Billability and statutory health insurance coverage of a fixed lingual retainer under German Medical Fee Schedule (GOZ) fee numbers 6100 and 6140

The Administrative Court of Appeal rejected the defendant's complaint and admitted the plaintiff's appeal on points of law due to the fundamental significance of the legal issue, ruling that the matter requires clarification by the higher court. The dispute concerns a health insurance benefits claim regarding whether the integration of a fixed lingual retainer in conjunction with specific dental services under fee numbers 6030 to 6080 of the German Medical Fee Schedule (GOZ) constitutes a separately billable item, either under or analogous to fee numbers 6100 and 6140 GOZ, and whether this constitutes an appropriate expenditure for statutory health benefits. The decision relies on Section 132(2) No. 1 of the Administrative Court Procedure Act (VwGO) to admit the appeal on the ground that the question of independent billability and subsequent eligibility for health benefits reimbursement presents a matter of general importance.