Difficulties in the Interpretation of the Term »Patient-Related« in the Scope of the Introduction of a Remuneration of Additional Payments According to the OPS

Since 2005 the catalogue of case-based lump sums, beside the DRG, also provides additional payments (AP) for expensive medical drugs. AP 34 and 35 (8-800..) are reserved for the calculation of the remuneration of thrombopheresis concentrates (TAC). AP 35 refers to »patient-related« TAC. The OPS-301 (version 2004) defines (8-800.6): »patient-related platelet concentrates means specifically prepared TAC for patients with suspicion of or proof of HPAor HLA-antibodies«. The Health Insurances examine the proper account calculated by the various medical institutions. Deviations from correct calculation were found in the account of AP 35.