DOCSLIB.ORG

보건의료정보 표준화 연구 Research of Health Information Standardization

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
보건의료정보 표준화 연구 Research of Health Information Standardization 보안과제( ), 일반과제( o ) A040165 보건의료기술연구개발(의료정보기술개발) 보건의료정보 표준화 연구 Research of Health Information Standardization 한국보건산업진흥원 한국보건산업진흥원 제 출 문 보건복지부 장관 귀하 이 보고서를 “보건의료정보 표준화 연구(고유번호 : 0412-MI02-0416-0001)” 과제의 최종보고서로 제출합니다. 2005 . 6 . 30 주관연구기관 : 한국보건산업진흥원 직인 주관연구책임자 : 공 재 근 직인 ❀ 보건의료정보 표준화에 참여해 주신 분들 ❀ 표준화위원회 •위원장 : 김 윤(서울의대 의료관리학교실) •표준화위원 서창해(인하의대 방사선과) 이영종(경원대 한의대) 감 신(경북의대 예방의학교실) 최행정(국민건강보험공단 일산병원 의무기록팀) 박현애(서울대 간호대) 김석일(가톨릭의대 예방의학교실) 김옥남(서울아산중앙병원 의무기록팀) 신형식(라이프엠) 황 건(인하대병원 성형외과) 이태한(보건복지부 혁신인사기획관) 이갑노(고려대 진단검사의학과) 임종규(보건복지부 보건의료서비스산업육성팀) 이숙향(숙명여대 임상약학대학원) 선우종성(보건복지부 정보화담당관실) 김보연(건강보험심사평가원 급여관리실) 박민수(보건복지부 공공보건정책과) 자문위원회 •위원장 : 곽연식 •자문위원 채영문(연세대 보건대학원) 윤순녕(서울대 간호대) 김명기(서울대 치과의료관리학과) 신현택(숙명여대 약학대학) 지제근(서울의대 병리과) 염용권(한국보건산업진흥원 보건의료기술연구 사업관리본부) 기획위원회 •위원장 : 김 윤(서울의대 의료관리학교실) •기획위원 박현애(서울대 간호대) 김곤희(보건복지부 공공보건정책과) 김석일(가톨릭의대 예방의학교실) 좌용권(한국보건산업진흥원) 신형식(라이프엠) 부유경(인하대병원 의료정보과) 김소윤(보건복지부 보건의료서비스산업육성팀) 박경모(경희대 동서의료공학과) 기획위원회 지원 이관익(한국보건산업진흥원) 곽미숙(서울대의대 의료관리학교실) 박정선(한국보건산업진흥원) 손수인(한국보건산업진흥원) 구현경(서울대의대 의료관리학교실) - 3 - 의료용어분과위원회 •분과위원장 : 서창해(인하대 의대 방사선과학) •분과위원 부유경(인하대병원 의료정보과) 김대성(한진정보통신) 최선근(인하의대 외과) 심진수(한진정보통신) 이연숙(인하대병원 전산정보팀) •자문위원 진호준(서울대 분당병원 내과) 김지영(분당재생병원 의무기록과) 최진욱(서울대 의용공학과) 유연순(이대목동병원 의무기록과) 박찬병(수원의료원) 서진숙(삼성서울병원 의무기록파트) 박덕영(강릉대학교 예방치학교실) 강재은(서울대 분당병원 의무기록파트) 서순원(단국대병원 의무기록과) 이은미(신촌세브란스병원 의무기록과) 최행정(건강보험공단일산병원 의무기록팀) 김란혜(경희의료원 의무기록과) 김옥남(서울아산병원 의무기록팀) 보건용어분과위원회 •분과위원장 : 감신(경북대의대 예방의학교실) •분과위원 이은미(신촌세브란스병원 의무기록과) 진대구(대구 성서병원) 이중정(계명대학교 의과대학) 정은경(질병관리본부) 이원영(중앙대학교 의과대학) 이상원(대구카톨릭대학교 의과대학) 황태윤(영남대학교 의과대학) 김찬호(경기도 안양시 보건소) 이인숙(서울대학교 간호대학) 이홍재(경기도 성남시 수정구 보건소) 박기수(포천중문의과대학교) •자문위원 조 훈(경북대학교 의과대학) 김영택(질병관리본부) 박기동(질병관리본부) 송근배(경북대학교 치과대학) - 4 - 간호용어분과위원회 •분과위원장 : 박현애(서울대학교 간호대학) •분과위원 박인숙(서울대학교병원) 최은영(분당서울대학교병원) 정은자(분당서울대학교병원) 조은미(서울대학교병원) 이선미(가톨릭대학교 간호대학) 김형숙(양천구 보건소) 진단용어분과위원회 •분과위원장 : 황 건(인하대학교병원 성형외과) •분과위원 정인혁(연세의대 해부학교실) 서순원(단국대병원 의무기록과) 송영빈(이화여대 인문외국어문학부) 부유경(인하대병원 의료정보과) 서진숙(삼성서울병원 의무기록파트) 백설경(아주대병원 의무기록팀) 의료행위용어분과위원회 •분과위원장 : 김옥남(서울아산병원 의무기록팀) •분과위원 서순원(단국대학병원) 최행정(공단일산병원) 서숙경(서울아산병원) 김선자(서울아산병원) 신종연(서울보건대학) 김성수(서울아산병원) 선미옥(강동성심병원) •자문위원 강길원(건강보험심사평가원 상대가치점수연구개발단) 검사용어분과위원회 •분과위원장 : 이갑노(고려대 구로병원 진단검사의학과) •분과위원 윤종현(보라매병원 진단검사의학과) 윤수영(고려대 안산병원 진단검사의학과) 민원기(울산의대 서울아산병원 진단검사의학과) 이기범(아주대병원 병리과) 임환섭(관동대 명지병원 진단검사의학과) 서연림(성균관의대 서울삼성병원 병리과) 송정한(서울대 분당병원 진단검사의학과) 이창규(고려대 구로병원 진단검사의학과) 채석래(동국대 일산불교병원 진단검사의학과) 권정아(고려대 진단검사의학과) - 5 - 의료재료분과위원회 •분과위원장 : 김보연(건강보험심사평가원 급여관리실) •분과위원 류시원(한국보건사회연구원 정보관리팀) 권연선(건강보험심사평가원 재료관리부) 유희상(식품의약품안전청 의료기기안전과) 김혜경(건강보험심사평가원 재료관리부) 노혜원(식품의약품안전청 의료기기규격과) 유정희(비브라운코리아 Regulatory Affairs팀) 강영규(식품의약품안전청 전자의료기기과) 이상수(메드트로닉 Reimbursement Department) 변성애(건강보험심사평가원상대가치점수연구개발단) 이경수(인하대병원 물류팀) •자문위원 김석일(가톨릭대학교 예방의학교실) 유규하(식품의약품안전청 의료기기규격과) 박기동(아주대학교 분자기술학과) 이재숙(건강보험심사평가원 심사정보부) 김성민(건국대학교 의과대학 의학공학부) 의약품분과위원회 • 분과위원장 : 이숙향(숙명여자대학교 임상약학대학원) • 분과위원 손인자 (서울대학교병원 약제부) 유미영 (건강보험심사평가원 약가분석부) 이병구 (서울대학교 분당병원 약제부) 공경희 (고려대 구로병원 약제과) 이은숙 (서울대학교 분당병원 약제부) 차태선 (한국제약협회) 홍성숙 (대한약학정보화재단) 김종주 (숙명여자대학교 임상약학대학원) 이정석 (식품의약품안전청 의약품관리과) • 자문위원 신현택 (숙명여자대학교 약학대학) 김보연 (건강보험심사평가원 급여관리실) 곽혜선 (이화여자대학교 약학대학) • 연구조원 장주연 (숙명여자대학교 임상약학대학원) 김수민 (숙명여자대학교 임상약학대학원) 오지은 (숙명여자대학교 임상약학대학원) - 6 - 한방용어분과위원회 •분과위원장 : 이영종(경원대학교 한의대) •분과위원 이충열 (경원대학교 한의대) 심범상 (경희대학교 한의대) 김용석 (경희대학교 한의대) 임병묵 (한국한의학연구원) 전찬용 (경원대학교 한의대) 박경모 (경희대학교 한의대) 백태현 (상지대학교 한의대) 엄동명 (한국한의학연구원) 임형호 (경원대학교 한의대) 한창호 (동국대학교 한의대) 송호섭 (경원대학교 한의대) 통계용어분과위원회 •분과위원장 : 최행정(국민건강보험공단 일산병원 의무기록팀) •분과위원 정은경(질병관리본부 만성병조사과) 김현영(질병관리본부 만성병조사과) 도세록(한국보건사회연구원 조사정보팀) 신동교(국민건강보험공단 일산병원 의무기록팀) 김옥남(서울아산병원 의무기록팀) 류상희(국민건강보험공단 일산병원 의무기록팀) 서순원(단국대학교병원 의무기록과) - 7 - 차 례 제1장. 최종 연구개발 목표 / 17 1. 연구 목표 ······································································································ 17 2. 연구 목표 달성도 ·························································································· 21 제2장. 최종 연구개발 내용 및 결과 / 27 1. 연구 내용 및 방법 ························································································· 27 2. 연구 개발 결과 ······························································································ 58 제3장. 연구결과 고찰 및 결론 / 175 1. 총괄적 연구결과 고찰 및 결론 ····································································· 175 2. 영역별 연구결과 고찰 및 결론 ····································································· 176 제4장. 연구 성과 / 187 1. 총괄연구개발과제의 연구결과 ······································································ 187 2. 총괄연구결과 세부내용(현재실적에 대한 내용) ············································· 188 3. 향후 성과 추진 계획 ···················································································· 193 제5장 연구개발 효과의 파급효과 / 197 1. 기술적 파급효과 ·························································································· 197 2. 경제적 파급효과 ·························································································· 198 3. 사회적 파급효과 ·························································································· 199 참고문헌 / 201 부 록 / 207 참여연구원 편성표 / 209 첨부서류 / 210 - 8 - 표 차례 표 1-1. 보건의료정보 표준화 목표와 범위 ·························································· 20 표 2-1. 현재 각 기관에서 활용하고 있는 의료재료 항목현황 ······························ 51 표 2-2. 의료용어 자료수집 결과 ········································································· 59 표 2-3. 의료용어 semantic type 분류 결과 ························································· 61 표 2-4. 검사분야 결과물 집계표 ········································································· 67 표 2-5. 각 기관별 의약품 관련 데이터베이스 항목 비교표 ································· 91 표 2-6. 미국 FDA 제형 코드 예 ········································································ 93 그림 차례 그림 1-1. 의료정보를 표현하는 용어/분류체계 관련 표준의 영역 ······················· 18 그림 1-2. 보건의료정보 표준화 위원회 구성 ······················································ 21 그림 2-1. 의료용어 수집 및 정제과정 ································································ 29 그림 2-2. 발췌용어의 기 용어사전에 의한 자동색인절차 ···································· 29 그림 2-3. 진단용어 한글 치환 단계 예시 ··························································· 33 그림 2-4. 의료행위용어 연구추진 방법 ······························································· 36 그림 2-5. 보험 EDI code 와 LOINC mapping을 위한 프로그램 예 ···················· 40 그림 2-6. 용어 한글번역 프로그램의 예 ····························································· 41 그림 2-7 의료재료 표준화 연구 체계 ································································· 42 그림 2-8. 의료용어 개념테이블 구축 화면 ·························································· 61 그림 2-9. 의료용어 동의어테이블 화면 ······························································· 64 그림 2-10. LOINC code, 보험코드, UMLS 통합 표 ············································ 68 그림 2-11. LOINC code, 영문 component, 한글 component 공통테이블 ············ 68 그림 2-12. 검사용어 동의어 테이블; component 중심으로 ·································· 69 그림 2-13. 동의어 테이블; 단어 중심으로 ··························································· 69 그림 2-14. 동의어 테이블; LOINC code, 한글명, 보험코드, 보험명 중심 ············ 70 그림 2-15. LOINC code와 UMLS code와의 mapping table ································ 70 - 9 - 요 약 문 연구과제명 보건의료정보 표준화 연구 중심단어 표준화, 의료정보, NHII, EHR 주관연구기관 한국보건산업진흥원 주관연구책임자 공 재 근 참여기업 총연구기간 2004 년 12 월 ～ 2005 년 5 월 연구 목적 - 국가 보건의료정보표준에 근거하지 않은 보건의료정보화는 고립 분산된 다수 의 의료정보시스템을 양산함으로써, 정보의 공유를 사실상 불가능하게 하며 국가적 보건의료정보표준이 없을 경우 보건의료정보산업과 의료기관이 별도의 표준을 유지하는 데 많은 비용과 노력이 필요하므로 보건의료정보산업의 경쟁 력을 떨어뜨림 - 우리나라 의료정보분야의 표준 개발은 매우 일천함. 건강보험 진료비청구에 사용되는 표준을 제외하고는 실제 광범위하게 사용되는 의료정보의 표준은 거 의 없는 실정이어서 의료정보 표준 관련 전문가들의 표준 개발 활동을 체계 적이고 지속적으로 지원하여 표준을 확보하여야 함 - 본 연구는 이상과 같은 필요성에 따라 우리나라 국가 단위의 보건의료정보의 표준화를 이룩하는데 그 목적이 있음 연구 방법 - 보건의료정보의 표준화 단계를 3단계로 나누고 1단계에서는 보건소와 공공병 원, 200-300병상의 종합병원에서 사용하는 용어와 물류식별코드표준화에 초점 을 맞추어 개발 - 1단계에서는 보건의료의 영역을 10개의 영역(의료용어, 보건용어, 간호용어, 진 단용어, 의료행위용어, 검사용어, 의료재료, 의약품, 한방용어, 통계용어)으로 구분하여 각 영역별 전문가들로 Working Group을 구성하여 표준(안) 개발 - 기존 국내 표준화 현황과 관련 연구 현황을 검토하여 이미 개발된 국내 보건 의료정보 표준(안)이 있는 경우, 이를 근거로 보건소 및 중소규모 의료기관 정 보화에 적합한 표준안 개발 - 기존에 개발된 국내 보건의료정보 표준(안)이 없는 경우, 국제적인 보건의료정 보 표준을 근거로 우리나라 보건소 및 중소규모 의료기관 정보화에 적합한 표 준안을 선별, 수정, 보완 - 11 - 연구 결과 - 의료용어 o UMLS 2005AA를 기초로 한 기본개념테이블과 동의어테이블 구축 o 총 수집 용어 38,664건 중 중복 정리 및 정제과정을 거쳐서 5,024건의 개념과 6,982건의 동의어를 정리하여 테이블로 구축 - 진단용어 o EMR 환경하에서 사용할 영문 한글 진단명의 표준화 - 의료행위용어 o 3788개 수술. 처치 분류명의 개념 테이블 구축 o ICD-9-CM 분류코드와 EDI 코드를 연결시키는 code mapping 작업 - 검사용어 o 보험EDI코드와 LOINC코드와 UMLS와 mapping : 7508 records o LOINC code, 영문component와 한글component, 보험EDI code 와 영문/한글 단축명: 7516 records o 동의어 table : Component 동의어 table 7516 records o LOINC code와 보험코드와 UMLS mapping table : 7516 records - 의료재료 o 표준코드(15자리) : 업체번호(5자리)와 제품번호(11자리)로 구성 o 의료재료데이터베이스 : 표준코드에 대한 상세정의 - 의약품 o 의약품 표준코드로 EAN 코드를 가장 유력하게 고려함 o 약효분류 코드로는 WHO의 ATC 코드를 사용하기로 함 o 의약품 정의 항목 : 제형, 투여경로, 함량단위, 포장형태 - 한방용어 o 의료용어사전에 적용할 용어체계의 수집 및 구조 확정 o 용어에 개념, 코드 및 관계 부여하여 용어사전 구축 - 12 - SUMMARY Title Research of Health Information Standardization Key Words Standardization, Health Information, EHR, NHII Korea Health Industry Institute Project Leader Jae-Keun, Kong Development Institute Associated Company Project Period 2004 . 12 . 1 - 2005 . 5 . 31 Purpose - Health informatization not supported by national health information standards results in isolated, disparate, and diverse health information systems, which makes unable to share health information. National health information standards enable to reduce the high cost and the duplicate of effort to maintain individual standard of each institution and to increase competitiveness of health information industry. - The standardization effort for the health information is not long. There is no practical comprehensive standardof health information except for the EDI standard for the claim of the medical insurance. It is essential to support the activities of
Load more

Recommended publications
  • November 5, 2003 – Letter to the Secretary – Comments on CHI
    November 5, 2003 The Honorable Tommy G. Thompson Secretary Department of Health and Human Services 200 Independence Avenue SW Washington, D.C. 20201 Dear Secretary Thompson: The National Committee on Vital and Health Statistics (NCVHS) commends you for your commitment toward government wide adoption of clinical data standards that you first announced on March 21, 2003. NCVHS recognizes and appreciates that there is new momentum to adopt clinical data standards that is driven by you and the Consolidated Healthcare Informatics Initiative (CHI). Consequently, NCVHS is now working closely with CHI to study, select and recommend domain specific patient medical record information (PMRI) terminology standards. We have mutually developed a process that allows NCVHS to discuss in open, interactive sessions CHI recommendations as part of the CHI Council acceptance process. The NCVHS has the following comments on the attached set of CHI domain area recommendations: • The NCVHS concurs with the CHI recommendations for Interventions and Procedures: Part B, Laboratory Test Order Names. • The NCVHS concurs with the CHI recommendations for the Medication Domain as modified in the attached document. We further note: o the need for additional funding for the Food and Drug Administration (FDA) to expedite the publication of a publicly available version of their Unique Ingredient Identifier (UNII) codes and to provide continued funding to maintain the UNII code standard; o that the dosage and administration sub-domain be investigated in the next phase of the CHI process; and o that the FDA National Drug Code (NDC) process be investigated and improvements identified be expeditiously pursued. • The NCVHS concurs with the CHI recommendations for the Immunization Domain as modified in the attached document.
    [Show full text]
  • Ata Lements for Mergency Epartment Ystems
    D ata E lements for E mergency D epartment S ystems Release 1.0 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES CDCCENTERS FOR DISEASE CONTROL AND PREVENTION D ata E lements for E mergency D epartment S ystems Release 1.0 National Center for Injury Prevention and Control Atlanta, Georgia 1997 Data Elements for Emergency Department Systems, Release 1.0 (DEEDS) is the result of contributions by participants in the National Workshop on Emergency Department Data, held January 23-25, 1996, in Atlanta, Georgia, subsequent review and comment by individuals who read Release 1.0 in draft form, and finalization by a multidisciplinary writing committee. DEEDS is a set of recommendations published by the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention: Centers for Disease Control and Prevention David Satcher, MD, PhD, Director National Center for Injury Prevention and Control Mark L. Rosenberg, MD, MPP, Director Division of Acute Care, Rehabilitation Research, and Disability Prevention Richard J. Waxweiler, PhD, Director Acute Care Team Daniel A. Pollock, MD, Leader Production services were provided by the staff of the Office of Communication Resources, National Center for Injury Prevention and Control, and the Management Analysis and Services Office: Editing Valerie R. Johnson Cover Design and Layout Barbara B. Lord Use of trade names is for identification only and does not constitute endorsement by the U.S. Department of Health and Human Services. This document and subsequent revisions can be found at the National Center for Injury Prevention and Control Web site: http://www.cdc.gov/ncipc/pub-res/deedspage.htm Suggested Citation: National Center for Injury Prevention and Control.
    [Show full text]
  • (USCDI), Version 1, July 2020 Errata
    Allergies and Intolerances .... 5 The USCDI is a standardized Assessment and Plan of set of health data classes and Treatment ............................ 5 Care Team Member(s) ......... 6 constituent data elements for Clinical Notes ........................ 7 nationwide, interoperable Goals ..................................... 8 Health Concerns ................... 8 health information exchange. Immunizations ...................... 9 Laboratory ............................ 9 A USCDI “Data Class” is an aggregation of various Data Elements by a common theme or use case. Medications ........................ 10 Patient Demographics ........ 10 A USCDI “Data Element” is the most granular level Problems ............................ 12 at which a piece of data is represented in the USCDI Procedures ......................... 12 for exchange. Provenance ........................ 13 Smoking Status ................... 13 Unique Device Identifier(s) for a Patient’s Implantable Device(s) ............................. 13 Vital Signs ........................... 14 2 Version History Version # Description of change Version Date 1 First Publication February 2020 1 (July 2020 Corrections to Applicable Standards July 2020 Errata) • Substance (Medication) - Removed UCUM • Patient’s Goals, Health Concerns, Assessment and Plan of Treatment - Removed LOINC, SNOMED CT • Laboratory Tests, Values/Results - Removed SNOMED CT and UCUM • Medications - Removed UCUM 3 USCDI v1 Summary of Data Classes and Data Elements Allergies and Intolerances Laboratory Smoking Status
    [Show full text]
  • Report-Health Terminologies and Vocabularies Environmental Scan
    Health Terminologies and Vocabularies Environmental Scan Conducted for the National Committee on Vital and Health Statistics Subcommittee on Standards September 14, 2018 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Terminologies and Vocabularies Environmental Scan NCVHS Subcommittee on Standards This report was written by Susan L. Roy, MS, MLS, SNOMED CT Coordinator, and Vivian A. Auld, MLIS, Senior Specialist for Health Data Standards, both with the National Institutes of Health (NIH), National Library of Medicine, in collaboration with the NCVHS Standards Subcommittee: NCVHS Membership William W. Stead, MD, NCVHS Chair Nicholas L. Coussoule,* Subcommittee Co-chair Alexandra Goss,* Subcommittee Co-chair Bruce B. Cohen, PhD David A. Ross, ScD Debra Strickland, MS* Denise E. Love, BSN, MBA* Jacki Monson, JD Linda L. Kloss, MA, RHIA*, Terminology and Vocabulary Project Lead Llewellyn J. Cornelius, PhD Richard W. Landen, MPH, MBA* Robert L. Phillips, Jr., MD, MSPH Roland J. Thorpe, Jr., PhD Vickie M. Mays, PhD, MSPH *Member of the Subcommittee on Standards Rebecca Hines, MHS, NCVHS Executive Secretary/DFO Health Scientist National Center for Health Statistics, CDC, HHS Rashida Dorsey, PhD, MPH, NCVHS Executive Staff Director Director, Division of Data Policy Senior Advisor on Minority Health and Health Disparities Office of Science and Data Policy Office of the Assistant Secretary for Planning and Evaluation, HHS The National Committee on Vital and Health Statistics (NCVHS) serves as the advisory committee to the Secretary of Health and Human Services (HHS) on health data, statistics, privacy, national health information policy, and the Health Insurance Portability and Accountability Act (HIPAA) (42U.S.C.242k[k]).
    [Show full text]
  • (Child Core Set) Technical Specifications and Reso
    Core Set of Children's Health Care Quality Measures for Medicaid and CHIP (Child Core Set) Technical Specifications and Resource Manual for Federal Fiscal Year 2019 Reporting February 2019 Center for Medicaid and CHIP Services Centers for Medicare & Medicaid Services This page left blank for double-sided copying ii ACKNOWLEDGMENTS For Proprietary Codes: CPT® codes copyright 2018 American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. SNOMED CLINICAL TERMS (SNOMED CT®) copyright 2004-2018 The International Health Terminology Standards Development Organisation. All Rights Reserved. The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) is published by the World Health Organization (WHO). ICD-9-CM is an official Health Insurance Portability and Accountability Act standard. The International Classification of Diseases, 9th Revision, Procedure Coding System (ICD-9-PCS) is published by the World Health Organization (WHO). ICD-9-PCS is an official Health Insurance Portability and Accountability Act standard. The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is published by the World Health Organization (WHO). ICD-10-CM is an official Health Insurance Portability and Accountability Act standard. The International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) is published by the World Health Organization (WHO). ICD-10-PCS is an official Health Insurance Portability and Accountability Act standard. This material contains content from LOINC® (http://loinc.org).
    [Show full text]
  • Billing and Coding Considerations for BLINCYTO®
    BLINCYTO® Billing Information Sheet Billing and Coding Considerations for BLINCYTO® This Information Sheet is intended to help healthcare professionals understand the key billing and coding considerations for BLINCYTO® and its related services and supplies when using the FDA-approved dosing options in inpatient and outpatient treatment settings. Updates for 2018 include: • Information on billing the 7-day infusion option (7-DIO) in addition to the shorter-duration 24-hour and 48-hour bags BLINCYTO® Dosing Options1 Dose per vial X number of Dosing option Number of billing units single-dose vials (SDVs*) 24-hour 35 mcg X 1 vial 35 48-hour 35 mcg X 1-2 vials 35-70 7-day 35 mcg X 4-6 vials 140-210 • New coding requirement for BLINCYTO® administered in the outpatient setting of 340B hospitals – The Centers for Medicare & Medicaid Services (CMS) requires use of new modifiers on Medicare claims for drugs acquired under the 340B Drug Discount Program2 • Medicare patients receiving BLINCYTO® in the inpatient setting are no longer eligible for additional reimbursement3 – The new technology add-on payment (NTAP) designation has been retired; hospitals may still be eligible for outlier payments based on payer guidance and managed care contract provisions *Number of SDVs depends on dose, infusion duration, and patient's weight.1 Please note that the information in this resource is intended to be educational and is not a guarantee of reimbursement. Coverage, coding, and billing requirements vary by health plan so be sure to check with individual payers for detailed guidance. Indications BLINCYTO® is indicated for the treatment of B-cell precursor acute lymphoblastic leukemia (ALL) in first or second complete remission with minimal residual disease (MRD) greater than or equal to 0.1% in adults and children.
    [Show full text]
  • The Role of Family Practice in Different Health Care Systems
    January 2002 · Vol. 51, No. 1 JFP ONLINE The Role of Family Practice in Different Health Care Systems A Comparison of Reasons for Encounter, Diagnoses, and Interventions in Primary Care Populations in the Netherlands, Japan, Poland, and the United States I.M. Okkes, MA, PhD; G.O. Polderman, MD; G.E. Fryer, PhD; T. Yamada, MD; M. Bujak, MD; S.K. Oskam, MSc, PhD; L.A. Green, MD; H. Lamberts, MD, PhD Amsterdam and Amstelveen, the Netherlands; Tokyo, Japan; Katowice, Poland; and Washington, DC Submitted, revised, October 21, 2001. From the Academic Medical Center/University of Amsterdam, Division of Public Health, Department of Family Practice, Amsterdam (I.M.O., S.K.O., H.L.); Family Physician, Transition Project, Amstelveen (G.O.P.); the Robert Graham Center: Policy Studies in Family Practice and Primary Care, Washington, DC (G.E.F., L.A.G.); the Japanese Association for Development of Community Medicine, Tokyo (T.Y.); and the Silesian Medical School, Katowice (M.B.). Reprint requests should be addressed to I.M. Okkes, MA, PhD, Academic Medical Center/University of Amsterdam, Division Public Health, Department of Family Practice, Meibergdreef 15, 1105 AZ Amsterdam, the Netherlands. E-mail: [email protected]. z OBJECTIVE: Our goal was to compare the content of family practice in different countries using databases containing information on reasons for encounter, diagnoses, and interventions that are coded with or can be addressed by the International Classification of Primary Care (ICPC). z STUDY DESIGN: In the Netherlands, Japan, and Poland data were collected identically with an electronic patient record (Transhis).
    [Show full text]
  • 2018 Annual Surveillance Report of Drug-Related Risks and Outcomes
    2018 ANNUAL SURVEILLANCE REPORT OF DRUG-RELATED RISKS AND OUTCOMES UNITED STATES Centers for Disease Control and Prevention National Center for Injury Prevention and Control Annual Surveillance Report of Drug-Related Risks and Outcomes | United States CDC National Center for Injury Prevention and Control | 2018 ACKNOWLEDGEMENTS This Surveillance Report was prepared by staff from the National Disclaimer Center for Injury Prevention and Control (NCIPC), Centers for Disease The findings and conclusions in Control and Prevention (CDC), U.S. Department of Health and Human this report are those of the authors Services, Atlanta, Georgia. and do not necessarily represent the views of the Centers for Disease Control and Prevention. This Contributors to this report included: Brooke E. Hoots, PhD, MSPH1, 2 3 research was supported in part by Likang Xu, MD, MS , Mbabazi Kariisa, PhD , Nana Otoo Wilson, PhD, an appointment to the Research 1 1 1,4 MPH, MSc , Rose A. Rudd, MSPH , Lawrence Scholl, PhD, MPH , Lyna Participation Program at the Centers 1 1 Schieber, MD, DPhil , and Puja Seth, PhD for Disease Control and Prevention 1Division of Unintentional Injury Prevention (DUIP), National Center for administered by the Oak Ridge Injury Prevention and Control, CDC Institute for Science and Education 2Division of Analysis, Research, and Practice Integration (DARPI), through an interagency agreement National Center for Injury Prevention and Control, CDC between the U.S. Department of 3Oak Ridge Institute for Science and Education, Oak Ridge, TN Energy and CDC. 4Epidemic Intelligence Service, CDC All material in this report is in the public domain and may be used Corresponding authors: Brooke E.
    [Show full text]
  • Coding Basics
    Coding Basics 60889-R5-V1 • This information is provided for your background education and is not intended to serve as guidance for specific coding, billing, and claims submissions. The decision on which codes best describe the services provided must be made by the individual providers based on specific payor guidance and requirements. 2 Agenda • Define each code set – HCPCS – CPT® – NDC – ICD-9-CM – ICD-10-CM • Discuss general formats • Apply coding basics to sample claim forms – Physician office setting (CMS-1500 claim form) – Hospital outpatient setting (UB-04 claim form) CPT is a registered trademark of the American Medical Association. All rights reserved. 3 Healthcare Common Procedure Coding System (HCPCS)1 HCPCS codes describe products, supplies, items and services not included in CPT They establish a standard coding system that allow claims to be processed in a consistent manner The use of the HCPCS is mandatory • It is alpha-numeric. The format is a single alphabetical letter (A to V) followed by 4 numeric digits • Maintained by Centers for Medicare and Medicaid Services (CMS) 1. Centers for Medicare & Medicaid Services (CMS), New CMS Coding Changes Will Help Beneficiaries. https://www.cms.gov/MedHCPCSGenInfo/Downloads/HCPCSReform.pdf. Accessed January 30, 2012. 4 Current Procedural Terminology (CPT)1 Developed by the American Medical Association (AMA), it is a list of descriptive terms that identify medical services and procedures It allows for communication of uniform information among physicians, coders, patients, and payers Category I CPT codes •Describe a procedure or service identified with a 5-digit code and descriptor nomenclature Category II CPT Codes •Supplemental tracking codes that can be used for performance measurement (optional) Category III CPT Codes •Temporary set of tracking codes for new and emerging technologies intended to facilitate data collection on and assessment of new services and procedures 1.
    [Show full text]
  • Who Gets Medication-Assisted Treatment for Opioid Use Disorder, and Does It Reduce Overdose Risk? Evidence from the Rhode Island All-Payer Claims Database Mary A
    No. 21-3 Who Gets Medication-assisted Treatment for Opioid Use Disorder, and Does It Reduce Overdose Risk? Evidence from the Rhode Island All-payer Claims Database Mary A. Burke, Riley Sullivan, Katherine Carman, Hefei Wen, J. Frank Wharam, and Hao Yu Abstract: This paper uses the all-payer claims database (APCD) for Rhode Island to study three questions about the use of medication-assisted treatment (MAT) for opioid use disorder (OUD): (1) Does MAT reduce the risk of opioid overdose; (2) are there systematic differences in the uptake of MAT by observable patient-level characteristics; and (3) how successful were federal policy changes implemented in 2016 that sought to promote increased use of buprenorphine, one of three medication options within MAT? Regarding the first question, we find that MAT as practiced in Rhode Island is associated with a reduced risk of repeated opioid overdose among patients who had an initial nonfatal opioid overdose, consistent with the strong endorsement of MAT by public health officials. Concerning the second, we find that factors such as age, gender, health insurance payer, and the poverty rate in one’s residential Zip code are associated with significant differences in the chance of receiving methadone and/or buprenorphine, suggesting that certain groups may face unwarranted disparities in access to MAT. About the third question, we find that a 2016 federal rule change enabled at least some experienced Rhode Island buprenorphine prescribers to reach more patients, and a separate 2016 policy aimed at recruiting new buprenorphine prescribers was also found to be effective. However, the data also suggest that many more patients in the state could be treated with buprenorphine if prescribers took full advantage of their prescribing limits.
    [Show full text]
  • Common Semantic Strategy for Health in the European Union WP8 Integration in National Policies and Sustainability Draft
    D8.2.2 Common Semantic Strategy for Health in the European Union WP8 Integration in National Policies and Sustainability Draft Revision 1.4, 10-05-2019 15th eHN meeting, June 2019 For Discussion Grant Agreement nº 801558 D8.2.2 Common Semantic Strategy WP8 Integration in National Policies and Sustainability Draft for Discussion Revision 1.4, 10-05-2019 CONTROL PAGE OF DOCUMENT Document name CSS for Health in the EU – Information paper for eHN Status Draft Author(s) Country Organisation Name Austria Sozial Ministerium Peter Brosch Croatia HZZO Vesna Kronstein Kufrin Czech Republic MoH Czech Republic Hynek Kruzik Estonia HWISC Kerli Linna Finland THL Mikko Härkönen Germany DIMDI Stefanie Weber Hungary AEEK Gergely Heja Eamon Coyne; Ireland HSE Theresa Barry Lithuania LMB Martynas Bieliauskas Netherlands NICTIZ Pim Volkert Norway EHELSE Jostein Vein MoH Poland Hubert Zycinski; Poland CZIOZ Ania Ostrowicka Henrique Martins; Diogo Martins; Jurgen Wehnert; Lilia Marques; Cristiana Antunes; Filipa Rasquinho; Portugal SPMS Daniela Costa; Filipe Mealha; Joana Cunha; Carla Pereira; Anabela Santos; Anderson do Carmo Slovenia NIJZ Lucija Tepej-Jocic Arturo Romero Gutiérrez; Spain MoH Spain Miguel Pedrera Jiménez Sweden Socialstyrelsen Daniel Karlsson 2/31 eHAction – Joint Action supporting the eHealth Network - www.ehaction.eu D8.2.2 Common Semantic Strategy WP8 Integration in National Policies and Sustainability Draft for Discussion Revision 1.4, 10-05-2019 REVISION HISTORY Revision Date Author Description Daniel Karlsson; Stefanie Weber; Mikko Härkönen; Vesna Kronstein Kufrin; Hynek st 0.1 11/02/2019 Kruzik; Hubert Zycinski; Kerli Linna 1 draft document Input of new content. 0.2 25/02/2019 Carla Pereira; Daniela Costa; Lucija Tepej-jocic Comments on the Document 0.3 05/03/2019 Arturo Romero; Jurgen Wehnert Comments on the Document Peter Brosch; Hynek Kruzik;Daniel Karlsson; Input of new content.
    [Show full text]
  • D8.2 - Policy Document About Technology Report
    D8.2 - Policy document about technology report WP8 - Integration in National Policies and Sustainability 08/06/2021 Version 1.0 Grant Agreement nº 801558 This document presents the work regarding the policy technology on eHealth. Through the huge level of information and granularity associated with this subject, this deliverable contains four chapters about: Electronic health record exchange format (EHRxF); the Common Semantic strategy (CSS); eHealth reference architecture (eHRA) and Common Strategy for the use of Digital Identification in Health in the European Union (eID). D8.2 – Policy document about technology report WP8 - Integration in National Policies and Sustainability Version 1.0, 08/06/2021 CONTROL PAGE OF DOCUMENT Document name D8.2 – Policy document about technology report Work Package WP1 - Coordination Dissemination level PU Status Approved Author(s) Country Organisation Name Sozial Ministerium Peter Brosch (CSS) Austria ELGA Stefan Sabutsch (EHRxF, CSS) GOEG Alexander Degelsegger-Márquez (eHRA) Federal Public Service Arabella D'Havé (CSS) of Health, Food Chain Belgium Safety and Environment Croatia HZZO Jelena Curać (EHRxF), Vesna Kronstein Kufrin (CSS); Ammochostos General Florentia Zeitouni (EHRxF) Cyprus Hospital MoH CY Vasilios Scoutellas (CSS) Czech Republic MoH Czech Republic Hynek Kruzik (All) Denmark Sundhedsdatastyrelsen Camilla Wiberg Danielsen (CSS) Estonia HWISC Katre Pruul (EHRxF), Kerli Linna (CSS) THL Heikki Virkkunen (EHRxF) Juha Mykkänen (EHRxF) Finnish Institute for Finland Health and Welfare Mikko Härkönen
    [Show full text]