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 - XML Representation

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<Claim xmlns="http://hl7.org/fhir">
  <id value="cla-1"/>
  <meta>
    <profile
             value="https://nhicore.nhi.gov.tw/base/StructureDefinition/Claim-twnhibase"/>
  </meta>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
      <code value="institutional"/>
    </coding>
  </type>
  <subType>
    <coding>
      <system
              value="https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-apply-type"/>
      <code value="1"/>
      <display value="送核"/>
    </coding>
  </subType>
  <use value="preauthorization"/>
  <patient>🔗 
    <reference value="Patient/pat-min"/>
  </patient>
  <created value="2024-05-30"/>
  <provider>🔗 
    <reference value="Organization/org-hosp-example"/>
  </provider>
  <priority>
    <coding>
      <system
              value="https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-tmhb-type"/>
      <code value="1"/>
      <display value="一般事前審查申請"/>
    </coding>
  </priority>
  <supportingInfo>
    <sequence value="1"/>
    <category>
      <coding>
        <system
                value="https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-supporting-info-type"/>
        <code value="geneInfo"/>
      </coding>
    </category>
    <valueReference>🔗 
      <reference value="Observation/obs-diagnostic-min"/>
    </valueReference>
  </supportingInfo>
  <diagnosis>
    <extension
               url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate">
      <valueDate value="2024-01-01"/>
    </extension>
    <sequence value="1"/>
    <diagnosisCodeableConcept>
      <coding>
        <system
                value="https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw"/>
        <code value="I50.812"/>
      </coding>
    </diagnosisCodeableConcept>
    <type>
      <text
            value="Adenocarcinoma, descending colon, cT3N2M1a, cStage IVA, KRAS G12V, with multiple liver metastases, status post FOLFIRI"/>
    </type>
  </diagnosis>
  <insurance>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>🔗 
      <reference value="Coverage/cov-min"/>
    </coverage>
  </insurance>
</Claim>