医疗保障药品分类与编码标准研究

Study on Classification and Coding Standards of Healthcare Security Drugs

目的:研究制定全国统一的医疗保障药品分类与编码标准体系。方法:通过问卷调查、数据分析、专家访谈与实地调研,了解全国医保系统内药品分类与编码标准执行情况及具体规则,深入对比分析《社会保险药品分类与代码》(LD/T90-2012)、国家药管平台药品招标采购唯一性识别码(YPID)、国家药品编码本位码的结构、特点与功能。结果与结论:医疗保障药品编码须遵循“权威性、唯一性、兼容性、代码与数据库联合使用”的原则,研究最终明确23位西药代码、20位中成药代码,涵盖药品分类、名称、剂型、规格、包装、企业等信息,能够满足药品招标采购、医保支付、监督管理、数据应用等业务的需要。同时研究还提出建设标准数据库、搭建动态维护平台,保证编码标准的有效实施。

Object:To study and formulate a unifi ed national standard system for classifi cation and coding of healthcare security drugs.Methods:Questionnaire survey,data analysis,expert interviews and related research were conducted to understand the implementation and specifi c rules of drug classifi cation and coding standards in the national healthcare security system.Results and conclusion:The coding of healthcare security drugs should follow the principle of"authoritativeness,uniqueness,compatibility,code combined with database".Finally,23-digit codes of Western medicine and 20-digit codes of Chinese patent medicines should be clarifi ed,covering the information of drug classifi cation,name,dosage form,specifi cations,packaging and enterprises,so as to meet the requirements of drug bidding,procurement and medical insurance payment.At the same time,the study also proposes building standard database and dynamic maintenance platform to ensure the eff ective implementation of coding standards.