Importance of laboratory services in emergency department treatment according to G-AEP criteria and in the leading symptom dyspnea

In the billing of outpatient emergencies in emergency departments, there are differing opinions between the Association of Statutory Health Insurance Physicians (KV) and the billing departments of hospitals regarding the laboratory analysis justified during diagnosis. From the point of view of the KV, the opinion is that treatment in the emergency department is comparable to that in a general practitioner's office. From the point of view of hospitals, however, there is a completely different order situation and clarification obligation for patient presentations in the emergency department. In a ruling of the Federal Social Court of 13 May 2020, it is recommended to form "case and diagnosis groups " to find a common view of justified laboratory parameters. Against this background, the present work considers frequent or dangerous differential diagnoses in addition to the German Appropriateness Evaluation Protocol (G-AEP) criteria for the leading complaint dyspnea. The laboratory analysis necessary for the exclusion of differential diagnoses will be worked out and a list of leading symptoms associated with justified and scientifically provable laboratory parameters will be developed and discussed according to the perspective of evidence-based medicine.