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>