G000FJ1-2015-120

www.hira.or.kr

C/O/N/T/E/N/T/S

Health

Insura

nce R

evie

w &

Assessm

ent S

erv

ice

1 13

2 14

3 16

4 17

5 (//) 18

6 19

7 20

8 21

9 22

10 23

11 24

,

12 25

13 26

14 27

15 28

16 29

17 30

18 31

19 32

20 33

21 34

22 35

23 36

24 37

25 39

C/O/N/T/E/N/T/S

Health

Insura

nce R

evie

w &

Assessm

ent S

erv

ice

26 40

27 41

28 42

29 43

30 45

31 46

32 47

33 48

34 49

35 50

36 51

37 () 52

38 53

39 54

40 55

41 56

42 57

43 58

44 59

45 60

46 61

47 62

48 ( ) 63

49 64

50 65

51 66

C/O/N/T/E/N/T/S

Health

Insura

nce R

evie

w &

Assessm

ent S

erv

ice

52 67

53 () 68

54 69

55 70

56 71

57 72

58 73

59 ADHD 74

60 75

61 76

62 77

63 78

64 79

65 80

66 81

67 82

68 83

69 84

70 85

71 86

72 87

73 88

74 A 89

75 B 90

76 C 91

77 92

78 93

79 94

80 96

C/O/N/T/E/N/T/S

Health

Insura

nce R

evie

w &

Assessm

ent S

erv

ice

81 97

82 (Scabies) 99

83 100

84 101

85 103

86 104

87 105

88 106

89 (COPD) 107

90 108

91 109

92 110

93 111

94 115

95 116

96 117

97 118

98 (_) 119

99 120

100 121

101 122

102 124

C/O/N/T/E/N/T/S

Health

Insura

nce R

evie

w &

Assessm

ent S

erv

ice

103 126

104 127

105 128

106 129

107 130

108 CT 131

109 MRI 132

110 PET 133

111 134

112 135

113 136

114 () 137

115 () 138

116 () 139

117 () 140

118 () 141

119 () 142

120 () 143

121 () 144

122 145

123 146

124 147

125 _ 148

126 149

127 150

C/O/N/T/E/N/T/S

Health

Insura

nce R

evie

w &

Assessm

ent S

erv

ice

128 _ 151

129 _ 152

130 _ 153

131 154

132 155

133 _ 156

134 _ 157

135 _ 158

136 159

137 160

138 161

139 () 163

140 164

141 165

142 166

143 167

144 PCI 168

145 171

146 172

147 (, , ) 173

148 174

149 175

150 177

&

1.

2.

1) (http://www.hira.or.kr)

3.0

2) (http://opendata.or.kr)

or

Setion I

Health Insurance R

eview &

Assessm

ent Service

Setion I

Health Insurance R

eview &

Assessm

ent Service

1

M4712 ,

M4713 ,

M4722 ,

M4723 ,

M50

M542

M9951

M47 M50

, M54 607 2., 3.

, M99 637

1.

: ()

:

M50, M542, M4712,

M4713, M4722, M4723, M9951

| 13

2

1

M80

M81

M82

2

+

M80

M81

M82

104601ACS, 104601ATB, 104602ACS alfacalcidol

121401ACS, 121402ACS calcifediol

121601ACS, 121604ACS, 121604ATB calcitriol

147401ATB disodium etidronate

177201ATB ipriflavone

207901ACS pamidronate disodium

228301ATB, 228302ATB, 228303ATB sodium alendronate

358001ATB raloxifene HCl

442301ATB, 442302ATE, 442303ATB risedronate sodium

468000ATE calcitriol+sodium alendronate

480304ATB ibandronic acid monosodium salt monohydrate(as ibandronic acid 150mg)

481100ATB, 481100ATR cholecalciferol(as vitamin D3 2800I.U) + sodium alendronate(as alendronic acid)

500200ATB cholecalciferol(as vitamin D3 5600I.U) +sodium alendronate(as alendronic acid)

500901ATB risedronate

511200ATB cholecalciferol concentrate(cholecalciferol 5600I.U) +risedronate sodium

518400ATB cholecalciferol (30000I.U) +risedronate sodium

518400ATB cholecalciferol (30000I.U) +risedronate sodium

617101ATB bazedoxifene acetate (as bazedoxifene)

151101BIJ, 151102BIJ, 115103BIJ elcatonin

207902BIJ, 207903BIJ pamidronate disodium

225701BIJ, 225703BIJ salcatonin

480301BIJ, 480302BIJ, 480303BIJ ibandronic acid monosodium salt monohydrate(as ibandronic acid 2mg)225702CSI, 225704CSI, 225706CSI, 225708CSI, 225709CSI, 225710CSI, 225711CSI

salcatonin

14

M80M82

, (ex: ) 1

1. , .

- -. Estrogen T-score -1 (T-score -1.0). Elcatonin, Raloxifene, Bazedoxifene, Vit D3 Bisphosphonate

( )

1) ) [Central bone; , (Ward's triangle ): (Dual-

Energy X-ray Absorptiometry: DEXA) T-score -2.5 (T-score -2.5)

) (QCT) : 80/ ) ), ) : T-score -3.0 (T-score -3.0))

2) : 1 ,) ) 6 ) ), ) 1 , ) 3 ,

T-score -2.5 (QCT 80/ ) .. X-ray

2. (Estrogen, Estrogen derivatives ) (Bisphosphonate, Elcatonin, Vit.D3, Raloxifene Bazedoxifene ) , . .

- -. . . Bisphosphonate Vit. D (: Alendronate + Cholecalciferol )

3.

M80 - M82

| 15

S02, S12, S22, S32, S42, S52, S62, S72, S82, S92, T02,

T08, T10, T12, T142

. ,

S02, S12, S22, S32, S42, S52, S62, S72, S82, S92, T02,

T08, T10, T12, T142

S - :

T - :

3

S02

S12

S22 ,

S32

S42

S52

S62

S72

S82

S92

T02

T08

T10

T12

T142

16

4

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

,

(M00-M03),

(M04-M14), (M15-M19) (M45)

M00, M01, M02, M03, M05, M0, M07, M08, M09, M11, M12,

M13, M14, M15, M16, M17, M18, M19, M45

| 17

(, , )5

M00 M01 M02 M03

M05 M06 M07 M08 M09 M10 M11 M12 M13 M14

M15 M16 M17 M18 1 M19

- M00-M03, M05-M14, M15-M19

[ M00-M19] , [ M00-M03] - [

M05-M14] - [

M15-M19]

.' '

(,,)

18

6

M05

M06

M05

, M06

M080 ,

M05, M06

| 19

7

S72080 ,

S72081 ,

S72080, S72081

S72080

, , S72081 ,

: ,

, :

20

8

S934

T132 ,

S934 ,

T132 ,

-

-

:

S934, T132

| 21

9

M750 ()

M750

()(M750)

22

()10

()

M4002 , (Postural kyphosis, cervical region)

() M4002

M4002

, M4002 ,

M4002

()

| 23

11

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

(M40-M54)

(M40-M54)

- : () ( ,

) - : , , ,

cf) : , . . (rheumatoid factor) , .

:

( )

24

12

E10

E11

E12

E13

E14

E10-E14

1 -14

2. : E10-E14

E10-E14 E10 - E14 ()

1 -14 2.

: E10-E14

| 25

13

(E10-E14)

: 4 5 E10-E14

.7

.70 ()()()

.71 ()()()

E1070, E1071, E1170, E1171, E1270,

E1271, E1370, E1371, E1470, E1471

(E10-E14)

: 4 5 E10-E14

.

E10-E14 .7

.70 ()()(),

.71 ()()()

26

14

E66

[ 2]

,

,

E66

E66

E660

E661 -

E662

E668 ()

E669

| 27

15

1E301

leuprolide acetate, triptorelin acetate

2 E301

E301

- leuprolide acetate, triptorelin acetate

(182602BIJ, 182604BIJ, 244902BIJ)

, E301

2

28

16

E50 A

E51

E52 []

E53 B

E54

E55 D

E56

E58

E59

E60

E61

E63

E64

(E50-E64)

E50 - E64

| 29

17

E40

E41

E42 -

E43 -

E44 -

E45

E46 -

(E40-E46)

E40 - E46

30

18

H442

H521

H442 , H521

,

- , , ,

:

H442, H521

| 31

19

H40

H42

H40, H42

(H40-H42)

32

()20

H30

H31

H32

H33 ()

H34

H35

H36

H43

() (H30-H36)

H30,H31, H32, H33, H34, H35, H36

()

| 33

21

1 H041

2H041

M350 []

H041

, H041

M350

1

34

22

H101

H1625 ,

.

H101 , H1625

,

(mast cell) (basophil)

(eosinophil)

:

H101, H1625

| 35

23

H3530

H3531

H3534

H3539 ( )

H3530, H3531, H3534, H3539

. H35

H3530 , H3531

, H3534 , H3539

,

:

36

24

1

E78

I10-I15

E10-E14

I60-I69

I05-I09I20-I52

2

E78

I10-I15

E10-E14

I60-I69

I05-I09

I20-I27 I30-I52

3

(, )

E78

I10-I15

E10-E14

I60-I69

I05-I09

I20-I27 I50-I52

| 37

, , , 3

() ,

, , , 5

- , , ,

-

(I05I52) I05, I06, I07, I08, I09, I26, I27, I30, I31, I32,

I33, I34, I35, I36, I37, I38, I39, I40, I41, I44, I45, I46, I47, I48, I49

: E78 : I10 - I15 : E10 - E14 : I60 - I69 : I20 - I25, I28, I42 - I43, I50 - I52

E78

I10-I15

E10-E14

I60-I69

I20-I25I28 I42-I43I50-I52

38

1, 2 -14 2.

( :I10-I13,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)

25

I10-I13,I15 E10-E14 I05-I09,I20-I27,I30-I52 I60-I69 C00-C97,D00-D09,D32-D33,D37-D48

B18-B19, K70-K77 F00-F99,G40-G41 A15-A16, A19 G00-G37,G43-G83 E00-E07 N18 M00-M19,M45

: I10-I13, I15 : E10-E14

: F00-F99,G40-G41 : I60-I69

: A15,A16,A19 : E00-E07

: I05-I09, I20-I27, I30-I52 : N18

: G00-G37,G43-G83 : M00-M19,M45

: B18,B19, K70-K77 : C00-C97, D00-D09, D32-D33, D37-D48

| 39

26

1

N96

N97

E282

E230

N97, N46

N97, N46 3

, N96 E282 E283 E230 I861 Q553

2

N97

N46

E282

E283

I861

Q553

4

N96

N46

N97

3N97

N46

40

27

R35 //

(R35) - 3.1.2 4

: 3

,

- R35

, 3.1.2 4

R35

R35

| 41

28

N20

N21

N22

N23

N20-N23

(N20-N23)

42

29

E78

I10-I15

E10-E14

M80-M82

E66

I05-I09,I20-I27,I30-I52

K70, K758, K760 ,

C50,D05

C18-C20,D010-D012

C61,D075

C53-C55,D06,D070

C22,D015

C32,D020

C15,D001

C00-C14, D000 (,)

C16,D002

C25,D017

C64

C67,D090

C34,D022

| 43

1996

, 2003

.

, , , ,

, ,

, , , , , , , ,

, , , ,(, ), , , , ,

:

: E78 : I10-I15

: E10 -E14 : M80 -M82

: E66 : I05-I09, I20-I27. I30-I52

: K70

C50,D05 C18-C20,D010-D012 C61,D075

C53-C55,D06,D070 C22,D015 C32,D020

C15,D00 C00-C14, D000 C16,D002

C25,D017 C64 C67,D090 C34,D022

44

30

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

, , ,

:

. ,

| 45

31

K50 [ ]

K51

[ ],

(K50,K51) -

K50-K51

46

32

1K70

K700

, (K70

K77) K700, K758, K760 2

(3) K70( ) (4) ,

, ,

K700, K758, K760

2

K700

K758

K760

| 47

33

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-S99, T00-T14

S00-S09, S10-S19, S20-S29,

, , S30-S39,

S40-S49, S50-S59,

S60-S69, S70-S79, S90-S99,

T00-T07,

T08-T14

48

34

I10

I11

I12

I13

I15

I10-I15

I10-I15

I10-I13 (

) 1 -14 _

2. I10-I13,I15

I15

| 49

35

I60

I61

I62

I63

I64

( )

( )

(I60-I69)

I60, I61, I62, I63, I64

()

I60

I61

I62

( )

I63

I64

50

36

I21

I22

(I21,I22)

I21, I22

I21()

-

| 51

()37

()

I83

I87

I83, I87

()(, , )

, ,

, . . :

(I83), (I87)

, , , , ,

,

()

52

38

I84 //

(I84) - 3.1.2 4

: 3

,

- I84 ,

3.1.2 4

I84

I84

| 53

39

I20

I20

>> ,

(I20)

54

40

I710 [ ]

I711

I712

I715

I716

I718 NOS

I719

.

(I71) [ ]

(I710), (I711), (I712),

(I715), (I716),

NOS(I718), (I719)

,

, :

I710, I711, I712, I715, I716, I718, I719

| 55

41

G474

G474

(narcolepsy) G47

G474 (narcolepsy and cataplexy)

56

42

1

C18

C19

C20

,

[3]

, (C18~C20)

(D010~D012) 2

1

C18 - C20, D010 - D012

C18 - C20 ()

2

C18

C19

C20

D010

D011

D012

| 57

43

F630

Z726

F630, Z726

F630 , Z726

F630

, ,

,

: (F30.-)

58

44

C91

C92

C93

C94

C95

C91-C95

)

C91-C95

(AML) C920

(CML) C921

(ALL) C91

(SAA) D60

(MDS) D46

C90

() C85

() C81

| 59

45

T36

T37

T38 ,

T39 ,

T40 []

T41

T42 , -

T43

T44

T45

T46

T47

T48 ,

T49 ,

T50 ,

T36-T50

,

(T36-T50)

60

46

C53

D06

C53 ,

D06

(corpus) (cervix) ,

:

C53, D06

| 61

47

D25 myoma

O341

D25myoma, O341

1) (Submucous myoma): ()

2) (intramural myoma): ,

,

3) (subserous myoma):

D25, O341

:

62

()48

()

C54

D070

()

C54 ,

D070

, .

:

C54, D070

| 63

49

D27

D391

D282

C56

C57

C796

C56, C57, D27, C796, D282, D391

C56

, C57 , C796

,

D27 , D282 ,

D391

,

,

: ,

64

50

C43

C44

C792

D04

, , , , ,

[3]

, (C43, C44, C792)

(D04)

C43, C44, D04, C792

| 65

51

L570

L570

. L570

, 20% :

66

3 . J30 , J450 , J46 , . [ ] L20 , L22 [], L23 , L24 , L25 L27 , L50 , . H101 , H1625

( ) , . ,

: ,

J30, J46, L20, L22, L23, L24, L25, L27,

L50 H101, J450 H1625

52

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

| 67

()53

()

T652

F170

F171

F172

T652, F170, F171, F172

(T672),

(F170), (F171),

(F172)

()

:

()

68

54

T630

T631

W59

X20

T63

T630 , T631 , W59

, X20

20 ,

(V,W,X,Y)

(: -VY.

)

[] :

T630, T631, W59, X20

| 69

55

X23 ,

,

(X23)

20 ,

(V,W,X,Y)

(: -VY.

)

X23

70

56

(T67)

- , ,

, ,

- T67

T67

T67

T67 "

T670

T671

T672

T673

T674

T675

T676

T677

T678

T679

| 71

57

T20

T21

T22

T23

T24

T25

T26

T27

T28

T29

T30

T31

T20 - T31

, ,

(T20-T31)

72

58

L93

M32

. , .

L93 , M32

(Systemic lupus erythematosus)

,

-

, , , , ,

.

-

L93, M32

| 73

ADHD( )59

ADHD F900

F900

ADHD

(F900)

attention deficit hyperactivity disorder, (ADHD)

ADHD

74

60

F500

F501

F508

(F50)

- ,

,

F500, F501, F508

| 75

61

F452

F452

F452

,

,

76

62

F530 ,

F530 ,

NOS

F530

| 77

63

F100

F101

F102

F103

F100, F101, F102, F103

F100 ,

F101 ,

F102 ,

F103

78

64

F431

F43

F431

F431

| 79

65

F32

F33

F32, F33

F32, F33

80

66

F840

F841

.

(F80-F89) F84 ,

: 3 -, ,

. 3

, (), ,

, .

:

F840, F841

| 81

67

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

(F00-F99)

1 -14 _2.

F00-F99,G40-G41

F G40, G41

82

68

F31 ()

F31

F31

| 83

69

1

F00

F01

F02

F03

F00 - F03

, , , , ,

F00 - F03 1

G30 ,

2

F00

F01

F02

F03

G30

84

70

F502

F503

F504

F505

,

,

(F50)

- , ,

,

F502 - F505

| 85

71

H65

H66

H67

H65 - H67

. ,

(H66-H75) (H65),

(H66), (H67)

, ,

:

86

72

P07

P07

(WHO) 37 259

(preterm infant) .

OECD

P07

P070

P0700 500g

P0701 500-749g

P0702 750-999g

P0709

P071

P0710 1000-1249g

P0711 1250-1499g

P0712 1500-1749g

P0713 1750-1999g

P0714 2000-2499g

P0719

| 87

73

K02 (Dental caries)

.

K02

K020 / ()

K021

K022

K023

K024 //

K028 ,

88

A74

A B15 A

A A(B15)

, , ,

,

B15

A

| 89

B75

1 B16 B

B16, B170, B180, B181

B (B15B19) B

2

, , ,

,

B

2

B16 B

B170 B ()

B180 - B

B181 - B

90

C76

CB171 C

B182 C

C C, C

(B171, B182)

, , ,

,

B171, B182

C

| 91

77

1

A15 A16 A17 A18 A19

A15 - A19, U880, U881, P370,

O980, B200

(A15~A19) 2

, -

A15 - A16, A19 A15 - A16, A19

, , , ,

A15 A16 A17 A18 A19

2 U880 U881 P370 O980 , B200 HIV

92

78

B850

,

(B85-B89) B850

B850

| 93

79

1

A50

A51

A52

A53

A54

A55 ()

A56

A57

A58

A59

A60 []

A63

A64

2

A50

A51

A52

A53

A54

A55 ()

A56

A57

A58

A59

A60 []

A630 ()

N341

B20 [HIV]

B21

B22

B23

B24

94

-

(A50 - A64) 1

(B20 - B24) (

)(N341)

, , ,

,

A50 - A64

| 95

80

B084

B084

(B084)

- A16 71 ,

,

, , ,

,

96

81

1

A02

A03

A04

A05

A06

A07

A08

A09

T61

T62

2

A02

A03

A04

A05

A06

A07

A08

T61

T62

5

A02

A03

A05

T61

T62

3 A05

4 A09

| 97

A02, A03, A05, T61, T62

(A00-A09) A02 A03

A05 T61

T62 5

A04

A06

A07

A08

A09

, , ,

,

,

, ,

,

98

(Scabies)82

(Scabies) B86 Sarcoptic itch

B86

(Scabies mite)

: .

4~6

1

.

. ()

()

() .:

,

B86

| 99

83

A04

A06

A07

A08

A09

A04, A06, A07, A08, A09

A04 , A06 , A07 , A08 , A09

[]

:

[ ] A02

A03

A05

T61

T62

, , , ,

100

84

A021

A207

A227

A241

A267

A327

A40

A41

A427

A548

B007

B377

J950

O080, O00-O07

O753

O85

P36

T802 ,

T814

T880

R650

R651 /

| 101

A40-A41,O85,P36

A021,A207,A227,A241,A267,A327,A427,A548,B007,B377,J950,

O080,O753,T802,T814,T880,R650,R651

- ()

. , (A30-A49): / / / /

/ / / /

. :/

. , :

., : / , /

. :

. , ,

(T80-T88)

: , / /

. , : /

, , , ,

102

85

L29

L29 65

,

(Serotonin), E(Prostaglandin E),

(Tachykinin), (Cytokines), (Protease),

(opioid peptides) :

,

L29( 65 )

| 103

2

L63

L64

L65

L66 [ ]

L67

Q84

86

1

L63

L64

L65

L66 [ ]

L63 - L66

1

104

87

D50-D53 (D50-D53)

D55-D59 (D55-D59)

D60-D64 (D60-D64)

D65-D69 , (D65-D69)

D70-D77 (D70-D77)

D80-D89 (D80-89)

(D50-D53),

(D55-D59), (D60-D64),

(D70-D77), (D80-D89)

D50 - D89

| 105

88

1 J00 []

J00 - J06

(J00 - J06) 2

(influenza) (J09-J18)

2

J00 []

J01

J02

J03

J04

J05 []

J06

106

(COPD)89

(COPD)

J431

J432

J438

J439

J44

(COPD)

.

J431 , J432

, J438 , J439

J44

: ,

J44, J431, J432, J438, J439

| 107

90

J30

J00

J310

J00, J30, J310

, - (J30), (J00),

(J310)

, .

:

108

91

J09

J10

J11

J09

, J10

, J11

A B

hemagglutinin(H) neuraminidase(N)

:

J09-J11

| 109

92

J12

J13

J14

J15

J16

J17

J18

J12 - J18

(J09-J18)

( J12-J18)

110

93

1

J30

J45

L20

J46

:

J45 , : J46 , J44.-

()

: J30 : L20 : J45

2

J30

J45

J46

L20

| 111

Health Insurance R

eview &

Assessm

ent Service

Setion II

Health Insurance R

eview &

Assessm

ent Service

Setion II

| 115

AN100

AN200 []-

AN300 []-

AN400 []-,

AN500 []-,

94

1

2 1

AN100 14 7 31 , 14 8 1

AN100, AN200, AN300, AN400, AN500

116

1

2 ( , )

95

1

2 16

1, 2

| 117

E7660

E7670

E7680 S

96

: (, , )

( ) , ,

S

1 2

2 4 ,

, , , S

E7660, E7670, E7680

118

E7611

97

- (,

)

1

2 2 4 ,

,

E7611

L1211

L1212

L1213

L1214

L1215

L0101

L0102 ()

98

| 119

1

2 6 [] ,

L1211, L1212, L1213, L1214, L1215, L0101,

L0102

| 119

120

21

22, 22-1

,

23

24

25 ,

26

51

99

1

2 6

3

6 3

31

32

33

34

35

71

100

| 121

1

2 6

4

6 4

122

G0011-0015 (CR) (DR)

101 C-ARM (G0400)

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)

152 (G5201-G5205)

155 (G5501)

156 (G5601-G5605)

101

| 123

1

2 3

1

3 1

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)

124

941 E9411-E9418(, , , , , )

942 E9421-E9422 (, )

943EA431-EA434E9431-E9439

(, , , , , )

944 E9441-E9449 ,(, )

945 E9451-E9454 , (, , )

946 E9461-E9467 (, , , )

947 E9471-E9474 (, )

102

1

2 2

[4 , , ]

( 2015-43())1.

, .

, , .

2.

.

- -

. 5 (V193)

(1) 1, 1, (2) (1) : 1 2

| 125

. I60I62

(V191, V268):

2

. (V192):

3

. 5

(V001~)(1) 1 2, (2) , (V005, V013,

V014, V015) 2

941-947

126

R3561 ( )

R3562 ( )

R3563 ( )

R3564 - - []

R3565 - -

103

1

2 9

( )

(2007.12.31) (2008.1.1 ~ )

R3561

( )

R3564 - - []

R3565 - -

R3562, R3563, R3564, R3565

| 127

R3148,RA318,R3146,RA317R3143,RA316,R3141,RA315

R4362,RA362,R4361,RA361

R3138,RA314,R3136,RA313R3133,RA312,R3131,RA311

R4358,RA434,R4356R4356,RA433,R4353,RA432R4351,RA431

R4507,R4508,R4509R4510,R4514,R4516,R4517R4518,R4519,R4520,R5001 R5002

R4380, RA380

V0111,V0112,V0121,V0122V0131,V0132

104

1

2 9

[, ]

R4358, R4356 2010.1.31

-435, -436, -438, -450, -451

-1

128

Q7701 -

Q7702 - (1 1)

Q7703 -

105

1

2 9

[ ]

Q7701, Q7702, Q7703

| 129

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

49-1N1497-N1499, N2497-N2499

49-2 N2491-N2492

106

1

2 9

44, 45, 46, 46-1, 47, 47-1,

47-2, 48, 48-1, 49, 49-1, 49-2

130

107

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

| 131

CT 245

245-1 Cone Beam

(Computed Tomography)108

,CT 1

2 3

2

: 245 2 CT

245, 245-1

, CT

132

MRI 246

(Magnetic Resonance Imaging)109

1

2 3

2

246

, MRI

PET

335

HC351 F-18 -

HC352 F-18 -

HC353 F-18 -

HZ223 F-18 FP-CIT

HZ331 F-18 FDG -

HZ332 F-18 FDG -

HZ333 F-18 FDG -

HZ334 F-18 FDG -

HZ335 F-18 FDG -

HZ336F-18 FDG -

(Positron Emission Tomography)110

| 133

1

2 3

3

HC351 F-18 -

2014.8.14HC352 F-18 -

HC353 F-18 -

HZ223 F-18 FP-CIT

335, 335-1, 335-2

, PET

134

Q7280 -

Q7281 -

QZ841 -

111

1

2 9

,

Q7280, Q7281, QZ841

| 135

P4551 ()-

P4552 ()-

P4553 ()-

P4554 ()-

P4561

112

1

2 9

[] ,

C73

D093

D34

P4551, P4552, P4553, P4554, P4561

136

N7131 -

N7132 -[]

N7133 -

N7134 -

N7135 -

113

1

2 9

C50 , D05

N7131, N7132, N7133, N7134, N7135

| 137

_S5371 -

S5372 -

_114

_ 1

2 9

:

S5371, S5372

_

138

_

Q8040-Q8044 -

Q8045-Q8050 -

Q8140-Q8144 --

Q8145-Q8150 --

_115

_ 1

2 9

_

:

804

_

| 139

_S5011 -

S5012 -

_116

_ 1

2 9

, ,

S5011, S5012

_

140

_

Q8121 --

Q8122 --

Q8123 -

_117

_ 1

2 9

, ,

( ,

) ,

:

Q8121, Q8122, Q8123

_

| 141

_ R3280

_118

_ 1

2 9

( )

()

:

R3280

_

142

_ Q8080

_119

_ 1

2 9

:

Q8070

_

| 143

_Q8061 -

Q8062 -

_120

_ 1

2 9

:

Q8061, Q8062

_

144

_

Q8101 -

Q8102 -

Q8103 -

_121

_ 1

2 9

:

Q8101, Q8102, Q8103

_

| 145

Q2791 -(Feeding Jejunostomy )

Q2792 -

Q2793 -

Q2794 -

Q2795 -

122

1

2 9

()

,

,

:

Q2791, Q2792, Q2793, Q2794, Q2795

146

AJ101,AJ111AJ121,AJ141

-3,1-2,4

AJ201,AJ211AJ221,AJ241

-3,1-2,4

AJ301,AJ311AJ321,AJ341

-3,1 -2,4

AJ100,AJ110AJ120,AJ130AJ140,AJ150AJ160,AJ180AJ190

-7,1-2,3-4,5-6,8-9

AJ200,AJ210AJ220,AJ230AJ240,AJ250AJ260,AJ280AJ290

-7,1-2,3-4,5-6,8-9

AJ300,AJ310AJ320,AJ330AJ340,AJ350AJ360,AJ380AJ390AJ500-AJ590

-7,1 -2,3 -4,5 -6,8 -9

123

1

2 1

9

| 147

O0215-O0217 ()

O0261- O0267 []

O2051 ()(2007.12.31)

O2052 ()

O2061,O2062 ()(2007.12.31)

124

1 2 9

:

O0215-O0217, O0261-O0267, O2051, O2052,

O2061-O2062

148

O7020 [1]

O7061 -

O7062 - [1]

, 125

, 1

2 9

[] ,

( [1] O7020 & - O9991)

R3562, R3563, R3564, R3565

,

| 149

AC101 -,

AC103 -,

AC105 -

126

3 [1]

[ ] 2001-40()

-

2

1 .

1 2

1

AC101, AC103, AC105

150

Q2196 ()

Q2197 ()

127

1

2 9

2007-139()

1. , ,

, ,

, , , -

.

2. ,

, 1

3 .

3. (RDI : Respiratory Disturbance Index) 15

5

,

.

- -

. , , , , , ,

. 85% (2008.1.1 )

Q2196, Q2197

| 151

_

NN031 ()

NN032 ()

_128

_ 1

2 8

NN031, NN032

_

152

_

NN011 ()

NN012 ()

NN013 ()

_129

_ 1

2 8

NN011, NN012, NN013

_

| 153

_

NN021

NN022

NN023 ()

_130

_ 1

2 8

NN021, NN022, NN023

_

154

N0935

N0936 ()

N0937 ( )

131

1

2 9

(), (), (),

()

:

N0935, N0936, N0937

| 155

HC341 []-() (1)

HC342 []-() (2)

HC343 []-

HC344 []-

HC345 []-

132

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

156

_

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]

_133

_ 1

2 7

, , , , ,

:

(, , )

, 1 ( 2011-10, 2011.2.1)

101, 101-1, 102, 103, 104,

105, 106

_

| 157

_

MM042 [1] [ 110]

MM041 MM043-MM046MM049

[ 111],,, ,-[1]

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]

_134

_ 1

2 7

115 104 ( 104

) ,

,

1

( 2009-135(), 2009.8.1 )

110, 111, 111-1, 112, 113,

115, 116, 117, 119, 120, 121

_

158

_

MM047,MM048 -,[1] [ 121]

MM105 [ 122]

MM111-113-, , [ 123]

MM114 [1] [ 124]

MM120 [ 125]

MM151 [ 126]

MM131,MM132 , 2 [1] [ 127]

MM141-143-, , [ 128]

MM290 [1] [ 129]

MM301,MM302- , [ 130]

MX141 [ 141]

MZ008 [ 131]

_135

_ 1

2 7

2015.8.1 MZ008

121, 122, 123, 124, 125,

126, 127, 128, 129, 130, 141

_

| 159

N0821 ( )

N0822 ( )

N0826 ( )-

N0827 ( )-

136

1

2 9

N0821, N0822, N0826, N0827

160

1

2 9

[]

:

N0827 ( )-

N0880

137

N0827, N0880

| 161

N0711 -[]

N0715 -[]

N1711 -[]

N1715 -[]

N1721 -[]-

N1725-[]-

N4710 -[]-

N4720-[]--

14.8.1

N3710 -[]- 14.8.1

N3720-[]--

14.8.1

N2710 -[]- 14.8.1

N2070 -[]- 14.8.1

N2072 -[]

N2712 -[]

N3712 -[]

N4712 -[]

N3722 -[]-

N4722-[]-

N4717 -[]- 14.8.1

N4727-[]--

14.8.1

N3717 -[]- 14.8.1

N3727-[]--

14.8.1

N2717 -[]- 14.8.1

N2077 -[]- 14.8.1

138

162

1

2 9

/

,

(N0711, N2072),

(N0715, N1715, N2712, N4712), (N1711,

N3712) (N1721, N1725, N3722, N4722)

: N0711, N0715, N1711, N1715, N1721, N1725

: N2072, N2712, N3712, N4712, N3722, N4722

| 163

U2232 (1/3)UH232

U2233 []UH233

()139

1 2 10 2 , U2232, U2233, UH232, UH233

:

[2] 3 (23-1)

- -

. 23-1 . 1/3

(1)

(2)

(3)

. 23-1 .

20

1 . (2013.7.1. )

UH232,UH233 ( )

- 2012-109, 100%

U2232, U2233, UH232, UH233

164

_1

UB111-UB119 [1]- (1)

_2

UB121-UB129 [1]-()

_3

UB131-UB139 [1]-

140

1 2 18

, ,

:

( 2015-103, 2015.7.1) 1.

. 70 (Maxilla or Mandible) (, ) (PFM Crown)

. - 1 2() . ,

.

(1) 3 -

(2) 3 -

/ -

( 2015-103, 2015.7.1)

UB111-UB119, UB121-UB129, UB131-UB139

| 165

1 UA101-UA109 [1]-

2 UA111-UA119 [1]-

3 UA121-UA129 [1]-

4 UA131-UA139 [1]-

5 UA141-UA149 [1]-

141

1

2 18

, , , (3 )

(-3638)

- '15.7.1. 75 70

- ( ), (1)

7 1

UA101-109, UA111-119, UA121-129,

UA131-139, UA141-149

O7031 -[]

O7032 -[1]

O7051 -[]

O7052 -[1]

142

1

2 9

[]

O7031, O7032, O7051, O7052

166

| 167

[]

O0261 ( )

O0262 ( )

O0263 ( )

O0264 ( )

O0265 ( )

O0266 ( )

O0267 [ ]

O0215 () - 1~3

O0216 () - 4~6

O0217 () - 7

O2052 ()

143

1 2 9

. , , ()

:

-

O0261-O0267, O0215-O0217, O2052

168

PCI

M6551 ()M6552 ()

M6561 ()M6563 (

)M6562 ()M6564 (

)

M6571 ()M6572 ()

PCI 144

PCI 1

2

9 [ ] ,

,

2015

M6551, M6552, M6561, M6562, M6563,

M6564, M6571, M6572

PCI

Health Insurance R

eview &

Assessm

ent Service

&

Setion III

Health Insurance R

eview &

Assessm

ent Service

&

Setion III

&

| 171

: (N20)

R3505 [,,]

R3506 (25,1)

R3507 (510,1)

R3211 [][,]

R3370 []

R3375 [,]

R3216 ()

R3217 ()

R3218 ()

R3421 ()

R3422 ()

R3423 ()

R3424 -

R3425 -()

R3426 -()

R3427 -()

145

N20 , 1 2 9 []

N20

R3505-R3507, R3211, R3370, R3375,

R3216-R3218, R3421-R3427

: (N40)

R3950

R3516

R3975

R3976

R3977

146

N40 ,

1

2 9

[]

N40

R3950, R3516, R3975, R3976, R3977

172

&

| 173

: (C53,C54)

R4250 []

R4154 -

R4155 -

R4156

R4157

R4143 ( )-

R4144( )- [ ]

R4145 ( )-

R4146( )- [ ]

147

C53, C54 ,

1

2 9

[ , ]

C53, C54

R4143-4145, R4154-4157, R4250

: (C73)

P4551[,,] ()-

P4552[,,] ()-

P4553[,,] ()-

P4554[,,] ()-

P4561

148

C73 ,

1

2 9

[]

C73

P4551-P4554, P4561

1

174

&

| 175

149

: (C16)

253

QA536 - QA533 ( )- , 2007.12.31QA534 ( )- , 2007.12.31QA535 ( )- 2007.12.31Q2533 ()- Q2534 ()- Q2535 ( ) 2007.12.31Q2536 ()- Q2537 ()-

255Q2550 () 256 ()-257 ()-

256Q2561 ()Q2562 ()

257Q2571 ()Q2572 ()Q2573 (Roux-en-Y)

259

Q0259 - QA594 ()- 2007.12.31QA595 ()- 2007.12.31QA596 []()- 2007.12.31QA597 ()- ( ) 2007.12.31QA598 ()-( ) 2007.12.31Q2594 ()- Q2595 ( ) 2007.12.31Q2596 []( ) 2007.12.31Q2597 ()- 2007.12.31Q2598 ()- Q0251 ()- Q0252 ()- Q0253 ()- Q0258 ()- Q0256 ()- Q0257 ()- Q0255 ()- Q0254 ()-

176

C16 ,

1

2 9

[]

C16

253, 255-257,259

&

| 177

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