全民健康保險重大傷病范圍

1、全民健康保險重大傷病範(fàn)圍運(yùn)用創(chuàng)傷嚴(yán)重程度分?jǐn)?shù)(Injury Severity Score, ISS)評估創(chuàng)傷嚴(yán)重程度1.ISS簡介2.AIS簡表全民健康保險重大傷病證明申請書呼吸器依賴患者重大傷病證明申請附表慢性腎衰竭需定期透析治療患者重大傷病證明申請附表重大傷病證明卡申請與換發(fā)注意事項全民健康保險保險對象免自行負(fù)擔(dān)費(fèi)用辦法重大傷病各項疾病檢附資料項目參考表衛(wèi)生署公告之罕見疾病名單(94.03.28更新)重大傷病範(fàn)圍疾病代碼1992年版與2001年版對應(yīng)表 (94.04.01新增)衛(wèi)生署公告罕見疾病名單疾病代碼1992年版與2001年版對應(yīng)表 (94.04.01新增)重大傷病範(fàn)圍1.須積極或長

2、期治療之癌癥 2.先天性凝血因子異常 3.嚴(yán)重溶血性及再生不良性貧血 4.慢性腎衰竭(尿毒癥)，必須接受定期透析治療者 5.需終身治療之全身性自體免疫癥候群 6.慢性精神病 7.先天性新陳代謝異常疾病(G6PD代謝異常除外) 8.心、肺、胃腸、腎臟、神經(jīng)、骨骼系統(tǒng)等之先天性畸型及染色體異常9.燒燙傷面積達(dá)全身百分之二十以上；或顏面燒燙傷合併五官功能障礙者。10.接受腎臟、心臟、肺臟、肝臟及骨髓移植後之追蹤治療 11.小兒麻痺、腦性麻痺、早產(chǎn)兒所引起之神經(jīng)、肌肉、骨骼、肺臟等之併發(fā)癥者 (其身心障礙等級在中度以上者) 12.重大創(chuàng)傷且其嚴(yán)重程度到達(dá)創(chuàng)傷嚴(yán)重程度分?jǐn)?shù)十六分以上者(INJURY SE

3、VERITY SCORE 16)(植物人狀態(tài)不可以ISS計算) 13.因呼吸衰竭長期使用呼吸器者。需使用呼吸器至少連續(xù)三十天，每天依賴呼吸器至少六小時，且造成呼吸之衰竭之原因尚未排除，或臨床上及生理方面仍未達(dá)穩(wěn)定狀態(tài)，目前持續(xù)使用中，短期內(nèi)無法脫離。14.因腸道大量切除或失去功能，或其它慢性疾病引起嚴(yán)重營養(yǎng)不良者，給予全靜脈營養(yǎng)已超過三十天，口攝飲食仍無法提供足量營養(yǎng) 15.因潛水、或減壓不當(dāng)引起之嚴(yán)重型減壓病或空氣栓塞癥，伴有呼吸、循環(huán)或神經(jīng)系統(tǒng)之併發(fā)癥且需長期治療者 16.重癥肌無力癥 17.先天性免疫不全癥 18.脊髓損傷或病變所引起之神經(jīng)、肌肉、皮膚、骨骼、心肺、泌尿及腸胃等之併發(fā)癥者

4、（其身心障礙等級在中度以上者）19.職業(yè)病 20.急性腦血管疾病 （限急性發(fā)作後一個月內(nèi)） 21.多發(fā)性硬化癥 22.先天性肌肉萎縮癥 23.外皮之先天畸型 24.痲瘋病 25.肝硬化癥 26.早產(chǎn)兒所引起之神經(jīng)、肌肉、骨骼、心臟、肺臟等之併發(fā)癥。 27.砷及其化合物之毒性作用（烏腳?。?8.後天免疫缺乏癥候群（指感染人類免疫缺乏病毒者）。 29.運(yùn)動神經(jīng)元疾病其身心障礙等級在中度以上或須使用呼吸器者。 30.庫賈氏病。31.經(jīng)本署公告之罕見疾病，但以列屬前三十類者除外。 衛(wèi)生署公告罕見疾病名單 940323修序號疾病名稱中文翻譯(中文翻譯僅供參考)ICD-9-CM編碼公告日期01Urea c

5、ycle disorders 尿素循環(huán)代謝障礙270.689120701Citrullinemia 瓜胺酸血癥270.602Amino acid metabolic disorders(Aminoacidopathies) 胺基酸代謝疾病270.901Homocystinuria 高胱胺酸尿癥270.41Hypermethioninemia高甲硫胺酸血癥270.402Cystinosis胱胺酸癥270.003Nonketotic hyperglycinemia非酮性高甘胺酸血癥270.704Phenylketonuria苯酮尿癥270.105Tetrahydrobiopterin defici

6、ency四氫基喋呤缺乏癥270.106Hereditary tyrosinemia遺傳性高酪胺酸血癥270.207Maple syrup urine disease糖楓尿癥270.303Hereditary coproporphyria遺傳性紫質(zhì)癥277.104Multiple sclerosis多發(fā)性硬化癥34005Gauchers disease高雪氏癥272.706Wilsons disease威爾森氏癥275.107Nesidioblastosis胰島母細(xì)胞瘤211.793/01/07衛(wèi)署公告刪除併入序號66項08Amyotrophiclateral sclerosis(ALS)肌萎縮

7、性側(cè)索硬化癥335.2009Organic acidemias有機(jī)酸血癥270.901lsovaleric acidemia異戊酸血癥270.302Glutaric aciduria type I,II戊二酸血癥，第一、二型270.903Propionic acidemia丙酸血癥270.304Methylmalonic acidemia甲基丙酸血癥270.3053-Hydroxy-3-methyl-glutaric acidemia3-氫基-3-甲基戊二酸血癥270.910Galactosemia半乳糖血癥271.111Fatty acid oxidation defect脂肪酸氧化作用缺陷

8、272.901Carnitine deficiency syndrome, primary原發(fā)性肉鹼缺乏癥272.912Mitochondrial defect粒腺體缺陷277.901Keams-Sayre syndromeKeams-Sayre氏癥候群277.902Leigh diseaseLeigh是童年期腦脊髓病變330.803MELASMELAS癥候群758.8904Mitochondrail NeurogastrointestinalEncephalopathy SyndromeMNGLE 癥候群粒腺體神經(jīng)胃腸腦病變癥候群277.992121913Aarskog-Scott synd

9、romeAarskog-Scott氏癥候群759.8989120714Achondroplasia軟骨發(fā)育不全癥756.415Angelman syndromeAngelman氏癥候群759.8916Ataxia telangiectasia共濟(jì)失調(diào)微血管擴(kuò)張癥候群334.817Cockayne syndromeCockayne氏癥候群759.8918Duchenne muscular dystrophy裘新氏肌肉失養(yǎng)癥359.119Glycogen storage disease肝醣儲積癥271.020GM1/GM2 gangliosidosisGM1/GM2神經(jīng)節(jié)甘脂儲積癥330.121H

10、ereditary epidermolysis bullosa遺傳性表皮分解性水皰癥757.3922Huntington disease(又稱Huntingtons chorea)亨丁頓氏舞蹈癥333.423Hutchinson Gilford progeria syndrome早老癥259.824lchthyosis,lamellar recessive層狀魚鱗癬（自體隱性遺傳型）757.125Kenny-Caffey syndromeKenny-Caffey氏癥候群759.8926Lesch-Nyhan syndromeLesch-Nyhan氏癥候群277.227Lowe sydromeL

11、owe氏癥候群270.828Mucopolysaccharidoses黏多醣癥277.529Osteogenesis imperfecta成骨不全癥756.5130Pseudohypoparathyroidism假性副甲狀腺低能癥275.4931Rett syndrome瑞特氏癥候群330.832Spinal muscular atrophy脊髓性肌肉萎縮癥335.1033Spinocerebellar ataxia脊髓小腦性共濟(jì)失調(diào)334.334Sulfite oxidase deficiency亞硫酸鹽氧化每缺乏270.035Thalassemia major重型海洋性貧血282.436T

12、uberous sclerosis結(jié)節(jié)性硬化癥759.537Waardenburg syndrome瓦登伯格氏癥候群270.238X-linked hypophosphatemic rickets性連遺傳型低磷酸鹽佝僂癥275.339Zellweger syndromeZellweger氏癥候群277.940Progressive intrahepatic cholestasis,PFIC進(jìn)行性家族性肝內(nèi)膽汁滯留癥751.6990020841Inbon errors of bile acid synthesis先天性膽酸合成障礙277.942Primary Paget dusease原發(fā)性變形

13、性骨炎731.00102Nitroacetylglutamate synthetase deficiency,NAG synthetase deficiency乙醯榖胺酸合成缺乏癥270.690031503Omithine transcarbamylase deficiency鳥胺酸甲胺醯基轉(zhuǎn)移缺乏癥270.643Apert syndrome愛伯特氏癥755.5544Cleidocranial dysplasia鎖骨顱骨發(fā)育異常755.5945DiGeorges syndromeDiGeorges癥候群279.1146Homozygous familial hypercholesterolem

14、ia同合子家族性高膽固醇血癥272.047Fucosidosis巖藻糖代謝異常（儲積癥）271.848PAH type PKU combine with Sucrase-isomaltase deficiency典型苯酮尿癥合併蔗糖同麥芽糖缺乏癥271.3+270.149Nemaline Rod MyopathyNemaline線狀肌肉病變359.090061250Fibrodysplasia Ossificans Progressiva進(jìn)行性骨化性肌炎728.1190071051Menkes syndromeMenkes氏癥候群759.89901018公告代碼275.1921219公告修正5

15、2Fabry diseaseFabry 氏癥272.790101853Prader-Willi syndromePrader-Willi氏癥候群759.8154Niemann-Pick diseaseNiemann-Pick氏癥，鞘髓磷脂儲積癥272.755Tricho-hepato-enteric syndrome髮-肝-腸癥候群759.756Collodion baby膠膜兒757.190121357Harlequin ichthyosis斑色魚鱗癬757.158Bullous Congenital ichthyosiform erythoderma（epidermolytic hyper

16、keratosis）水泡性魚鱗癬樣紅皮癥（表皮鬆懈角化過度癥）757.159Laron syndrome（Laron Dwarfism）Laron氏侏儒癥候群259.460Smith-Lemli-Opitz syndromeSmith-Lemli-Opitz 氏癥候群759.89901213公告代碼272.8921219公告修正61Bardet-Biedl syndromeBardet-Biedl氏癥候群759.8990121362Larsen syndromeLarsen氏癥候群（顎裂-先天性脫位）癥候群755.863Sialidosis涎酸酵素缺乏癥272.791041264Alstrom

17、 SyndromeAlstrom氏癥候群759.291080665Chronic primary granulomatous disease原發(fā)性慢性肉芽腫病288.1910806公告代碼279.3921219公告修正66Persistent hyperinsulinemic hypoglycemia of infancy（PHHI）持續(xù)性幼兒型胰島素過度分泌低血糖癥251.191080667Familial hyperchylomicronemia家族性高乳糜微粒血癥272.368W A G R syndrome（Wilms tumor-Aniridia-Genitourinary Anom

18、alies-mental Retardation）威爾姆氏腫瘤、無虹膜、性器異常、智能障礙癥候群（W A G R癥候群）759.8969Ectodermal Dysplasias外胚層增生不良癥757.3191111370Beckwith Wiedemann syndromeBeckwith Wiedemann氏癥候群759.8971Congenital insensitivity to pain with anhidrosis（CIPA）先天性痛不敏感癥合併無汗癥705.072Wolfram syndrome，DIDMOADWolfram氏癥候群277.973Adrenoleukodystr

19、ophy腎上腺腦白質(zhì)失養(yǎng)癥272.774McCune Albright syndromeMcCune Albright氏癥候群756.5975Crouzon syndromeCrouzon氏癥候群756.0911113公告代碼755.55921219公告修正76Thrombasthenia血小板無力癥287.191111377Schwartz Jampel syndromeSchwartz Jampel氏癥候群756.8978Fraser syndromeFraser氏癥候群759.8979Mucolipidosis黏脂質(zhì)癥272.792061380Ehlers Danlos syndrome

20、 先天結(jié)締組織異常第四型756.8381Myotonic dystrophy肌肉強(qiáng)直癥359.282Congenital Hyper IgE syndrome先天性高免疫球蛋白E癥候群279.983Tyrosinemial 、穌胺基酸癥第一型、第二型、第三型270.284Hyperlysinemia高離氨基酸血癥270.785Histidinemia組胺酸血癥270.5863-Methylcrotonyl-CoA carboxylase deficiency三甲基巴豆醯輔酶A梭化酵素缺乏癥270.987Multiple carboxylase deficiency多發(fā)性梭化酶缺乏癥270.98

21、8Split-hand/ Split-foot malformation （SHFM）裂手裂足癥hand：755.58foot：755.6792121989Metachromatic Leukodystrophy（MLD）MLD癥候群330.090Campomelic dysplasia with autosomal sex reveral短指發(fā)育不良及性別顛倒758.8991Osteopetrosis骨質(zhì)石化癥756.5292Carbohydrate-deficiency glycoprotein syndrome碳水化合缺乏醣蛋白癥候群277.993Trimethylaminuria臭魚癥

22、277.894Congenital generalized lipodystrophy先天性全身脂質(zhì)營養(yǎng)不良癥272.695Multiple pterygium syndrome多發(fā)性翼狀膜癥候群759.8993032996Idiopathic Infantile Arterial Calcification特發(fā)性嬰兒動脈硬化癥747.8997Miller Dieker syndromeMiller Dieker 癥候群742.298Medium-chain acyl-coenzyme A dehydrogenase deficiency（MCAD）中鏈脂肪酸去氫酵素缺乏癥277.899Hyperprolinemia高脯胺酸血癥270.8100Cystic fibrosis 囊狀纖維化癥277.00101Pyruvate dehydrogenase deficiency丙酮酸鹽脫氫酶缺乏癥271.8930824102Neuronal ceroid lipofuscinosis神經(jīng)元蠟樣脂褐質(zhì)儲積癥330.1103Meleda diseaseMeleda島病757.39104Neurofibromatosis type II神經(jīng)纖維瘤癥候群第二型237.72105Alexander disease Alexander 氏病331.89106ACTH