臺灣健保署基礎實作指引
0.0.1 - ci-build

臺灣健保署基礎實作指引, published by 衛生福利部中央健康保險署. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TWNHIFHIR/base/ and changes regularly. See the Directory of published versions

: 事前審查-送核、套組檢驗、多事前審查癌藥品項 - JSON Representation

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{
  "resourceType" : "Claim",
  "id" : "cla-1",
  "meta" : {
    "profile" : [
      🔗 "https://nhicore.nhi.gov.tw/base/StructureDefinition/Claim-twnhibase"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Claim-twnhibase.html\">事前審查-Claim TWNHIBASE</a></p></div><p><b>狀態</b>：Active</p><p><b>類型</b>：Institutional<span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/CodeSystem/claim-type\">ClaimTypeCodes</a>#institutional)</span></p><p><b>申報類別</b>：送核<span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-nhi-apply-type.html\">NHI-申報類別值集</a>#1)</span></p><p><b>目的</b>：Preauthorization</p><p><b>病人</b>：<a href=\"Patient-pat-min.html\">Patient/pat-min</a> &quot;王大明&quot;</p><p><b>申請日期</b>：2024-05-30</p><p><b>醫事機構代碼</b>：<a href=\"Organization-org-hosp-example.html\">Organization/org-hosp-example</a></p><p><b>申請案件類別</b>：一般事前審查申請<span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-nhi-tmhb-type.html\">NHI-申請案件類別值集</a>#1)</span></p><h3>Diagnoses</h3><p><b>診斷日期</b>：2024-01-01</p><p><b>國際疾病分類代碼</b>：慢性右心臟衰竭<span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw\">臺灣健保署2023年中文版ICD-10-CM值集</a>#I50.812)</span></p><p><b>簡要病摘</b>：Adenocarcinoma, descending colon, cT3N2M1a, cStage IVA, KRAS G12V, with multiple liver metastases, status post FOLFIRI</p><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>：1</p><p><b>category</b>：<span title=\"Codes:{https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-supporting-info-type geneInfo}\">基因資訊</span></p><p><b>value</b>：<a href=\"Observation-obs-diagnostic-min.html\">Observation/obs-diagnostic-min</a></p></blockquote><h3>Insurances</h3><p><b>sequence</b>：1</p><p><b>coverage</b>：<a href=\"Coverage-cov-min.html\">Coverage/cov-min</a></p></div>"
  },
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "institutional"
      }
    ]
  },
  "subType" : {
    "coding" : [
      {
        "system" : "https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-apply-type",
        "code" : "1",
        "display" : "送核"
      }
    ]
  },
  "use" : "preauthorization",
  "patient" : {
    🔗 "reference" : "Patient/pat-min"
  },
  "created" : "2024-05-30",
  "provider" : {
    🔗 "reference" : "Organization/org-hosp-example"
  },
  "priority" : {
    "coding" : [
      {
        "system" : "https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-tmhb-type",
        "code" : "1",
        "display" : "一般事前審查申請"
      }
    ]
  },
  "supportingInfo" : [
    {
      "sequence" : 1,
      "category" : {
        "coding" : [
          {
            "system" : "https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-supporting-info-type",
            "code" : "geneInfo"
          }
        ]
      },
      "valueReference" : {
        🔗 "reference" : "Observation/obs-diagnostic-min"
      }
    }
  ],
  "diagnosis" : [
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate",
          "valueDate" : "2024-01-01"
        }
      ],
      "sequence" : 1,
      "diagnosisCodeableConcept" : {
        "coding" : [
          {
            "system" : "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw",
            "code" : "I50.812"
          }
        ]
      },
      "type" : [
        {
          "text" : "Adenocarcinoma, descending colon, cT3N2M1a, cStage IVA, KRAS G12V, with multiple liver metastases, status post FOLFIRI"
        }
      ]
    }
  ],
  "insurance" : [
    {
      "sequence" : 1,
      "focal" : true,
      "coverage" : {
        🔗 "reference" : "Coverage/cov-min"
      }
    }
  ]
}