German Dental FHIR Profiles (R4) - Local Development build (v0.41.6) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Code Systems

Code Systems

This implementation guide defines the following code systems for German dental terminology. External catalog and standard systems such as BEMA, GOZ, FDI teeth, and FDI surfaces are referenced by canonical URL rather than redefined by this IG.

No local dental specialty CodeSystem

Dental PractitionerRole.specialty uses SNOMED CT (http://snomed.info/sct) via DentalPractitionerSpecialty. This IG must not define a local dental specialty CodeSystem while SNOMED CT covers the required concepts (there is no KZBV equivalent to KBV BAR2-WBO for dental specialties). Runtime displays and validation for those SCTIDs come from the gated package de.cognovis.terminology.dental.snomed; the public IG carries code references only.

Billing Code Systems

• GOZ (http://fhir.de/CodeSystem/bzaek/goz) — external canonical for the Gebührenordnung für Zahnärzte (PKV)
• GOÄ Zahnarzt — Relevante GOÄ-Positionen für Zahnärzte
• beb'97 — Private zahntechnische Leistungen

Clinical Code Systems

• SWS 2.0 tooth status (https://fhir.cognovis.de/dental/CodeSystem/sws2-zahnstatus) — published external tooth-chart terminology from de.cognovis.terminology.dental.sws-zahnstatus
• Oral Health Screening Component — structural component identifiers only; bruxism type and grade values remain in the published upstream terminology
• Dental Category — Dental resource category marker
• FDI tooth surfaces (http://terminology.hl7.org/CodeSystem/FDI-surface) — external HL7 Terminology code system
• BEMA Befundklasse — Befundklassen (c/k/f/e/b)
• Periodontal Measurement Site — Six vendor-neutral tooth measurement sites
• PSI Score — PSI scores 0 through 4
• Prophylaxis Index Method — API, QHI, PI, SBI, PBI, and GI assessment methods
• Dental Deposit Type — Biofilm and calculus
• Dental Deposit Vertical Location — Supra-, gingival, and subgingival location
• Dental Deposit Surface — Tooth, root, implant, and pontic surfaces
• Caries Risk Level — IG-owned qualitative aggregate caries-risk levels
• Dental Assessment Type — stable profile-level assessment identifiers
• ICDAS Caries Score — visual coronal lesion scores 0 through 6
• Pulp Sensibility Component — cold, heat, and electric test modalities
• Pulp Sensibility Response — qualitative sensibility responses
• Prosthetic Device Finding — technical findings concerning removable prostheses and implant suprastructures
• OSAS Oral Appliance Eligibility — dental pathway dispositions without medical thresholds
• OSAS Oral Appliance Complication — manufacturer-neutral complications
• Sleep Appliance Service — service stages for medically ordered oral-appliance care

Administrative Code Systems

• KZV Regionen — 17 Kassenzahnärztliche Vereinigungen
• ZE Befundkürzel — cognovis-interner Befund-Status (ergänzend, nicht ersetzend; KZBV-DPF ist authoritativ — s.u.)
• ZE Therapiekürzel — cognovis-interner Therapie-Status (ergänzend)

Die drei KZBV-Taxonomien für Zahnersatz-Workflows

Im Dental-IG kommen drei unterschiedliche KZBV-publizierte Code-Listen zum Tragen, die im praktischen Gebrauch oft verwechselt werden. Sie haben jeweils ihren eigenen Workflow-Zweck:

Taxonomie	URL / CS	Zweck	Codes	Quelle
Festzuschuss-Befunde	https://fhir.cognovis.de/dental/CodeSystem/festzuschuss-befund	Anspruchsbegründung § 55 SGB V (Festzuschuss-Berechnung)	54 numerische Codes 1.1–8.6	KZBV FZ-Kompendium
KZBV-DPF-Befundkürzel	http://fhir.de/CodeSystem/kzbv/dpf-befundkuerzel (Paket de.cognovis.terminology.dental.dpf-kuerzel@2022.0.0)	Zahnschema-Notation im eHKP / Papier-HKP (verbindlich ab 2022)	33 alphabetische Codes (a, ab, b, e, k, pw, ww, x, )()	KZBV EBZ Anlage 2
KZBV-DPF-Therapiekürzel	http://fhir.de/CodeSystem/kzbv/dpf-therapiekuerzel (selbes Paket)	Therapieplanung im eHKP/HKP	43 alphabetische Codes (K, B, T, SB, SK, T2, …)	KZBV EBZ Anlage 2

Daneben existieren die cognovis-internen ze-befundkuerzel und ze-therapiekuerzel CSes — sie sind ergänzend, decken klinische Status-Codes ab die in KZBV-DPF nicht existieren (z.B. "Krone defekt", "Magnetanker", "KFO-Retainer", "Reparatur Brücke").

Wichtig: Lexikalisch überlappende Codes (x, B, K, e, b) haben unterschiedliche Semantik zwischen den Code-Systemen. Bei Coding immer die system-URL explizit setzen — sie ist der einzig verlässliche Diskriminator zwischen den parallelen Befund-Taxonomien.

Tooth-status migration

The draft canonical https://fhir.cognovis.de/dental/CodeSystem/dental-befund-status is retired. Producers use https://fhir.cognovis.de/dental/CodeSystem/sws2-zahnstatus for observed tooth-chart status and bind against https://fhir.cognovis.de/dental/ValueSet/sws2-zahnstatus-complete. Tooth status is carried by DentalFindingDE.valueCodeableConcept, never by Condition.stage.

SWS tooth findings, KZBV DPF prosthetic abbreviations, and the local ZE planning extensions are separate namespaces. A matching lexical code does not permit conversion without an explicit mapping.