., G8.0, G8., G8., G8., G8.9, G8.6, G8.6, G8.64, G8.65, G8.66, G8.67, G Rheumatoide Arthritis und entzündliche Bindegewebserkrankungen M05.0, M05.00, M05.0, M05.0, M05.0, M05.04, M05.05, M05.06, M05.07, M05.08, M05.09, M05., M05.0, M05., M05., M05., M05.4, M05.5, M05.6, M05.7, M05.8, M05.9, M05., M05.0, M05., M05., M05., M05.4, M05.5, M05.6, M05.7, M05.8, M05.9, M05., M05.0, M05., M05., M05., M05.4, M05.5, M05.6, M05.7, M05.8, M05.9, M05.8, M05.80, M05.8, M05.8, M05.8, M05.84, M05.85, M05.86, M05.87, M05.88, M05.89, M05.9, M05.90, M05.9, M05.9, M05.9, M05.94, M05.95, M05.96, M05.97, M05.98, M05.99, M06.0, M06.00, M06.0, M06.0, M06.0, M06.04, M06.05, M06.06, M06.07, M06.08, M06.09, M06., M06.0, M06., M06., M06., M06.4, M06.5, M06.6, M06.7, M06.8, M06.9, M06., M06.0, M06., M06., M06., M06.4, M06.5, M06.6, M06.7, M06.8, M06.9, M06., M06.0, M06., M06., M06., M06.4, M06.5, M06.6, M06.7, M06.8, M06.9, M06.4, M06.40, M06.4, M06.4, M06.4, M06.44, M06.45, M06.46, M06.47, M06.48, M06.49, M06.8, M06.80, M06.8, M06.8, M06.8, M06.84, M06.85, M06.86, M06.87, M06.88, M06.89, M06.9, M06.90, M06.9, M06.9, M06.9, M06.94, M06.95, M06.96, M06.97, M06.98, M06.99, M08.0, M08.00, M08.0, M08.0, M08.0, M08.04, M08.05, M08.06, M08.07, M08.08, M08.09, M08., M08.0, M08., M08., M08., M08.4, M08.5, M08.6, M08.7, M08.8, M08.9, M08., M08.0, M08., M08., M08., M08.4, M08.5, M08.6, M08.7, M08.8, M08.9, M08., M08.4, M08.40, M08.4, M08.4, M08.4, M08.44, M08.45, M08.46, M08.47, M08.48, M08.49, M08.7, M08.70, M08.7, M08.7, M08.7, M08.74, M08.75, M08.76, M08.77, M08.78, M08.79, M08.8, M08.80, M08.8, M08.8, M08.8, M08.84, M08.85, M08.86, M08.87, M08.88, M08.89, M08.9, M08.90, M08.9, M08.9, M08.9, M08.94, M08.95, M08.96, M08.97, M08.98, M08.99, M09.0, M09.00, M09.0, M09.0, M09.0, M09.04, M09.05, M09.06, M09.07, M09.08, M09.09, M09., M09.0, M09., M09., M09., M09.4, M09.5, M09.6, M09.7, M09.8, M09.9, M09., M09.0, M09., M09., M09., M09.4, M09.5, M09.6, M09.7, M09.8, M09.9, M09.8, M09.80, M09.8, M09.8, M09.8, M09.84, M09.85, M09.86, M09.87, M09.88, M09.89, M., M.0, M., M., M., M.4, M.5, M.6, M.7, M.8, M.9, M0.0, M0., M0., M0., M0.8, M.0, M., M., M., M.4, M.5, M.6, M.7, M.8, M.9, M.0, M., M.8, M.9, M.0, M., M., M.9, M4.0, M4., M4., M4.8, M4.9, M5., M5., M5., M5.5, M5.8, M5.9, M6.0, M6.8, M45.0, M45.00, M45.0, M45.0, M45.0, M45.04, M45.05, M45.06, M45.07, M45.08, M45.09, M46.0, M46.00, M46.0, M46.0, M46.0, M46.04, M46.05, M46.06, M46.07, M46.08, M46.09, M46.8, M46.80, M46.8, M46.8, M46.8, M46.84, M46.85, M46.86, M46.87, M46.88, M46.89, M46.9, M46.90, M46.9, M46.9, M46.9, M46.94, M46.95, M46.96, M46.97, M46.98, M46.99, M49., M49.0, M49., M49., M49., M49.4, M49.5, M49.6, M49.7, M49.8, M49.9, M49.4, M49.40, M49.4, M49.4, M49.4, M49.44, M49.45, M49.46, M49.47, M49.48, M49.49, M49.8, M49.80, M49.8, M49.8, M49.8, M49.84, M49.85, M49.86, M49.87, M49.88, M Schädlicher Gebrauch von Alkohol / Drogen ohne Abhängigkeitssyndrom F0.0, F0., F.0, F., F.0, F., F.0, F., F4.0, F4., F5.0, F5., F6.0, F6., F8.0, F8., F9.0, F9., F55.0, F55., F55., F55., F55.4, F55.5, F55.6, F55.8, F55.9 Nicht abrechenbar, wenn Alkohol- oder Drogenabhängigkeit 68 Schizophrenie 6

7 Anhang zu Anlage 4 zum Vertrag über die Hausarztzentrierte Versorgung nach 7 b SGB V F0.0, F0., F0., F0., F0.4, F0.5, F0.6, F0.8, F0.9, F, F5.0, F5., F5., F5.8, F Schwere angeborene Herzfehler Q., Q.4, Q4.0, Q4., Q4., Q6.0, Q6., Q6., Q6., Q6.4, Q6.5, Q6.6, Q6.8, Q6.9, A9., D89.0, D89., D89., E0.0, E0., E0.8, E0.9, E.0, E., E., E., E.4, E.5, E.0, E., E., E.8, E.9, E.0, E., E., E., E.6, E.7, E4.0, E4., E4., E4., E4.4, E4.8, E4.9, E5.0, E5.00, E5.0, E5.08, E5.09, E5.8, E5.9, E6.0, E6., E6.8, E6.9, E7.0, E7., E7., E7., E7.4, E7.5, E7.8, E7.9, E.0, E., E.8, E.9, E.0, E., E.8, E.9, E5., E70.0, E70., E70., E70., E70.8, E70.9, E7.0, E7., E7., E7., E7.0, E7., E7., E7., E7.4, E7.5, E7.8, E7.9, E74.0, E74., E74., E74., E74.4, E74.8, E74.9, E75.0, E75., E75., E75., E75.4, E75.5, E75.6, E76.0, E76., E76., E76., E76.8, E76.9, E77.0, E77., E77.8, E77.9, E8.0, E8., E8., E8.0, E8., E8.8, E8.9, E85.0, E85., E85., E85., E85.4, E85.8, E85.9, E88.0, Q89., Q schwere Stoffwechselstörungen A06.7, A0., A.0, A6.0, A., A.0, A6., A4., A44., A46, B8., B40., B4.0, B4., B45., B46., B55., B78., L00.0, L00., L0.0, L0., L0.0, L0., L0., L0., L0.4, L0.8, L0.9, L0.0, L0.0, L0.0, L0., L0.0, L0., L0., L0., L0.8, L0.9, L04.0, L04., L04., L04., L04.8, L04.9, L05.0, L05.9, L08.0, L08., L08.8, L08.9, L88, N49.80, N Schwerwiegende bakterielle Infektionen der Unterhaut und des Fettgewebes A06.7, A0., A.0, A6.0, A., A.0, A6., A4., A44., A46, B8., B40., B4.0, B4., B45., B46., B55., B78., L00.0, L00., L0.0, L0., L0.0, L0., L0., L0., L0.4, L0.8, L0.9, L0.0, L0.0, L0.0, L0., L0.0, L0., L0., L0., L0.8, L0.9, L04.0, L04., L04., L04., L04.8, L04.9, L05.0, L05.9, L08.0, L08., L08.8, L08.9, L88, N49.80, N Schwerwiegende Komplikationen K5.0, K6.7 7 Sonstige Demenzerkrankungen F00.0, F00., F00., F00.9, F0.0, F0., F0., F0., F0.8, F0.9, F0.0, F0., F0., F0., F0.4, F0.8, F0, F04, F05., F06.5, F06.6, F06.8, F06.9, F09, G. 74 Sonstige ernste bösartige Neubildungen C0, C0.0, C0., C0., C0., C0.4, C0.8, C0.9, C0.0, C0., C0.9, C04.0, C04., C04.8, C04.9, C05.0, C05., C05., C05.8, C05.9, C06.0, C06., C06., C06.8, C06.9, C07, C08.0, C08., C08.8, C08.9, C09.0, C09., C09.8, C09.9, C0.0, C0., C0., C0., C0.4, C0.8, C0.9, C.0, C., C., C., C.8, C.9, C, C.0, C., C., C.8, C.9, C4.0, C4., C4.8, C6.0, C6., C6., C6., C6.4, C6.5, C6.6, C6.8, C6.9, C8.0, C8., C8., C8., C8.4, C8.5, C8.6, C8.7, C8.8, C8.9, C9, C0, C.0, C., C., C.8, C6.0, C6., C6.8, C6.9, C0.0, C0., C.0, C., C., C., C.8, C.9, C.0, C., C., C., C.8, C.9, C, C4.0, C4., C4., C4., C4.8, C4.9, C7, C8.0, C8., C8., C8., C8.4, C8.8, C9.0, C9.8, C9.9, C40.0, C40., C40., C40., C40.8, C40.9, C4.0, C4.0, C4.0, C4., C4., C4., C4.4, C4.8, C4.9, C45.0, C45., C50.0, C50., C50., C50., C50.4, C50.5, C50.6, C50.8, C50.9, C56, C57.0, C57., C57., C57., C57.4, C58, C6, C66, C67.0, C67., C67., C67., C67.4, C67.5, C67.6, C67.7, C67.8, C67.9, C68.0, C68., C68.8, C68.9, C80, C97, D05., D4.0, D4., D4.9, D4.0, D4., D4., D4., D4.4, D4.7, D4.9, D44., D44.4, D Sonstige Gerinnungsstörungen D65.0, D65., D65., D65.9, D68.0, D68., D68., D68., D68.4, D68.8, D68.9, D69.0, D69., D69., D69., D69.0, D69., D69.4, D69.40, D69.4, D69.5, D69.5, D69.5, D69.57, D69.58, D69.59, D69.6, D69.60, D69.6, D69.8, D Sonstige Pneumonien, Empyem, Lungenabszess A06.5, A0., A., A., A4.0, A4.0, B0., B05., B.4, B8.0, B8., B8., B9., B9., B40.0, B40., B40., B4.0, B58., B67., J0.0, J.0, J.0, J., J., J.8, J.9, J, J5., J5.4, J5.7, J5.8, J5.9, J6.0, J6.8, J7.0, J7., J7., J7., J7.8, J8.0, J8., J8., J8.8, J8.9, J85.0, J85., J85., 7

8 Anhang zu Anlage 4 zum Vertrag über die Hausarztzentrierte Versorgung nach 7 b SGB V J85., J86.0, J86.9, U Spinalkanalstenose M48.0, M48.00, M48.0, M48.0, M48.0, M48.04, M48.05, M48.06, M48.07, M48.08, M48.09, M99., M99.0, M99., M99., M99., M99.4, M99.9, M99., M99.0, M99., M99., M99., M99.4, M99.9, M99.4, M99.40, M99.4, M99.4, M99.4, M99.44, M99.49, M99.5, M99.50, M99.5, M99.5, M99.5, M99.59, M99.6, M99.60, M99.6, M99.6, M99.6, M99.64, M99.69, M99.7, M99.70, M99.7, M99.7, M99.7, M99.74, M Status asthmaticus (Alter > 7 Jahre), postinflammatorische Lungenfibrose J84.0, J84., J84.8, J84.9, J99.0, J99., J Terminale Lebererkrankung I85.0, I85.9, I98., I98.0, I98., K7., K76.7, K Transplantation der Niere (inkl. Registrierung) T86., T86.0, T86., T86., T86.9, Z Transplantation sonstiger Organe K9., K9., K9., K9., K9.4, L99., L99., L99., L99., L99.4, N6.5, T86.5, T86.50, T86.5, T86.5, T86.59, T86.8, T86.8, T86.88, T86.9, Z94.5, Z94.6, Z94.7, Z94.8, Z94.80, Z94.8, Z94.88, Z Transplantation von Leber, Herz oder Pankreas K77., K77., K77., K77., K77.4, T86., T86.4, T86.40, T86.4 T86.49, T86.8, Z94., Z Transplantation von Lunge, Graft-versus-host- Krankheit, Registrierung zur Organtransplantation sonstige Organe T86.0, T86.00, T86.0, T86.0, T86.0, T86.04, T86.09, T86., T86.8, Z94., Z Traumatische Amputation S48.0, S48., S48.9, S58.0, S58., S58.9, S68.0, S68., S68., S68., S68.4, S68.8, S68.9, S78.0, S78., S78.9, S88.0, S88., S88.9, S98.0, S98., S98., S98., S98.4, T05.0, T05., T05., T05., T05.4, T05.5, T05.6, T05.8, T05.9, T.6, T.6, T87.0, T87., T87., T87., T87.4, T87.5, T Wahn, Psychosen, psychotische und dissoziative Störungen F.0, F.8, F.9, F.0, F., F., F., F.8, F.9, F4, F8, F9, F60.0, F60., F60., F60., F60.0, F60., F60.4, F60.5, F60.6, F60.7, F60.8, F60.9, F6, F6.8, F6.80, F6.88, F6.9, F68., F68.8, F69 86 Wirbelkörperfrakturen M48.4, M48.40, M48.4, M48.4, M48.4, M48.44, M48.45, M48.46, M48.47, M48.48, M48.49, M48.5, M48.50, M48.5, M48.5, M48.5, M48.54, M48.55, M48.56, M48.57, M48.58, M48.59, M49.5, M49.50, M49.5, M49.5, M49.5, M49.54, M49.55, M49.56, M49.57, M49.58, M49.59, M80.08, M80.8, M80.8, M80.8, M80.48, M80.58, M80.88, M Zerebrale Ischämie oder nicht näher bezeicheter Schlaganfall G46.0, G46., G46., G46., G46.4, G46.5, G46.6, G46.7 8