m RS MDC DRG 01 01 01 01

中風嚴重程度之m. RS 加編 MDC DRG 01 01 01 01 01 01 01419 01420 01421 01422 01423 01424 01425 01426 01427 01428 01429 01430 虛擬碼英文 Modified Rankin scale 5 Modified Rankin scale 2 Modified Rankin scale 3 Modified Rankin scale 4 Modified Rankin scale 0 Modified Rankin scale 1 虛擬碼 ICD 10 I 600005 I 600002 I 600003 I 600004 I 600000 I 600001 例 DRG 01423 特定性腦血管疾患，暫時性腦部缺氧除外，m. RS 2 -4分， 有復健，年齡大於等於 18歲，有合併症或併發症 SPECIFIC CEREBROVASCULAR DISORDERS EXCEPT 　 TRANSIENT ISCHEMIC ATTACKm. RS 2 -4（TIA） WITH REHABILITATION THERAPY AGE ≧ 18 WITH CC DRG 01424 特定性腦血管疾患，暫時性腦部缺氧除外，m. RS 2 -4分， 有復健，年齡大於等於 18歲，無合併症或併發症 SPECIFIC CEREBROVASCULAR DISORDERS EXCEPT 　 TRANSIENT ISCHEMIC ATTACKm. RS 2 -4（TIA） WITH REHABILITATION THERAPY AGE ≧ 18 WITHOUT CC 　 　 PRINCIPAL DIAGNOSIS I 670 Dissection of cerebral arteries, nonruptured I 671 Cerebral aneurysm, nonruptured I 6789 Other cerebrovascular disease R 4701 Aphasia AND 　 SECONDARY DIAGNOSIS 出院時 I 600004 Modified Rankin scale 4 分數 I 600003 Modified Rankin scale 3 I 600002 Modified Rankin scale 2 7

開放性動脈廔管閉塞術 加編 MDC DRG 05 11006 05 11106 虛擬碼英文 PATENT DUCTUS ARTERIOSUS(＜ 2. 5 MM) 虛擬碼 ICD 10 0200002 DRG 11006 開放性動脈廔管(＜ 2. 5 MM)，重大心血管手術(2)，有合併症或併發症 例 PATENT DUCTUS ARTERIOSUS(＜ 2. 5 MM) AND MAJOR CARDIOVASCULAR PROCEDURES(2) WITH CC DRG 11106 開放性動脈廔管(＜ 2. 5 MM)，重大心血管手術(2)，無合併症或併發症 PATENT DUCTUS ARTERIOSUS(＜ 2. 5 MM) AND MAJOR CARDIOVASCULAR PROCEDURES(2) WITHOUT CC PRINCIPAL DIAGNOSIS Q 250 Patent ductus arteriosus AND 　 OPERATING ROOM PROCEDURES Occlusion of Ductus Arteriosus with Intraluminal Device, Percutaneous Endoscopic 02 LR 4 DT Approach 02 LR 4 ZT Occlusion of Ductus Arteriosus, Percutaneous Endoscopic Approach AND 　 OPERATING ROOM PROCEDURES 原ICD 9 0200002 PATENT DUCTUS ARTERIOSUS(＜ 2. 5 MM) 虛擬碼 註：處置碼"0200002"為虛擬處置碼，虛擬處置碼僅用於開放性動脈廔管(PDA)＜ 2. 5 MM 為 0002 進行閉塞術之個案。 8

心房同步雙心室心律調節器 加編 MDC DRG 05 05 05 虛擬碼英文 11606 Atrial synchronous biventricular pacing device implant 11606 Insertion of Lead - Atrial synchronous biventricular pacing device implant 11606 Atrial synchronous biventricular pacing device implant and lead insertion 虛擬碼 ICD 10 0200003 0200004 0200005 DRG 11606 心房同步雙心室心律調節器裝置術 ATRIAL SYNCHRONOUS BIVENTRICULAR PACING DEVICE IMPLANT 例　 OPERATING ROOM PROCEDURES 0 JH 837 Z Insertion of Cardiac Resynchronization Pacemaker Pulse Generator into 　 Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach Insertion of Cardiac Resynchronization Defibrillator Pulse Generator into 0 JH 839 Z 　 Abdomen Subcutaneous Tissue and Fascia, Percutaneous Approach AND 　 　 OPERATING ROOM PROCEDURES 　 0200003 Atrial synchronous biventricular pacing device implant 　 0200004 Insertion of Lead - Atrial synchronous biventricular pacing device implant 　 0200005 Atrial synchronous biventricular pacing device implant and lead insertion 　 註：使用心房同步雙心室心律調節器generator and (or) lead之個案，請增編虛擬碼 　 "0200003"、"0200004"、"0200005"。 9

不符適應症之冠狀動脈 血管支架置入-1 MDC DRG 虛擬碼英文 取代 虛擬碼 ICD 10 0200001 0200001 05 11201 Dilation of Coronary Artery, One Site with Intraluminal Device, off restrictions use 05 11202 Dilation of Coronary Artery, One Site with Intraluminal Device, off restrictions use 05 11601 Dilation of Coronary Artery, One Site with Intraluminal Device, off restrictions use 05 11602 Dilation of Coronary Artery, One Site with Intraluminal Device, off restrictions use 05 11605 Dilation of Coronary Artery, One Site with Intraluminal Device, off restrictions use DRG 11201 多處血管及其他經皮心臟血管手術 例 　 MULTIPLE SITES AND OTHRE PERCUTANEOUS CARDIOVASCULAR PROCEDURES DRG 11202 單處血管經皮心臟血管手術 SINGLE SITE PERCUTANEOUS CARDIOVASCULAR PROCEDURES OPERATING ROOM PROCEDURES OR 　 COMBINATION OF 2 OPERATING ROOM PROCEDURES Dilation of Coronary Artery, One Site with Intraluminal Device, off 0200001 restrictions use WITH OR WITHOUT SECONDARY DIAGNOSIS 原ICD 9 I 2582 coronary chronic total occlusion(CTO) 冠狀動脈慢性完全閉塞 虛擬碼 註：個案申請「冠狀動脈支架」經審查不符適應症，經醫院解釋，個案仍同意自 為 0001 費時，請以虛擬處置碼"0200001"表示。 12

部分不符適應症之冠狀動脈 血管支架置入-1 加編 MDC DRG 虛擬碼英文 Dilation of Coronary Artery, One Site with Intraluminal Device, partial off restrictions use Dilation of Coronary Artery, One Site with Intraluminal Device, partial off 05 11602 restrictions use Dilation of Coronary Artery, One Site with Intraluminal Device, partial off 05 11605 restrictions use 05 11601 虛擬碼 ICD 10 0200006 DRG 11601 經皮冠狀動脈單處血管成形術，伴有冠狀動脈血管支架 例 　 SINGLE SITE PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY (PTCA) WITH CORONARY ARTERIAL STENT IMPLANT 註 1：個案執行血管成形術且使用經審查不符適應症之冠狀動脈血管支架時，請以 虛擬處置碼 0200001取代原處置碼。 註 2：個案如執行單處血管成形術且使用多支架（含部分健保支架及部分經審查不 符適應症之自費支架）時，請編列單處血管成形術伴有血管支架之ICD-10 -PCS，另 請以虛擬處置碼 0200006表示自費支架 14

四肢血管(3. 4版) 例 加編 MDC DRG 05 05 虛擬碼英文 Above knee Below knee one vessel Below knee two vessel 47803 Below knee three vessel or more Upper arm Forearm one vessel Forearm two vessel or more Above knee Below knee one vessel Below knee two vessel 47903 Below knee three vessel or more Upper arm Forearm one vessel Forearm two vessel or more 虛擬碼 ICD 10 04 U 0001 04 L 0002 04 L 0003 03 U 0001 03 L 0002 DRG 47803 其他血管手術(3)，未施行非冠狀動脈血管成形術及血管 支架植入術，有合併症或併發症 OTHER VASCULAR PROCEDURES(3) WITHOUT 　 ANGIOPLASTY OF NON-CORONARY VESSEL AND INSERTION OF NON-CORONARY ARTERY STENT OR STENTS WITH CC DRG 47903 其他血管手術(3)，未施行非冠狀動脈血管成形術及血管 支架植入術，無合併症或併發症 OTHER VASCULAR PROCEDURES(3) WITHOUT 　 ANGIOPLASTY OF NON-CORONARY VESSEL AND INSERTION OF NON-CORONARY ARTERY STENT OR STENTS WITHOUT CC, COMMUNICATION THERAPY AGE ≧ 18 WITHOUT CC OPERATING ROOM PROCEDURES Control Bleeding in Respiratory Tract, Via 0 W 3 Q 7 ZZ Natural or Artificial Opening 　 WITH OR WITHOUT 　 OPERATING ROOM PROCEDURES 　 04 U 0001 Above knee 　 04 L 0001 Below knee one vessel 04 L 0002 Below knee two vessel 04 L 0003 Below knee three vessel or more 03 U 0001 Upper arm 03 L 0001 Forearm one vessel 03 L 0002 Forearm two vessel or more 16

顯微手術-1(4. 0版) 加編 例 MDC DRG 09 09 21 21 26301 26401 26501 26601 44105 44106 DRG 26301 　 DRG 26401 　 　 　 　 虛擬碼英文 Microsurgery Microsurgery 虛擬碼 ICD 10 0 H 00001 0 H 00001 皮膚潰瘍或蜂窩組織炎，皮膚重建相關顯微手術，有合併症或併發症 SKIN RECONSTRUCTION MICROSURGERY FOR SKIN ULCER OR CELLULITIS WITH CC 皮膚潰瘍或蜂窩組織炎，皮膚重建相關顯微手術，無合併症或併發症 SKIN RECONSTRUCTION MICROSURGERY FOR SKIN ULCER OR CELLULITIS WITHOUT CC OPERATING ROOM PROCEDURES 0 KXH 0 ZZ Transfer Right Thorax Muscle, Open Approach 0 KXH 4 ZZ Transfer Right Thorax Muscle, Percutaneous Endoscopic Approach 0 KXJ 0 ZZ Transfer Left Thorax Muscle, Open Approach 0 KXJ 4 ZZ Transfer Left Thorax Muscle, Percutaneous Endoscopic Approach AND 　 OPERATING ROOM PROCEDURES 0 H 00001 Microsurgery 17

顯微手術-2(4. 0版) MDC DRG 10 10 28707 28708 虛擬碼英文 Microscopic procedure 加編 虛擬碼 ICD 10 0 J 00001 例 DRG 28707 內分泌、營養及新陳代謝疾患之顯微局部皮瓣重建手術，有合併症或併發症 FLAP MICROSCOPIC RECONSTRUCTION FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC DRG 28708 內分泌、營養及新陳代謝疾患之顯微局部皮瓣重建手術，無合併症或併發症 FLAP MICROSCOPIC RECONSTRUCTION FOR ENDOCRINE, NUTRITIONAL AND 　 METABOLIC DISORDERS WITHOUT CC OPERATING ROOM PROCEDURES Transfer Left Foot Subcutaneous Tissue and Fascia with Skin and 　 0 JXR 3 ZB Subcutaneous Tissue, Percutaneous Approach Transfer Left Foot Subcutaneous Tissue and Fascia with Skin, Subcutaneous 　 0 JXR 3 ZC Tissue and Fascia, Percutaneous Approach AND 　 　 OPERATING ROOM PROCEDURES 　 0 J 00001 Microscopic procedure 　 　 18

眼科單純及複雜微創手術-1(4. 0版) 加編 MDC DRG 02 02 03603 03604 03605 04203 04204 04211 虛擬碼 ICD 10 Complicating microincision 0800001 Vitreomacular microincision 0800002 Simple microincision 0800003 Deep anterior lamellar keratoplasty 0800004 Descemet's Stripping Automated Endothelial Keratoplasty 0800005 Descemet's Stripping Automated Endothelial Keratoplasty with precut cornea 0800006 Deep anterior lamellar keratoplasty 0800004 虛擬碼英文 DRG 03603 微創視網膜手術合併玻璃體手術-複雜，合併白內障水晶體手術 MICROINCISION RETINAL PROCEDUR WITH VITREOUS PROCEDUR-COMPLICATED，WITH 例 　 LENS PROCEDURES OPERATING ROOM PROCEDURES 08 RK 3 JZ Replacement of Left Lens with Synthetic Substitute, Percutaneous Approach 　 AND 　 　 OPERATING ROOM PROCEDURES 　 0800001 Complicating microincision 　 20

血栓溶解劑(4. 0版) 加編 例 MDC DRG 01 01 01415 01416 01417 01418 虛擬碼英文 Thrombolytic agent 1 unit 虛擬碼 ICD 10 3 E 00001 DRG 01415 特定性腦血管疾患，暫時性腦部缺氧除外，採血栓溶解治療1支，有復健，年齡大於等於 18歲， 有合併症或併發症 SPECIFIC CEREBROVASCULAR DISORDERS EXCEPT TRANSIENT ISCHEMIC ATTACK（TIA） WITH 　 THROMBOLYTIC AGENT 1 UNIT WITH REHABILITATION THERAPY AGE ≧ 18 WITH CC DRG 01416 特定性腦血管疾患，暫時性腦部缺氧除外，採血栓溶解治療1支，有復健，年齡大於等於 18歲， 無合併症或併發症 SPECIFIC CEREBROVASCULAR DISORDERS EXCEPT TRANSIENT ISCHEMIC ATTACK（TIA）WITH 　 THROMBOLYTIC AGENT 1 UNIT WITH REHABILITATION THERAPY AGE ≧ 18 WITHOUT CC 　 　 　 PRINCIPAL DIAGNOSIS I 671 Cerebral aneurysm, nonruptured I 6789 Other cerebrovascular disease AND 　 NON-OPERATING ROOM PROCEDURES 3 E 00001 Thrombolytic agent 1 unit 22

抗凝血藥物或血栓溶解治療(4. 0版) 加編 MDC DRG 虛擬碼英文 虛擬碼 ICD 10 3 E 00003 3 E 00004 3 E 00003 3 E 00004 Anticoagulant drug therapy Interventional thrombolytic therapy Anticoagulant drug therapy 04 07801 Interventional thrombolytic therapy Anticoagulant drug therapy 04 07802 Interventional thrombolytic therapy Anticoagulant drug therapy 05 12801 Interventional thrombolytic therapy Anticoagulant drug therapy 05 12802 Interventional thrombolytic therapy DRG 07803 肺栓塞，併低血壓或休克 例 　 PULMONARY EMBOLISM WITH HYPOTENSION OR SHOCK SECONDARY DIAGNOSIS 　 I 959 Hypotension, unspecified 　 R 579 Shock, unspecified 　 WITH OR WITHOUT 　 NON-OPERATING ROOM PROCEDURES 　 3 E 00003 Anticoagulant drug therapy 　 3 E 00004 Interventional thrombolytic therapy 　 23 　 註：有使用抗凝血藥物治療或血栓溶解介入治療者，需編虛擬碼，以利未來再分類。 04 07803

為復健入院 加編並取代 主診斷 MDC DRG 23 23 23 46201 46202 46203 46204 46205 46206 46207 46208 46209 46210 46211 46212 虛擬碼英文 Admission for rehabilitation Admission for rehabilitation Admission for rehabilitation 虛擬碼 ICD 10 U 000 REH U 000 REH U 000 REH 例 DRG 46201 復健，含物理治療、職能治療及語言治療， 年齡大於等於 18歲，有合併症或併發症 REHABILITATION INCLUDING PHYSICAL 　 THERAPY , OCCUPATIONAL THERAPY , COMMUNICATION THERAPY AGE ≧ 18 WITH CC DRG 46202 復健，含物理治療、職能治療及語言治療， 年齡大於等於 18歲，無合併症或併發症 REHABILITATION INCLUDING PHYSICAL 　 THERAPY , OCCUPATIONAL THERAPY , COMMUNICATION THERAPY AGE ≧ 18 WITHOUT CC PRINCIPAL DIAGNOSIS 　OR 　 　PRINCIPAL DIAGNOSIS 　U 000 REH Admission for rehabilitation 註：為復健而入院，若無表列主診斷者，應 　 以虛擬碼"U 000 REH"為主診斷碼，其病況 　為次診斷碼。 24

物理、職能及語言治療(4. 0版) 分布於MDC 1及MDC 23之DRG 　 例 　 　 取代 　 　 Assistance with Respiratory Ventilation, Greater than 96 Consecutive Hours, Intermittent Positive Airway Pressure Assistance with Respiratory Ventilation, Greater than 96 5 A 09559 Consecutive Hours, Continuous Negative Airway Pressure Assistance with Respiratory Ventilation, Greater than 96 5 A 0955 B Consecutive Hours, Intermittent Negative Airway Pressure Assistance with Respiratory Ventilation, Greater than 96 5 A 0955 Z Consecutive Hours 5 A 1935 Z Respiratory Ventilation, Less than 24 Consecutive Hours 5 A 1945 Z Respiratory Ventilation, 24 -96 Consecutive Hours 5 A 1955 Z Respiratory Ventilation, Greater than 96 Consecutive Hours AND 　 NON-OPERATING ROOM PROCEDURES F 000001 Physical Therapy F 000002 Occupational Therapy F 000003 Communication Therapy 5 A 09558 25