Contents 1. 16 2. 17 3. 18 4. 19 5. 20 6. 21 7. 22 8. 23 9. 24 10. 25 11. (COPD) 26 12. 27 13. 28 14. 29 15. 30 16. 31 17. 32 18. 33 19. 34 20. 35 21. 36 22. 38

23. 39 24. 40 25. 41 26. 42 27. 44 28. 45 29. 46 30. (//) 48 31. 50 32. 51 33. 52 34. 53 35. 54 HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE 36. 55 37. 56 38. 57 39. 58 40. 59 41. 60 42. 61 43. 62 44. () 63 45. 64 46. 65 47. 66 48. 67 49. 68 50. 69 51. 70

Contents 52. () 71 53. 72 54. 73 55. 74 56. 75 57. 76 58. 77 59., 78 60. 79 61. 80 62. 81 63. 82 64. 83 65. 84 66. 85 67. 86 68. 87 69. 88 70. 89 71. 90 72. 91 73. 92 74. 93 75. 94 76. 95 77. 96 78. 97

79. 98 80. 99 81. 100 82. 101 83. (,, )_ 102 84. _ 103 85. _ 104 86. _ 105 87. _ 106 88. _ 107 89. _ 108 90. _ 109 91. _ 110 92. _ 111 HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE 93. 112 94. 113 95. 114 96. 115 97. 116 98. 117 99. 118 100. 119 101. 120 102. 121 103. 122

Contents 104. 123 105. 124 106. 125 107. 126 108. 127 109. 128 110. 129 111. 130 112. 131 113. 132 114. 133 115. ADHD( ) 134 116. 135 117. 136 118. 137 119. ( ) 138 120. 139 121. 140 122. A 141 123. B 142 124. C 143 125. 144 126. 145 127. 146 128. 147 129. 148 130. 150 131. (Scabies) 151 132. 152

133. 153 134. 154 135. 155 136. 156 137. 157 138. 158 139. 160 140. 161 141. 162 HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE 142. 166 143. 167 144. 168 145. () 169 146. () 170 147. 171 148. 172 149. 173 150. 174 151. 175

Contents 152. (CT) 176 153. (MRI) 177 154. (PET) 178 155. 179 156. 180 157. 182 158. C(hepatitis C) 184 159. 185 160. 186 161. 187 162. 188 163. 189 164. 190 165. 191 166. 192 167. 193 168. 194 / 169. 195 170. 196 171. ( ) 197 172. 198 173. 199 174. 200

175. (PCI) 201 176. 202 177. (CABG) 203 178. _ 204 179. _ 205 180. _ 206 181. _ 207 182. _ 208 183. _ 209 184. _ 210 185. _ 211 HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE 186. 212 187. 213 188. 214 189. 215 190. 216 191. 217 192. 218 193. 219 194. 220 195. 221 196. 222

Contents 197. 224 198. 225 199. 226 200. (, ) 227 201. 228 202. 229 203. _ 230 204. _ 231 205. _ 232 206. 233 207. _ 234 208. _ 235 209. _ 236 210. () 237 211. 238 212. 239 213. 240 214. 241 215. 242 216. 243 217. 244

& 218. 248 219. 249 220. 250 221. 251 222. 252 223. 254 224. 255 225. 256 HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE

1., 2., 3., 1. () 225 (http://opendata.hira.or.kr) - - (/ ) 2. () /, / 5, / 10,,,, 12

3. (http://opendata.hira.or.kr) 4. () 13

C H A P T E R HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE

1 K74 K702 K703. : (Liver cirrhosis) K74, K702, K703. K74, K702, K703 16

2 K803 K804 K805 ().. [] 간담 ( 간내담관 ) 담낭십이지장 식도위췌장 ( 이자 ) 췌관 : / (Gallstone of bile duct). K803, K804, K805 17

3 K800 K801 K802.. [] () :, (Gallstone of gallbladder) K800 ~ K802. K800, K801, K802 18

4 K700 K758 K760 ( ) (),,,. : (Fatty liver), K700, K758, K760. (3) K70( ) (4),,,. K700, K758, K760 19

5 K21 -.,,,. : / - K21. K21 20

6 K50 K51.,,,.,.. K50, K51 21

7 // I84 2015.12 K64 2016.1.1 (Haemorrhoid).,,. [] : (Haemorrhoid) (K64). 7 (K64) 2016.1.1. // (I84) 2015.12.31.. I84, K64 K64 2016.1.1 22

8 J00 [] J01 J02 J03 J04 J05 J06 []. (J00 ~ J06). - (influenza) (J09 ~ J18). J00 ~ J06 23

9 J09 J10 J11 A B hemagglutinin(h) neuraminidase(n). : (J09), (J10), (J11). J09 ~ J11 24

10 A15 A16 A19,., (,,,,, ). :. A15, A16, A19. A15, A16, A19 25

11 (COPD) (COPD) J431 J432 J438 J439 J44. : / (COPD). (J44) (J431), (J432), (J438), (J439). OECD J40, J41, J43, J44, J47. J44, J431, J432, J438, J439 26

12 J12 J13 J14 J15 J16 J17 J18,.,,,,,,. (J09 ~ J18) ( J12 ~ J18). J12 ~ J18, 1. J12 ~ J18 27

13 J93 S270. [].. : / (J93) (S270). J93, S270 28

14 I10 I11 I12 I13 I15 (I10 ~ I15). (I15) I10 ~ I13. 1, -14, 2. (I10 ~ I13, I15). I10 ~ I13, I15 29

15 I60 I61 I62 I63 I64 ( ) ( ). I60 ~ I64. [ ] () ( ) I60 I61 I62 I63 I60, I61, I62, I63, I64 30

16 I21 I22 (Acute myocardial infarction) (I21) (I22). (I21). I21 I22. I21, I22 31

17 I20.. : (Angina pectoris) (I20). I20 32

18 I710 I711 I712 I715 I716 I718 I719 [ ] NOS,,. : (Thoracic aortic aneurysm). (I71) [ ],,,,, NOS,. I710, I711, I712, I715, I716, I718, I719 33

19 I83 I87 (,, ),,,. : (I83), (I87). : (I870), (I871), ()()(I872), (I878), (I879). I83, I87 34

20 G474 REM, (, hypnagogic) (),,. (Narcolepsy) (G47) (narcolepsy and cataplexy)(g474). G474 35

21 G04 A1781 A321 A83 A84 A85 A86 A872 B004 B020 B060 B582 B602 B832 G05 NEC NOS 36

,,,. : G04, G05, A83, A84, A85, A86 A321, A872, B004, B020, B060, B582, B602, B832, A1781. G04, G05,A83, A84, A85, A86 A321, A872, B004, B020, B060, B582, B602, B832 A1781 37

22 G40 G41 (Epilepsy) (Status epilepticus) (Epilepsy),, -,,,, (24 2 ). -. : (Epilepsy) (G40), (G41). G40, G41 38

23 M80 M81 M82 (Osteopprosis) M80, M81, M82. (ex: ). M80, M81, M82 39

24 M50 M542 () (Cervical disc) (). (Cervical disc) (M40 ~ M54) (M50) (M542). M50, M542 40

25 M4712 M4713 M4722 M4723 M50 M542,,,, M9951 (). : (Cervical disease) (M40-M54) 2., 3., (M99) 1.. M50, M542, M4712, M4713, M4722, M4723, M9951 41

26 M40 M41 M42 M43 M45 M46 M47 M48 M49 M50 M51 M53 M54 42

[ ] : () (, ). :,,,. (M40 ~ M54). (M45). ( ) (M40 ~ M54) 43

27 S02 S12 S22 S32 S42 S52 S62 S72 S82 S92 T02 T08 T10 T12 T142, (Fracture)., S02, S12, S22, S32, S42, S52, S62, S72, S82, S92, T02, T08, T10, T12 T142. S - :. T - :. S02, S12, S22, S32, S42, S52, S62, S72, S82, S92, T02, T08, T10, T12, T142 44

28 S72080 S72081,,,,. : (Fracture of neck of femur). S72080, S72081 45

29 M00 M01 M02 M03 M05 M06 M07 M08 M09 M11 M12 M13 M14 M15 M16 M17 M18 M19 M45 1 46

(Arthritis),,.. (M45). ( ) M00, M01, M02, M03, M05, M06, M07, M08, M09, M11, M12, M13, M14, M15, M16, M17, M18, M19, M45 47

30 (//) M00 M01 M02 M03 M05 M06 M07 M08 M09 M10 M11 M12 M13 M14 M15 M16 M17 M18 M19 1 48

(Arthritis) M00 ~ M19., : [ M00 ~ M03]. : [ M05 ~ M14]. : [ M15 ~ M19]... (,, ) M00 ~ M03, M05 ~ M14, M15 ~ M19 49

31 M05 M06. : (Rheumatoid arthritis) (M05), (M06). (M080),. M05, M06 50

32 S934 T132,. -. -. : (Sprain and strain of ankle) (S934),, (T132). S934, T132 51

33 M10,.. : (Gout) (M10). M10 52

34 M750. []? : (Frozen shoulder) ()(M750). M750 53

35 M50 S134 M542 () (M50), (M542), (S134). [] M50, S134, M542. 16, (M4002) 2017 M50, S143, M542 17 (M4002 M50, S143, M542 ). () M50, S134, M542 54

36 C22 D015,. (Liver cancer) (C22),, (D015). D015. (C220), (C221),, ( ). C22, D015 55

37 C25 D017,,. : (pancreas cancer) (C25), (D017). D017. C25, D017 56

38 C00 ~ C14, D000 C15, D001 C16, D002 C17 C18 ~ C20, D010 ~ D012 (, ) C21, D013 D017 D014 D019,,,,,,,,. C00 ~ C21, D000 ~ D002, D010 ~ D014, D017, D019 57

39 C1600 C1610 C1620 C1630 C1640 C1650 C1660 C1680 C1690. 0, 1-4, 5. : SIM 6 :, 2013.3.21 (C16) 5 0.. C1600, C1610, C1620, C1630, C1640, C1650, C1660, C1680, C1690 58

40 C1601 C1611 C1621 C1631 C1641 C1651 C1661 C1681 C1691,,. : SIM 6 :, 2013.3.21 (C16) 5 1.. C1601, C1611, C1621, C1631, C1641, C1651, C1661, C1681, C1691 59

41 C1609 C1619 C1629 C1639 C1649 C1659 C1669 C1689 C1699 0, 1-4, 5. : SIM 6 :, 2013.3.21 (C16) 5 9.. C1609, C1619, C1629, C1639, C1649, C1659, C1669, C1689, C1699 60

42 C18 C19 C20 D010 D011 D012,. : (Colorectal cancer) [3],. C18 ~ C20. C18 ~ C20, D010 ~ D012 61

43 C53 D06 (corpus) (cervix),. : (Cervical cancer) (C53), (D06). C53, D06 62

44 () () C54 D070. : () (C54), (D070). C54, D070 63

45 C64 ( ). [] : (C64). C64 64

46 C67 D090 (Bladder cancer),,. :. :,. :. :. [] : (Bladder cancer). C67, D090 65

47 C61 D075. [] : (C61) (D075). C61, D075 66

48 H442 H521,. -,,,. : (Myopia) (H442), (H521). H442, H521 67

49 H49 H50. [] : / (H49) (H50). H49, H50 68

50 H25 H26 H28 Q120,. [] : (Cataract) (H25, H26, H28) (Q120). H25, H26, H28, Q120 69

51 H40 H42. [] : (Glaucoma) (H40 ~ H42). H40, H42 70

52 () H30 ( ) H31 H32 H33 H34 H35 () H36 H43 () (Chorioretinal disease) (H30 ~ H36) (H43). () H30, H31, H32, H33, H34, H35, H36, H43 71

53 H3530 H3531 H3534 H3539 ( ),,.. :. (H3530), (H3531), (H3534), (H3539). H3530, H3531, H3534, H3539 72

54 H16 H191 H192 H193 B300 B0051 (B00.51+) (B30.0+) (H192*) (H191*),,,.. : (Keratitis),. + :, () * :, H16, H191, H192, H193, B300, B0051 73

55 H041 (H041). ()(M350) (H041). H041 74

56 H101 H1625,, (mast cell) (basophil) (eosinophil).. :. (H101),, (H1625). H101, H1625 75

57 H65 H66 H67,,. [] : (Otitis media).,. H65, H66, H67 76

58 J00 J30 J310,.. :,. - (J30), (J00), (J310). J00, J30, J310 77

59,, Q35 Q36 Q37,.,,,,,,. :, (Cleft and Cleft lip), (Q35 ~ Q37)., Q35, Q36, Q37 78

60 J04 J05 J37.. : : (J04), (J05), (J37). J04, J05, J37 79

61 K02 (Dental caries). K020 K021 K022 K023 K024 K028 /() //, K02 80

62 K05 A691 K044 K045 K046 K048 K090 () ().,,,. : (K05), (A691), (K044), (K045), (K046), (K048), (K090). K05, A691, K044, K045, K046, K048, K090 81

63 L29,, E,,,, (opioid peptides). : (L29). 65 (). 65. L29 ( 65 ) 82

64 L22 [] L23 L24 L25.. :. : (L22), (L23), (L24), (L25). L22, L23, L24, L25 83

65 L84 (Corns).. :. (L84). L84 84

66 L63 L64 L65 L66 [ ]. (L63), (L64), (L65), (L66). L63 ~ L66 85

67 T20 T21 T22 T23 T24 T25 T26 T27 T28 T29 T30 T31,, (T20 ~ T31). T20 ~ T31 86

68 L40.,,,. [] :. : (L40). L40 87

69 L93 M32 (Systemic lupus erythematosus),. -,,,,,. -..,. (L93 ), (M32). L93, M32 88

70 L570, 20%. :. (L570).. L570 89

71 C43 C44 C460 C792 C840 D04 (Kaposi's sarcoma of skin) (Mycosis fungoides) (Skin cancer),,,,. (Skin cancer) [3] (C43, C44, C792) (D04). (D04). C43, C44, D04, C460, C792, C840 90

72 F980 N393 N394 R32. - : - : - : - : - : - : (Incontinence),. R32, F980, N393, N394 91

73 N30 (Cystitis). : (N30).,. ( ) N30 92

74 N31 N328 N329. : (N31), (N328), (N329).. /.( ) N31, N328, N329 93

75 N10 N11 N12 N13 N15 N16 - - - - -.. :. -(N10 ~ N16) - (N14) N10 ~ N13, N15 ~ N16. N10, N11, N12, N13, N15, N16 94

76 N20 N21 N22 N23,,,. : (Urinary stone) (N20 ~ N23). N20 ~ N23 95

77 R351 2016.1.1 R352 2016.1.1 // R35 // 2015.12.31 5. : (Enuresis) (R35). 2016.1.1. (R351), (R352) 2016.1. 2016 R35, (R351, R352) R35 //. R351, R352, // R35 96

78 N97 N46 (Infertility) N97, N46.. N96 E282 E283 E230 I861 Q553 N97, N46 97

79 D25 O341 (myoma).. 1) (Submucous myoma) : (). 2) (intramural myoma) :,,. 3) (subserous myoma ) :. : (Myoma uteri) (D25) (O341). D25, O341 98

80 D27 D282 C48 C56 C57 C796 D391,,,. :,. - (C48) NCCN guide line,. - (D391). _ : D27, D282 _ : C48, C56, C57, C796, D391 99

81 P07 (WHO) 37 259 (preterm infant). (P07). OECD. P070 P0710 1000-1249g P0700 500g P0711 1250-1499g P0701 500-749g P0712 1500-1749g P0702 750-999g P0713 1750-1999g P0709 P0714 2000-2499g P071 P0719 P07 100

82 Q00 ~ Q07 Q10 ~ Q18 Q20 ~ Q28 Q30 ~ Q34 Q35 ~ Q37 Q38 ~ Q45 Q50 ~ Q56 Q60 ~ Q64 Q65 ~ Q79 Q80 ~ Q89,,,.,,. :.,. : Q00 ~ Q07, Q10 ~ Q18, Q20 ~ Q28, Q30 ~ Q34, Q35 ~ Q37, Q38 ~ Q45, Q50 ~ Q56, Q60 ~ Q64, Q65 ~ Q79, Q80 ~ Q89., 101

83 (,, )_ (,, )_ O11 O14 O15 O10 O13 O16 O12, [-] [-],.. 20, 20.,.. :. O10, O11, O12, O13, O14, O15, O16 102

84 O420 O45 O60 24 []. 34 1cm 50%, 80%. 3cm. ( ) :,. O45, O60, O420 103

85 O30 O31 O632 O661 O663 O692 2, (multifetal gestation),.,. 2, 2.. (, ) :. O30, O31, O632, O661, O663, O692 104

86 O620 O621 O622 (O620), (O621), (O622).,.. :,. O620, O621, O622 105

87 O4200 O4201 O4210 O4211 O4220 O4221 O4290 O4291 24, (34 ) 24, (34, 37 ) 24, (34 ) 24, (34, 37 ),, (34 ),, (34, 37 ), (34 ), (34, 37 ) (preterm birth) 20 36 6.,,,,,,. :. O4200, O4201, O4210, O4211, O4220, O4221, O4290, O4291 106

88 O24 ( 110 ~ 120mg/ ). : (Glucose). (insulin resistance),,,. :. O24 107

89 O365. (O36). : 2015. O365 108

90 O340,. -, (). :. O340 109

91 O35., : (O35). (Q00 ~ Q89)..( ) O35 110

92 O44., (O44). O440 O441.( ) O44 111

93 E10 E11 E12 E13 E14,, (Diabetes) (E10 ~ E14). 1-14 2. : E10 ~ E14. E10 ~ E14. E10 ~ E14 112

94 E1070 E1071 E1170 E1171 E1270 E1271 1 1 2 2 - - E1370 E1371 E1470 E1471.. (E10 ~ E14).70.71. E1070, E1071, E1170, E1171, E1270, E1271, E1370, E1371, E1470, E1471 113

95 E66 (Obesity) (E66). E660 E661 E662 E668 E669 - () [ 2].. E66 114

96 E78 I10 ~ I15 E10 ~ E14 I60 ~ I69 I20 ~ I25, I28, I42 ~ I43, I50 ~ I52,,, 3. :,,,,. -,,,. -. (I05 I52) I20 ~ I25, I28, I42 ~ I43, I50 ~ I52. - : E78 - : I10 ~ I15 - : E10 ~ E14 - : I60 ~ I69 - : I20 ~ I25, I28, I42 ~ I43, I50 ~ I52 115

97 E301 ()(Precocious puberty) (E301)... GnRH 2013-127() ) (1) (Tanner stage) 2, (2) GnRH() (LH) 2 ~ 3 5 IU/L ) (1) : 9(8 365), 10(9 365) (2) : 11(11 364), 12(12 364) ) (1) GnRH(). (2) GnRH(). E301 116

98 E50 E51 E52 E53 E54 E55 E56 E58 E59 E60 E61 E63 E64 A [] B D (E50 ~ E64). E50 ~ E64 117

99 E40 E41 E42 E43 E44 E45 E46 - - - - (E40 ~ E46). E40 ~ E46 118

100 D50 ~ D53 D55 ~ D59 D60 ~ D64 D65 ~ D69 D70 ~ D77 D80 ~ D89,. : 13 ~ 17 g/dl, : 12 ~ 16 g/dl (D50 ~ D53), (D55 ~ D59), (D60 ~ D64), (D70 ~ D77), (D80 ~ D89). D50 ~ D89 119

101 C91 C92 C93 C94 C95,.,.,,,,,,. : (Leukaemia) (C91 ~ C92). C91 ~ C95 120

102 F32 F33. : (F32) (F33). F32, F33 121

103 F31 (). : (F31). F31 122

104 F510 G470 [],,,. -,,. : (F510), (G470). F510, G470 123

105 F20 F21 F231 F232 F25 --,,,,. :. (F20), (F21), (F231), - -(F232), (F25). F20, F21, F25, F231, F232 124

106 F400 F410 ( ). -.. -. :. (F400), (F410). F400, F410 125

107 F840 F841 3,, 3,,,. :. (F80 ~ F89) (F84) (F840), (F841). F840, F841 126

108 F530, 10 ~ 20% 4 3 ~ 6 1.. : (F530), (NOS). F530 127

109 F452,,. : (F452). F452 128

110 F431,,,,. : (F431). F431 129

111 F00~F09 F10~F19 F20~F29 F30~F39 F40~F49 F50~F59 F60~F69 F70~F79 F80~F89 F90~F98 F99 G40 G41, [], - (F00 ~ F99) (G40), (G41). 1-14 (AH200), 2. : F00 ~ F99, G40 ~ G41 F (G40) (G41). F00 ~ F99, G40 ~ G41 130

112 F40 F41., - (F40-F48) (F40), (F41). F400 F401 F402 F408 F409 F410 F411 F412 F413 F418 F419 () F40, F41 131

113 F60 F61. -. : F600 F601 F602 F603 F604 F605 F606 F607 F608 F609 [] F60, F61 132

114 F00 F01 F02 F03,,,,, F00 ~ F03. (G30) (F00). F00 ~ F03 133

115 ADHD( ) ADHD ( ) F900 ADHD (F900). attention deficit hyperactivity disorder, (ADHD) ADHD F900 134

116 F500 F501 F508,,,,,. : (F50) (F500), (F501), (F508). F500, F501, F508 135

117 F502 F503 F504 F505,. (F50) (F502), (F503), (F504), (F505). F502 ~ F505 136

118 F100 F101 F102 F103,,,. : (F100), (F101), (F102), (F103). F100, F101, F102, F103 137

119 ( ) ( ) T652 F170 F171 F172 ( ). : (T652), (F170), (F171), (F172). ( ) T652, F170, F171, F172 138

120 F630 Z726,. : (Gambling addiction) (F630), (Z726). F630.,,,. : (F30.-) F630, Z726 139

121 T36 T37 T38 T39 T40 T41 T42 T43 T44 T45 T46 T47 T48 T49 T50,, [], -,,,, (T36 ~ T50). T36 ~ T50 140

122 A A B15 A A A. A(Acute hepatitis A) A(B15).,,,,. A B15 141

123 B B B16 B170 B180 B181 B B () - B - B B B. B(Hepatitis B) (B15 B19) B.,,,,. B B16, B170, B180, B181 142

124 C C B171 B182 C C C C. C(Hepatitis C) C (B171), C(B182).,,,,. C B171, B182 143

125 A04 A06 A07 A08 A09, (A04), (A06), (A07), (A08), (A09). []. [ ] - A02 - A03 - A05 - T61 - T62 A04, A06, A07, A08, A09 144

126 A50 A51 A52 A53 A54 A55 A56 A57 A58 A59 A60 A63 A64 () [] -. (B20 ~ B24) ( )(N341).,,,,. A50 ~ A64 145

127 A15 A16 A17 A18 A19 P370 O980, B200 U880 2015.12.31 U881 2015.12.31 U843 2016.1.1 (Tuberculosis).,,,,. A15 ~ A19, P370, O980, B200, U880, U881, U843 146

128 B084 ( ) A16 71,,. : (Hand, foot and mouth disease) (B084).,,,,. B084 147

129 A021 A207 A227 A241 A267 A327 A40 A41 A427 A548 B007 B377 J950 O080 O753 O85 P36 T802 T814 T880 R650 R651, O00-O07, / 148

(Sepsis) ().., (A30 ~ A49) : / / / / / / / /.. : /.., :.., : /, /.. :..,, (T80 ~ T88) :, / /.., : /. A40 ~ A41, O85, P36 A021, A207, A227, A241, A267, A327, A427, A548, B007, B377, J950, O080, O753, T802, T814, T880, R650, R651 149

130 B850,,, (Pediculus capitis), (Pediculus corporis) (Phthirus pubis). : (Pediculus capitis), (B850). B850 150

131 (Scabies) (Scabies) B86 (Scabies, ), (Scabies mite). -. - 4 ~ 6 1. -. - () () (). (B86). :.( ) B86 151

132 A02 A03 A05 T61 T62.,,,,.. - A04 - A06 - A07 - A08 - A09 A02, A03, A05, T61, T62 152

133 T630 T631 W59 X20 (T63) (T630), (T631), (W59), (X20). 20, (V, W, X, Y). ( : -V Y. ),. W59, X20, T630, T631 153

134 X23,,, (X23). 20, (V, W, X, Y). ( : -V Y. ),. X23 154

135 T67,,,,. (T67). - (T67). (T67) T670 T671 T672 T673 T674 T675 T676 T677 T678 T679 T67 155

136 T33 T34 T35,,,,.. : (T33), (T34), (T35). T33, T34, T35 156

137 S00 ~ S09 S10 ~ S19 S20 ~ S29 S30 ~ S39 S40 ~ S49 S50 ~ S59 S60 ~ S69 S70 ~ S79 S80 ~ S89 S90 ~ S99 T00 ~ T07 T08 ~ T14,,, S00 ~ S09, S10 ~ S19, S20 ~ S29,,, S30 ~ S39, S40 ~ S49, S50 ~ S59, S60 ~ S69, S70 ~ S79, S90 ~ S99, T00 ~ T07, T08 ~ T14. S00 ~ S99, T00 ~ T14 157

138 J30 J450 J46 L20 L22 L23 L24 L25 L27 L50 H101 H1625 T887 [], 158

(3).. : (J30), (J450), (J46).. [ ] : (L20), [] (L22), (L23), (L24), (L25), (L27), (L50).. : (H101), (H1625).., : (T887). /.( ) 2017 T887. J30, J46, L20, L22, L23, L24, L25, L27, L50, J450, H101, T887, H1625 159

139 J30 L20 J45 J46,,.. : 100 J30, L20, J45, J46 160

140 I10 ~ I15 E10 ~ E14 F00 ~ F99, G40 ~ G41 A15 ~ A16, A19 I05 ~ I09, I20 ~ I27, I30 ~ I52 I60 ~ I69 G00 ~ G37, G43 ~ G83 C00 ~ C97, D00 ~ D09, D32 ~ D33, D37 ~ D48 E00 ~ E07 B18 ~ B19, K70 ~ K77 N18 M00 ~ M09, M11~ M19, M45 1, 2-14 2.,,,,,,,,,,,. : I10 ~ I15 : F00 ~ F99, G40 ~ G41 : A15, A16, A19 : I05 ~ I09, I20 ~ I27, I30 ~ 52 : G00 ~ G37, G43 ~ G83 : B18, B19, K70 ~ K77 : E10 ~ E14 : I60 ~ I69 : E00 ~ E07 : N18 : M00 ~ M09, M11 ~ M19, M45 : C00 ~ C97, D00 ~ D09, D32 ~ D33, D37 ~ D48 161

141 E78 I10 ~ I15 E10 ~ E14 M80 ~ M82 E66 I05 ~ I09, I20 ~ I27, I30 ~ I52 K70, K758, K760, C50, D05 C18 ~ C20, D010 ~ D012 C53 ~ C55, D06, D070 C22, D015 C32, D020 C15, D001 C00 ~ C14, D000 (, ) C16, D002 C25, D017 C34, D022 C61, D075 C64 C67, D090 162

1996, 2003.,,,,,,,,,,,,,,,,, (, ),,,. : : E78 : I10 ~ I15 : E10 ~ E14 : M80 ~ M82 : E66 : I05 ~ I09, I20 ~ I27, I30 ~ I52 : K70, K758, K760 C50, D05 C18 ~ C20, D010 ~ D012 C53 ~ C55, D06,D070 C22, D015 C32, D020 C15, D001 C00 ~ C14, D000 C16, D002 C25, D017 C34, D022 C61, D075 C64 C67, D090 163

C H A P T E R HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE

142 E7581 E7582 E7586.. : 1 2 2 4,, 758, 758-1, 758.. E7581, E7582, E7586 166

143 E7590 E7591 E7592 E7593 () () () () (Bronchoscope).,. : 1 2 2 4,, -759. E7590, E7591, E7592, E7593 167

144 E7611 (,, ) 1 2 2 4,, 761. E7611 168

145 () () E7621 E7622 () () () (ERCP, Endoscopic retrograde cholangiopancreatography) : ( ) ( ) (X ). (/) - : - : : () E7621, E7622 169

146 () () Q7761 Q7762 Q7763 Q7764 Q7765 Q7766 Q7767 () - () ()(, ) ()() - () (). : 1 2 9 776 (). () Q7761, Q7762, Q7763, Q7764, Q7765, Q7766, Q7767 170

147 E7651 E7652 [ ]- [ ]- : 2 (double balloon enteroscopy) 1 (single balloon enteroscopy) : 1 2 2 4,, 765 [ ] E7651, E7652 171

148 E7660 E7670 E7680 S. : 1 2 2 4,, 766, 767, 768 S. E7660, E7670, E7680 172

149 E7740 E7741 [] [] (). :, (). :, SIM 5 : 1 2 2 4,, 774. E7740, E7741 173

150 E7721 E7722 () (). :. : 1 2 2 4,, 772. E7721, E7722 174

151 E7500 E7501 -,. :,,. : HIRA 1 2 2 4,, 750. E7500, E7501 175

152 (CT) (CT) 245 245-1 Cone Beam (CT) 1 2 3 2 245. 245 2 CT. (Cone beam CT ) Cone Beam CT CT. (CT) 245, 245-1 176

153 (MRI) (MRI) 246 (MRI) 1 2 3 2 246. 246 2 MRI. (MRI) 246 177

154 (PET) (PET) HC351 F-18-2014.8.1 HC352 F-18-2014.8.1 HC353 F-18-2014.8.1 HZ223 F-18 FP-CIT 2014.9.1 HZ331 F-18 FDG - HZ332 F-18 FDG - HZ333 F-18 FDG - HZ334 F-18 FDG - HZ335 F-18 FDG - HZ336 F-18 FDG - HC361 C-11-2015.8.1 HC362 C-11-2015.8.1 HC371 Ga-68 2016.7.1 1 2 3 3 335 (PET). 2014 HC351 ~ HC353, HZ223 15 HC361 ~ HC362 80%. : 4 (50% or 80%). (PET) 335, 335-1, 335-2, 336, 337 178

155 HC341 HC342 HC343 HC344 HC345 HC346 []-() (1) []-() (2) []- []- []- []- -PQCT 1 2 3 3. () 2007-92() (1) 65 70 (2) 1 65 (3) 1 (4) (fragility) (5) (6) 3, central bone(spine, hip). 1. (BMI 18.5) 2.. 3. 40. HC341, HC342, HC343, HC344, HC345, HC346 179

156 G0011-0015 (CR) (DR) 101 G0400 C-ARM 102 G0430, G0440 105 G0050, G0051 110 G1001 ~ G1005 111 G1101 ~ G1105 112 G1201 ~ G1205 113 G1301 ~ G1305, 114 G1401 ~ G1405 115 G1501 ~ G1505 115-1 G0501 ~ G0505 [] 116 G1601 ~ G1605 117 G1701 ~ G1705 118 G1801 ~ G1805 119 G1901 ~ G1905 120 G2001 ~ G2005 () 121 G2101 ~ G2105 [] 123 G2301 ~ G2305 124 G2401 ~ G2405 125 G2501 ~ G2505 127 G2701 ~ G2705 131 G3101 ~ G3105 132 G3201 ~ G3205 133 G3301 ~ G3305 134 G3401 ~ G3405 135 G3501 ~ G3505 139 G3901 ~ G3905 140 G4001 ~ G4005 141 G4101 ~ G4105 142 G4201 ~ G4205 143 G4301 ~ G4305 144 G4401 ~ G4405 145 G4501 ~ G4505 146 G4601 ~ G4605 147 G4701 ~ G4705 149 G4901 ~ G4905 150 G5001 ~ G5005 151 G5101 ~ G5105 180

152 G5201 ~ G5205 155 G5501 156 G5601 ~ G5605 161 G6101 ~ G6105 162 G6201 ~ G6205 163 G6301 ~ G6305 164 G6401 ~ G6405 165 G6501 ~ G6505 166 G6601 ~ G6605 171 G7101 ~ G7105 172 G7201 ~ G7205 173 G7301 ~ G7305 174 G7401 ~ G7405 175 G7501 ~ G7505 176 G7601 ~ G7605 177 G7701 ~ G7705 178 G7801 ~ G7805 179 G7901 ~ G7905 181 G8101 ~ G8105 182 G8201 ~ G8205 191 G9101 ~ G9105 195 G9501 ~ G9505 196 G9601 197 G9701, G9761 198 G9801 199 G9901 1 3 (FULL PACS) 1 2 3 1. 3 1 181

157 E9411 ~ E9418 (,,,,, ) 16.9.30. EB411 ~ EB416 (,, ) 16.10.1. E9421 ~ E9422 (, ) 16.9.30. EB421 ~ EB422 (, ) 16.10.1., EA431 ~ EA434 E9431 ~ E9439 EB430 ~ EB436 (,,,,, ) (,, ) 16.9.30. 16.10.1. E9441 ~ E9449, (, ) 16.9.30. EB441 ~ EB457 E9451 ~ E9454 (,,, ), (,, ) 16.10.1. 16.9.30. EB461 ~ EB471, (, ) 16.10.1. E9461 ~ E9467 EB481 ~ EB490 (,,, ) (,,, ) 16.9.30. 16.10.1. EB501 ~ EB504 (, ) 16.10.1. E9471 ~ E9474 (, ) 16.9.30. EB511 ~ EB518 (1, 2.3) 16.10.1. EB521 ~ EB523, (, ) 16.10.1. 182

1 2 2 [4,, ]. ( ) ( 2017-68(), 2017.4.12.) 1..,, 1),,,. 2) :.. 1), 2 50%. (951(1) )... 1 2 2() 9( ).. 2016.10.1.. (EB401, EB402). 941 ~ 947 183

158 C(hepatitis C) C C4424006 C4871 C4872 C4873006 C6092006 C6093006 C7487 CY424006 CY425006 CZ961006 C5961006 C6081006 C RNA ( ) C() C() C(Immunoblot) -- C C [] C()- C RNA () C RNA (bdna ) [C ] [C Virus] [C Virus] C(hepatitis C) C (hepatitis C virus, HCV). : C C (anti-hcv Ab), C RNA. C C4424006, C4871, C4872, C4873006, C6092006, C6093006, C7487, CY424006, CY425006, CZ961006, C5961006, C6081006 184

159 E6751 E6755 E6752 - - -,,,, ( 10 ~ 20mmHg) 1 2 2 3 675 E6751, E6755, E6752 185

160 Q7651 Q7652 QZ933 - - - (Endoscopic Treatment of Upper Gastrointestinal Tumor-Removal or Ablation). 1.5 ~ 2.0cm : 2000 1 2 9, [ ] 765. Q7651, Q7652, QZ933 186

161 Q7701 Q7702 Q7703 - - (1 1) - 1 2 9 [ ] 770. Q7701, Q7702, Q7703 187

162 Q7280 Q7281 QZ841 - - - 1 2 9,. Q7280, Q7281, QZ841 188

163 P4551 P4552 P4553 P4554 P4561 ()- ()- ()- ()- 1 2 9 [] 455, 456. C73 D093 D34 P4551, P4552, P4553, P4554, P4561 189

164 N7131 N7132 N7133 N7134 N7135 - -[] - - - 1 2 9. C50, D05 N7131, N7132, N7133, N7134, N7135 190

165 N7140 N7141 N7142 N7143 N7144 N7145 N7146 N7147 N7148 N7149 N7150 N7151 N7152 N7153 - -- - -- - -- - -- - -- - -- - -- - - - - - - - - - - - -( ) -- -- ( 2015-43),. - -..., : 4. N7140, N7141, N7142, N7143, N7144, N7145, N7146, N7147, N7148, N7149, N7150, N7151, N7152, N7153 191

166 Q2791 Q2792 Q2793 Q2794 Q2795 -(Feeding Jejunostomy ) - - - - (),,. : 1 2 9 279. Q2791, Q2792, Q2793, Q2794, Q2795 192

167 O0215 O0216 O0217 O2051 O2052 ()-1 ~ 3 ()-4 ~ 6 ()-7 ()(2007.12.31) (). [] : : 1 2 9. O0215 ~ O0217, O2051, O2052 193

168 [] O0261 ( ) O0262 ( ) O0263 ( ) O0264 ( ) O0265 ( ) O0266 ( ) O0267 [ ] O0215 ()-1 ~ 3 O0216 ()-4 ~ 6 O0217 ()-7 O2052 (). : 1 2 9 206, 205.. O0261 ~ O0267, O0215 ~ O0217, O2052 194

169 S5341 S5342 - -.. : 1 2 9 [_] 534. S5341, S5342 195

170 S5173 S5174 S5175 S5176 ()- ()- ()- ()- 1 2 9 [_] 517. 10 10 ( 2009-122). () 2009-122, [2]. 2-. - -. 10. 10 -,,, - 10.. ~. 1 2 S5173, S5174, S5175, S5176 196

171 ( ) ( ) S5291 S5292 S5293 _ ( ).,. 1 2 9 [_] 529. S5291, S5292, S5293 197

172 S5040 S5041 S5042 S5043 S5044 S5045 S5047 S5048 S5049 S5033 []- []- [,,, ] []- []- []-, []- []- []- []- []- 04.8.1 1 2 9 [] [ ]. S5040, S5041, S5042, S5043, S5044, S5045, S5047, S5048, S5049, S5033 198

173 Q2195 ()- 2014.8.1 Q2196 () Q2197 () 1 2 9. 2007-139() 1.,,,,,,, -. 2.,, 1 3. 3. (RDI : Respiratory Disturbance Index) 15 5,. - -.,,,,,,. 85% Q2195, Q2196, Q2197 199

174 Q2161 () Q2162 () Q2191 [] Q2193, Q2194, Q2192 4 ~ 7 () (). : 1 2 9 [, ] 216, 219. Q2161, Q2162, Q2191, Q2193, Q2194, Q2192 200

175 (PCI) M6551() M6552() (PCI) M6561() M6563( ) M6562() M6564( ) M6571() M6572() PCI(Percutaneous coronary intervention) 1 2 9 [ ] 655, 656, 657. ( ). (PCI) M6551, M6552, M6561, M6563, M6562, M6564, M6571, M6572 201

176 M6580 M6581 M6582 - - -,,. :,. : 1 2 9 [ ] 658. M6580, M6581, M6582 202

177 (CABG) (CABG) O1641 (-)-(1) OA641 (-)-, 1 O1640 (-)-(2) 17.7.1. OA640 (-)-, 2 17.7.1. O1642 (-)-(2 ) 17.6.30. OA642 (-)-, 2 17.6.30. O1648 (-)-(3) 17.7.1. OA648 (-)-, 3 17.7.1. O1649 (-)-(4 ) 17.7.1. OA649 (-)-, 4 17.7.1. O1647 (-)- OA647 (-)- (CABG). ( ). (CABG). O1641, OA641, O1640, OA640, O1642, 0A642, O1648, OA648, O1649, OA649, O1647, OA647 203

178 Q8040 ~ Q8044 Q8045 ~ Q8050 Q8140 ~ Q8144 Q8145 ~ Q8150 - - -- -- _ 1 2 9 804. _ 804 204

179 S5371 S5372 - - _. : _ 1 2 9 537. _ S5371, S5372 205

180 S5011 S5012 - - _ 1 2 9.,,. _ S5011, S5012 206

181 _ Q8121 -- _ Q8122 -- Q8123 - _ :,, (, ). : 1 2 9. _ Q8121, Q8122, Q8123 207

182 R3280 _ : ( ) (). : _ 1 2 9. _ R3280 208

183 Q8080 _ :. : _ 1 2 9. _ Q8080 209

184 Q8061 Q8062 - - _ :. : _ 1 2 9. _ Q8061, Q8062 210

185 _ Q8101 - _ Q8102 - Q8103 - _ :. : _ 1 2 9. _ Q8101, Q8102, Q8103 211

186 R4351, R4353, R4356, R4358 (RA431, RA432, RA433, RA434) R3131, R3133, R3136, R3138-435 (RA311, RA312, RA313, RA314) R3141, R3143, R3146, R3148 (RA315, RA316, RA317, RA318) -436 R4361, R4362(RA361, RA362) -438 R4380 (RA380) R4507, R4508, R4509-450 R4510, R5001, R5002 R4517, R4518, R4514-451 R4519, R4520, R4516 V0111, V0112, V0121-1 V0122, V0131, V0132 ( 50% ) [ ] ( 50% ) ( 50% ) ( 50% ) ( 50% ) 1 2 9 [, ].. -435, -436, -438, -450, -451-1 212

187 R4351, R4353, R4356, R4358 (RA431, RA432, RA433, RA434) ( 50% ) 435 R3131, R3133, R3136, R3138 (RA311, RA312, RA313, RA314) R3141, R3143, R3146, R3148 (RA315, RA316, RA317, RA318) [ ] ( 50% ) ( 50% ) 436 R4361, R4362(RA361, RA362) ( 50% ) 438 R4380(RA380) ( 50% ),.,,. : R3131, R3133, R3136, R3138, R3141, R3143, R3146, R3148, R4351, R4353, R4356, R4358, R4361 ~ 2, R4380, RA311 ~ 8, RA361 ~ 2, RA380, RA431 ~ 4 213

188 R4507 R4508 R4509 R4510 R4514 R4516 R4517 R4518 R4519 R4520 R5001 R5002 1 1 1 1 1 1 1 :. : HIRA R4507 ~ 10, R4514, R4516 ~ 20, R5001 ~ 2 214

189 R4331 R4332 R4341 R4342 R4343 R4344 R4345 - - []()- []()- []- []- []- (, ),,,,.,. : 1 2 9 [, ] 433, 434. R4331, R4332, R4341, R4342, R4343, R4344, R4345 215

190 R3561 R3562 R3563 R3564 R3565 ( )_2007.12.31 ( ) ( ) - - [ ] - - 1 2 9. ( ) (2007.12.31) (2008.1.1 ~ ) R3561 ( ) R3564 R3565 - - [ ] - - R3561, R3562, R3563, R3564, R3565 216

191 44 N0444 ~ N0447 45 N0451 ~ N0453 46 N2461 ~ N2470 N0468 ~ N0469 N0466, N1466 N1460, N1469 46-1 N2471 ~ N2472 47 N0471 ~ N0472 47-1 N0473 ~ N0474 47-2 N0475 48 N0480 48-1 N0630 49 N1491 ~ N1496 49-1 N1497 ~ N1499, N2497 ~ N2499 49-2 N2491 ~ N2492 1 2 9. 44, 45, 46, 46-1, 47, 47-1, 47-2, 48, 48-1, 49, 49-1, 49-2 217

192 S4634 S4635 S4636 S4637 S4633 S4743 ()- ()- ()- ()- - - 1 2 9 [] 463, 474. S4634, S4635, S4636, S4637, S4633, S4743 218

193 N0935 N0936 N0937 () ( ) N0938 ( )- 2014.8.1. 1 2 9. N0935, N0936, N0937, N0938 219

194 N0821 N0822 N0826 N0827 ( ) ( ) ( )- ( )- 1 2 9. N0821, N0822, N0826, N0827 220

195 N0880 N0881-1 2 9 []., -2502,. - - - - - 2 (2014.8.1 ) N0880, N0881 221

196 N0711 N0715 N1711 -[] -[] -[] N1715 -[] N4710 -[]- 14.8.1 N3710 -[]- 14.8.1 N2710 -[]- 14.8.1 N2070 -[]- 14.8.1 N2072 N2712 N3712 -[] -[] -[] N4712 -[] N4717 -[]- 14.8.1 N3717 -[]- 14.8.1 N2717 -[]- 14.8.1 N2077 -[]- 14.8.1 222

,. 1 2 9 /.. N1721 N1725 N3722 N4722 -[]- -[]- -[]- -[]- N3720 -[]-- 14.8.1 N3727 -[]-- 14.8.1 N4727 -[]-- 14.8.1 N4720 -[]-- 14.8.1 : N0711, N0715, N1711, N1715, N4710, N3710, N2710, N2070 : N2072, N2712, N3712, N4712, N4717, N3717, N2717, N2077 223

197 L1211 L1212 L1213 L1214 L1215 L0101 L0102 L0103 () 1 2 6 1. ( ).. L1221 L1222 L1223 L1224 L1225 [115] [115] [115] [115] [115] L0101 L0102 () L0103 L1211, L1212, L1213, L1214, L1215, L0101, L0102, L0103 224

198 21 LA210 LA201 ~ LA206 (Epidural PCA) 22 LA321 ~ LA322 LA222 ~ LA228 22-1 LA330 23 LA340 ~ LA341 LA232 ~ LA234 LA241 ~ LA245 24 LA346 ~ LA347 LA247 ~ LA249 LA270 ~ LA275 25 LA251, LA253, LA352 ~ LA356 LA357 ~ LA359 LA261 26 LA361 ~ LA362 LA264 ~ LA265 LA366 ~ LA367 51 LY051 ~ LY052 2017.2.1. 1 2 6 3. 6 3 225

199 31 LB310 32 LB320 33 LB331 LB333 ~ LB336 34 LB341 ~ LB346 35 LB351 LB412 ~ LB413 LB353 ~ LB355 71 LX071 1 2 6 4. 6 4 226

200 (, ) O7020 [1] O7061 O7062 - -[1]. 1.5 ~ 3L 2 ~ 4. : 17, 1 2 9 [],.. ([1] O7020 & - O9991) (, ) : O7020, : O7061, O7062 227

201 O7031 O7032 O7051 O7052 - [ ] - [1] - [ ] - [1] 1 2 9 []. O7031, O7032, O7051, O7052 228

202 1 2 (, ) 1 2 16. 1, 2 229

203 MM010 [ 101] MM011 () [ 101-1] MM012 () [ 101-1] MM015 () [ 101] MM020 [1] [ 102] MM030 [1] [ 103] MM070 [TENS] [ 104] MM080 (ICT) [ 104] MM090 [1] [ 105] MM101 [1] [ 106],,,,,. : _ 1 2 7. _ 101, 101-1, 102, 103, 104, 105, 106 230

204 MM042 [1] [ 110] MM041 MM043 ~ MM046 MM049 [1],,,, [ 111] MM170 [1] [ 111-1] MM051 ~ MM052 -, [ 112] MM060 [ 113] MM085 [1] [ 115] MM102 ~ MM103 -, [1] [ 116] MM161 [] [ 117] MM190 [1] [ 119] MM200 [1] [ 120] MX121 [1] [ 121] _ 1 2 7. _ 110, 111, 111-1, 112, 113, 115, 116, 117, 119, 120, 121 231

205 _ MM047, MM048 -, [1] [ 121] MM105 [ 122] MM111 ~ MM113 -,, [ 123] MM114 [1] [ 124] MM120 [ 125] MM151 [ 126], MM131, MM132 _ 2 [1] [ 127] MM141 ~ MM143 -,, [ 128] MM290 [1] [ 129] MM301, MM302 -, [ 130] MX141 [ 141] MZ008 (2015.8.1.) [ 131] _ 1 2 7. MZ008 : 2015.8.1 _ 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 141, 131 232

206 MM300 [1] [ 30] MM303 [ 30-1] MM310 [1] [ 31] MM320 [1] [ 32] MM331 ~ MM334 [1] [ 33] MM341 ~ MM344 [PUVA, Goeckermann, Ingram ] [ 34] MM350 [1] [ 35] MM360 ( ) [1] [ 36] MM380 Air Fluidized Theraphy[ ] [1] [ 38] MM400 [1] [ 40] MM410 [ 41] MM420 [1] [ 42] MM430 [1] [ 43] MM440 ~ MM441 [1] 2017.1.1. [ 44] MM451 ~ MM453 2017.2.1. [ 45] MX031 [1] [ 31] MX032 [1] [ 32] MX034 [1] [ 34] MX035 [ ] [ 35] MX036 [1] [ 36] 1 2 7. 30, 30-1, 31 ~ 36, 38, 40 ~ 45, 31 ~ 36 233

207 NN031 NN032 () () _ 1 2 8. _ NN031, NN032 234

208 NN011 NN012 NN013 () () () _ 1 2 8. _ NN011, NN012, NN013 235

209 NN021 NN022 NN023 _ 1 2 8. _ NN021, NN022, NN023 236

210 () () U2232 U2233 (1/3) [] (). 1 2 10 2, 23. () 2013-104 - 20 1. -,,, 100% (2012-109) UH232, UH233. UH232, UH233( ). U2232, U2233(UH232, UH233 : ) 237

211 _ 1 _ 2 _ 3 UB111 ~ UB119 [1]- (1) [1]- UB121 ~ UB129 () UB131 ~ UB139 [1]- 1 2 18. () 2016-112, 16.7.1 1.. (Maxilla or Mandible) (, ) (PFM Crown).. 1 2().,.( ) ( ) - 2014-100(14.7.1.) : 75 - - 2015-103(15.7.1.) : 70-2016-112(16.7.1.) : 65 UB111 ~ UB119, UB121 ~ UB129, UB131 ~ UB139 238

212 1 UA101 ~ UA109 [1]- 2 UA111 ~ UA119 [1]- 3 UA121 ~ UA129 [1]- 4 UA131 ~ UA139 [1]- 5 UA141 ~ UA149 [1]- 1 2 18,,, (3 ). (, ) _ 2016-112. (1) (, ) : (2) : ( ). : 7 1. - ( ) ( ) - 2012-71 (12.7.1.) : 75 - - 2015-103(15.7.1.) : 70-2016-112(16.7.1.) : 65 UA101 ~ UA109, UA111 ~ UA119, UA121 ~ UA129, UA131 ~ UA139, UA141 ~ UA149 239

213 AN100 14.7.31. AN200 []- AN300 AN400 []- []-, 14.8.1. AN500 []-, 1 2 1. 2014 8 1. AN100, AN200, AN300, AN400, AN500 240

214 AI101 AI102-4 -5 2014.8.1. (), 2014-126(), (2014.8.1.) (Multidisciplinary Care).. : (V193) (V027). (1) (2). [ ()].. (Primary tumor) 3 ( )., 2. AI101, AI102 241

215 AC101 -, 2015.12.31 AC103 -, AC105 - V1100 - V1200 -(B) V1210 -(A) V1220 -(C) 2016.1.1 V1300 -(B) V1310 -(A) V1320 -(C) V1400 - V1500 -_(B) V1510 -_(A) V1520 -_(C) 2017.1.1. V1800 -_(B) V1810 -_(A) V1820 -_(C) 2016.1, AC101, AC103, AC105. _ 2015-241(), 2016.1.1. 2 1. AC101, AC103, AC105, V1100, V1200, V1210, V1220, V1300, V1310, V1320, V1400, V1500, V1510, V1520, V1800, V1810, V1820 242

216 AK100 ~ AK401 AK110 ~ AK411 (1), (2), (3), (4) (1), (2), (3), (4), 12 1 [] 2- (5). _ 2016-268. ANC 500/ Grade (GVHD) AIDS. - : ANC 3 500/ - : Grade GVHD Grade - :. -10 243

217 (9) AJ110 ~ AJ190 AJ100 AJ210 ~ AJ290 AJ200 AJ310 ~ AJ390 AJ300 AJ510 ~ 590 AJ500 1~9 7 1~9 7 1~9 7 1~9 7 2015-145(2015.9.1.) : 9 5 (AJ110, AJ120, AJ130, AJ100, AJ150) / () () (9) AJ111 AJ121 AJ101 AJ141 AJ211 AJ221 AJ201 AJ241 AJ311 AJ321 AJ301 AJ341 AJ111 AJ121 AJ131 AJ101 AJ151 AJ211 AJ221 AJ231 AJ201 AJ251 1 2 3 4 5 1 2 3 4 5 1 2 3 4 2016-209(2016.12.1.) : 4 5 -, - 4, AJ112 AJ122 AJ102 AJ142 1 2 3 4 (9) AJ212 AJ222 AJ202 AJ242 1 2 3 4 2015-145(2015.9.1.) AJ312 AJ322 AJ302 AJ342 1 2 3 4 244

1 2 1-9 3 3 4.... -9,. 245

C H A P T E R & HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE

218 : (N20, N21, N22, N23) R3505 [,, ] R3506 (2 5,1) R3507 (5 10,1) R3211 [][, ] R3370 [] R3375 [, ] R3216 () R3217 () R3218 () R3421 () R3422 () R3423 () R3424 - R3425 -() R3426 -() R3427 -() R3390 R3461 (, ) R3511 (, ) R3671 () R3672 () R3673 () N20, N21, N22, N23, 1 9 []. N20,N21,N22,N23 R3505 ~ R3507, R3211, R3370, R3375, R3216 ~ R3218, R3390, R3421 ~ R3427, R3461, R3511, R3671 ~ R3673 248

219 : (N40) R3950 R3516 R3975 R3976 R3977 N40, 1 2 9 []. N40 R3950, R3516, R3975, R3976, R3977 249

220 : (C53, D06), (C54, D070) R4250 R4154 R4155 R4156 R4157 R4143 R4144 R4145 R4146 [] - - ( )- ( )- [ ] ( )- ( )- [ ] C53, C54, 1 2 9 [, ]. C53, D06, C54, D070 R4143 ~ R4146, R4154 ~ R4157, R4250 250

221 : MYOMA(D25), (O341) R4143 ~ R4146 R4154 ~ R4155 R4073 ~ R4074 R4221 R4427 ~ R4428 R4482 - - -,. : (R4507 ~ R5002) D25, O341 R4143, R4144, R4145, R4146, R4154, R4155, R4073, R4074, R4221, R4427, R4428, R4482 251

222 : (C16), (D002) QA536 - Q2533 ()- 253 Q2534 ()- Q2536 ()- Q2537 ()- Q2550 () 255 Q2551 ()- Q2552 ()- 256 Q2561 Q2562 () () Q2571 () 257 Q2572 () Q2573 (Roux-en-Y) Q0259 - Q2594 ()- 259 Q2598 Q0251 ()- ()- Q0252 ()- Q0253 ()- 252

Q0258 ()- Q0256 ()- 259 Q0257 ()- Q0255 ()- Q0254 ()- C16, 1 2 9 []. C16, D002 253, 255 ~ 257, 259 253

223 : (C73) P4551 P4552 P4553 P4554 P4561 [,, ] ()- [,, ] ()- [,, ] ()- [,, ] ()- C73, 1 2 9 []. C73 P4551 ~ P4554, P4561 254

224 : (C50), (D05) N7131 N7132 N7133 N7134 N7135 - -[ ] - - -[ C50, 1 2 9 []. C50, D05 N7131, N7132, N7133, N7134, N7135 255

225 : (C23), (D0151) Q7410 Q7380 (Gallbladder carcinoma).,,,,,,,. :,,,. : C23, D0151, 1 2 9 [ ]. C23, D0151 Q7380, Q7410 256

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