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MINISTRY OF
HEALTH
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SOCIALIST
REPUBLIC OF VIETNAM
Independence – Freedom – Happiness
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No.: 4210/QD-BYT
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Hanoi, September
20, 2017
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DECISION
PROVIDING
FOR OUTPUT DATA STANDARDS AND FORMATS USED IN MANAGEMENT, ASSESSMENT AND
PAYMENT FOR MEDICAL SERVICES COVERED BY HEALTH INSURANCE FUND
MINISTER OF HEALTH
Pursuant to the Government’s Decree No.
75/2017/ND-CP dated June 20, 2017 defining Functions, Tasks, Powers and Organizational
Structure of Ministry of Health;
Pursuant to the Government’s Decree No.
166/2016/ND-CP dated December 24, 2016 providing for electronic transactions in
social, health and unemployment insurance sectors;
Pursuant to the Government’s Resolution No.
36a/NQ-CP dated October 14, 2015 on E-government;
At the request of the Director of Health
Insurance Department,
HEREBY DECIDES:
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1. Table 1: General entries relating to medical
services covered by health insurance fund;
2. Table 2: Entries relating to drugs covered by
health insurance fund;
3. Table 3: Entries relating to medical technical
services and medical supplies covered by health insurance fund;
4. Table 4: Entries relating to subclinical
results;
5. Table 5: Entries relating to clinical
progression;
6. Table 6: List of cost-based groups of medical
services;
7. Table 7: List of Department’s codes;
8. Table 8: List of codes of accidents and
injuries;
9. Table 9: List of codes of procurements and drug
categories.
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Article 2. Implementation
1. Health facilities shall assume responsibility to
send data to the Portal for medical data of Ministry of Health at http://congdulieuyte.vn
and the Portal for receipt of health insurance assessment-related information
of the Vietnam Social Security Authority at https://gdbhyt.baohiemxahoi.gov.vn
with respect of information in Table 1, Table 2 and Table 3 prescribed in
Article 1 herein as of October 31, 2017.
2. Information in Table 4 and Table 5 prescribed in
Article 1 herein shall be sent by health facilities as of April 01, 2018.
Article 3. This Decision shall come into force as from the date on
which it is signed. Decision No. 2286/QD-BYT dated June 02, 2017 by Minister of
Health providing for output data standards and formats used in management,
assessment and payment for medical services covered by health insurance fund is
abrogated.
Article 4. Chief of Office of Ministry of Health, Director of Health
Insurance Department, Directors/ Directors General of Departments/Authorities
affiliated to Ministry of Health, Directors of Departments of Health of
provinces or central-affiliated cities, and heads of relevant agencies shall be
responsible for implementation of this Decision./.
PP. MINISTER
DEPUTY MINISTER
Pham Le Tuan
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(Enclosed with
Decision No. 4210/QD-BYT dated September 20, 2017 by Minister of Health)
No.
Entry
Data type
Maximum length
Description
1
MA_LK
String
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Unique treatment code (for data connection
between table 1 and table 2-5 in each medical examination or treatment
(PRIMARY KEY)).
2
STT
Numeric
10
Ordinal numbers starting at 1 in each data
transmission.
3
MA_BN
String
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Patient’s code granted by the health facility.
4
HO_TEN
String
255
Full name of patient
5
NGAY_SINH
String
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Date of birth specified in the patient's health
insurance card, including 8 characters: 4 characters of year + 2 characters
of month + 2 characters of day (if day and month are unknown, default value
is “0101”)
6
GIOI_TINH
Numeric
1
Sex; Encoded (1: Male; 2: Female; 3: Unknown)
7
DIA_CHI
String
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Address is recorded according to the address
specified in the patient’s health insurance card or the patient’s current address,
including: house number (if any); street (if any); commune/ward/town; urban
or sub-urban district/provincial-affiliated town or city;
province/centrally-affiliated city
8
MA_THE
String
n
- Code of health insurance card issued by the social
security agency
- With regard to patients who do not have health
insurance cards but are eligible to receive health insurance benefits, such
as children or organ transplant patients, etc., provisional codes shall be
recorded according to the following rule: Object code + code of health
insurance benefits + province code + KT + 8 characters starting at 00000001
and ending at 99999999 according to the ascending ordinal numbers of
patients.
E.g.: TE101KT00000011 (This provisional
code is granted to the 11th child patient whose birth certificate/
certificate of live birth is granted by a competent authority of Hanoi City).
- While receiving treatment, if a patient is
granted a new health insurance card with its code changed, the new code
(comprising 15 characters) shall be added and separated from the existing one
by a semicolon “;”
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MA_DKBD
String
n
Code of primary health facility, comprising 5
characters, as specified in the patient’s health insurance card.
- While receiving treatment, if a patient is
granted a new health insurance card with a change in code of primary health
facility, the new code of primary health facility shall be added and
separated from the existing one by a semicolon “;”
- In case of unavailability of a health insurance
card, code of province/city + 000 shall be specified. E.g.: 01000 if the
patient lives in Hanoi City.
10
GT_THE_TU
String
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Effective date of the health insurance card, comprising
8 characters: 4 characters of year + 2 characters of month + 2 characters of
day.
- While receiving treatment, if a patient is
granted a new health insurance card with a change in its effective date, the
new effective date shall be added and separated from the existing one by a
semicolon “;”
- In case of unavailability of a health insurance
card, the date on which the patient receives medical services (comprising 8
characters: 4 characters of year + 2 characters of month + 2 characters of
day) shall be specified.
11
GT.THE_DEN
String
n
Expiry date of the health insurance card,
comprising 8 characters: 4 characters of year + 2 characters of month + 2
characters of day.
- While receiving treatment, if a patient is granted
a new health insurance card with a change in its expiry date, the new expiry
date shall be added and separated from the existing one by a semicolon “;”
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12
MIEN_CUNG_CT
String
8
- Effective date of copayment exemption
certificate granted by a social security agency, comprising 8 characters: 4
characters of year + 2 characters of month + 2 characters of day.
E.g.: If the patient is eligible for copayment
exemption as from March 31, 2017, it is represented as 20170331
- In case of unavailability of copayment
exemption certificate granted by a social security agency, this entry is left
blank.
13
TEN_BENH
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n
Medical diagnosis shall be sufficiently specified
as shown in medical record.
14
MA_BENH
String
15
Code of major disease according to ICD 10 or code
of disease in traditional medicine.
15
MA_BENHKHAC
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255
Code of other disease (if any) according to ICD
10 or code of disease in traditional medicine. If a patient suffers from multiple
health conditions, codes of diseases shall be separated by semicolons “;”
16
MA_LYDO_VVIEN
Numeric
1
Encoding of the object receiving medical services
covered by health insurance fund (1: Appropriate referral; 2: Emergency case;
3: Inappropriate referral; 4: Unrestricted referral (i.e. receiving medical
services at a health facility other than the registered one in the same
province/city)
17
MA_NOI_CHUYEN
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5
Code of health facility where the patient is referred
to (this code is granted by the social security agency)
18
MA_TAI_NAN
Numeric
1
Accident/injury; using reference encoding
specified in Table 8 (List of accidents and injuries) enclosed herewith.
19
NGAY_VAO
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12
- Time when the patient receives medical
services, comprising 12 characters: 4 characters of year + 2 characters of
month + 2 characters of day + 2 characters of hour (24-hour format) + 2
characters of minute. E.g.: If a patient receives medical services at 15:20
PM on March 31, 2017, it is represented as 201703311520
20
NGAY_RA
String
12
- Time of discharge, comprising 12 characters: 4
characters of year + 2 characters of month + 2 characters of day + 2 characters
of hour (24-hour format) + 2 characters of minute.
E.g.: If a patient is discharged from the
hospital at 09:20 AM on April 05, 2017, it is represented as 201704050920;
- In case of outpatient treatment, date of
finishing the outpatient treatment (the final date of using medicines or
medical services as prescribed by physician) shall be specified; “0000” is
default value for 2 characters of hour + 2 characters of minute.
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21
SO_NGAY_DTRI
Numeric
3
Actual days of treatment
22
KET_QUA_DTRI
Numeric
1
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23
TINH_TRANG_RV
Numeric
1
Discharging status; Encoded (1: Discharged; 2:
Referred to other hospital; 3: Escaped from the hospital; 4: Discharged as
requested by the patient)
24
NGAY_TTOAN
String
12
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E.g.: If a patient is discharged from the
hospital at 09:20 AM on April 05, 2017, it is represented as 201704050920;
- This entry shall be left blank when sending
data to the target gateway if the patient has left the hospital but failed to
make payment of medical expenses. When the patient pays medical
expenses or the health facility completes payment procedures (because the
patient has escaped from the health facility without payment of medical
expenses), the health facility shall provide additional information about the
date of payment and send complete date to the target gateway or provide
additional information about the date of payment directly on the target
gateway.
25
T_THUOC
Numeric
15
Total amount of costs of drugs (including
oxygen), fluid replacement, transfusion of blood and blood products (including
costs of nucleic acid test (NAT), antibody test and platelet
screening KIT), cost of blood transport and packaging cost (for oriental
medicines) in XML2 file, rounded to the nearest hundredth. A decimal point
(“.”) shall be used to separate the whole numbers (or units) and the first
decimal number.
26
T_VTYT
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15
Total amount of costs of medical supplies in XML3
file, rounded to the nearest hundredth. A decimal point (“.”) shall be used
to separate the whole numbers (or units) and the first decimal number.
27
T_TONGCHI
Numeric
15
Total costs of each medical examination or
treatment which is total amount of money in XML2 and XML3 files, rounded to
the nearest hundredth. A decimal point (“.”) shall be used to separate
the whole numbers (or units) and the first decimal number.
28
T_BNTT
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15
Total amount self-paid by the patient for medical
services which are not covered by the health insurance fund in XML2 and XML3
files, rounded to the nearest hundredth. A decimal point (“.”) shall be used
to separate the whole numbers (or units) and the first decimal number.
29
T_BNCCT
Numeric
15
Total amount co-paid by the patient according to
the health insurance coverage in XML2 and XML3 files, rounded to the nearest
hundredth. A decimal point (“.”) shall be used to separate the whole numbers
(or units) and the first decimal number.
30
T_BHTT
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15
Total amount of which payment request is
submitted to the social security agency in XML2 and XML3 files, rounded to
the nearest hundredth. A decimal point (“.”) shall be used to separate the
whole numbers (or units) and the first decimal number.
31
T_NGUONKHAC
Numeric
15
Total amount of the patient’s medical expenses
covered by other financial sources in XML2 and XML3 files, rounded to the
nearest hundredth. A decimal point (“.”) shall be used to separate the whole numbers
(or units) and the first decimal number.
32
T_NGOAIDS
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15
Cost of non-capitated medical services, rounded
to the nearest hundredth. A decimal point (“.”) shall be used to separate the
whole numbers (or units) and the first decimal number.
33
NAM_QT
Numeric
4
The year in which payment request for medical
services is submitted to a social security agency.
34
THANG_QT
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2
The month in which payment request for medical
services is submitted to a social security agency.
35
MA_LOAI_KCB
Numeric
1
Encoded types of medical services (1: Medical
examination; 2: Outpatient treatment; 3: Inpatient treatment)
- In case of long-term treatment of a chronic
disease, XML file shall be sent every month (between the first day and the
last day of each month).
- In case of outpatient treatment of other
diseases, only XML file shall be sent upon the completion of a treatment.
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MA_KHOA
String
15
Department's code; if a patient receives
treatment at multiple departments, code of the department that consolidates
the patient’s medical records shall be specified.
37
MA_CSKCB
String
5
Code of health facility where the patient
receives treatment ( this code is granted by the social security agency)
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MA_KHUVUC
String
2
Code of place of residence specified in the
health insurance card, i.e. K1 or K2 or K3”
39
MA_PTTT_QT
String
255
International procedural code (according to
ICD-9-CM Volume 3) (This entry must be specified upon the availability of
reference table of international procedural codes and written directive promulgated
by Ministry of Health). In case of multiple procedures, procedural codes
shall be separated by semicolons (;)
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CAN_NANG
Numeric
5
Only weights of patients who are children under 1
year of age are specified. This entry reflects the body weight in
kilograms (kg) of a child patient measured at the time of hospitalization.
This kilogram of body weight is represented by a
decimal, rounded to the nearest hundredth. Decimal point is a dot (.).
E.g.: 5.75 kg.
Table
2: Entries relating to drugs covered by health insurance fund
(Enclosed with
Decision No. 4210/QD-BYT dated September 20, 2017 by Minister of Health)
STT
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Data type
Maximum length
Description
1
MA_LK
String
100
Unique treatment code (for data connection
between table 1 and this table in each medical examination or treatment).
2
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Numeric
6
Ordinal numbers starting at 1 in each data
transmission.
3
MA_THUOC
String
255
- Code of active ingredient as specified in the
Set of code lists used in medical examination and treatment, and payment of
covered medical services (hereinafter referred to as “Set of code lists in
healthcare sector”) promulgated by Ministry of Health;
- Code of oxygen: 40.17;
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+ If antibody tests are done, 2 characters “KT”
shall be added to the codes of blood and blood products, and separated by a
dot “.”
+ If NAT tests are done, 3 characters “NAT” shall
be added to the codes of blood and blood products, and separated by a dot “.”
+ If both antibody test and NAT test are done, 5
characters “KTNAT” shall be added to the codes of blood and blood products,
and separated by a dot “.”
- Cost of blood transport shall be specified as
“VM.XXXXX”, in which "XXXXX" is the code of the health facility
providing blood; - Packaging cost for oriental medicines shall be specified
as “BB.XXXXX”, in which "XXXXX" is the code of the health facility
that requests for payment.
4
MA_NHOM
Numeric
2
Used to classify and sort medical expenses into
corresponding sections (referred to Table 6 enclosed herewith)
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TEN_THUOC
String
1024
It must be the drug name granted registration
number by the Drug Administration of Vietnam or Traditional Medicine
Administration of Vietnam
6
DON_VI_TINH
String
50
- Smallest unit of drug as announced by the Drug Administration
of Vietnam or the Traditional Medicine Administration of Vietnam;
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7
HAM_LUONG
String
1024
Concentration of drug granted registration number
by the Drug Administration of Vietnam or the Traditional Medicine
Administration of Vietnam; if drugs contain multiple active ingredients,
concentration of each active ingredient shall be specified and separated from
each other by a semicolon (;)
- In case of traditional ingredients or family
medicines without concentrations, this entry shall be left blank or filled
with drug weight (if available).
8
DUONG_DUNG
String
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Code of administration route as specified in the
Set of code lists in healthcare sector promulgated by Ministry of Health
9
LIEU_DUNG
String
255
Dose: quantity of medicine prescribed to be taken
at one time * times of taking drug per day E.g.: Dose of “A” drug is 2 tablets
each time and 2 times per day, it shall be represented as “2 tablets/time * 2
times/day”
10
SO_DANG_KY
String
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Drug registration number issued by the Ministry of
Health or the Drug Administration of Vietnam or the Traditional Medicine
Administration of Vietnam (no space is added between characters)).
11
TT_THAU
String
25
Drug bid-related information, including: number
of bid award decision, procurement, and drug category according to the list
approved by the social security agency. Information shall be separated by
semicolons (;). Codes procurements and drug categories are specified in Table
9.
E.g.: Drugs of category 2 of the Generic drug
procurement are provided under the bid award decision No. 12/QD-SYT, this
entry shall be represented as “12/QD-SYT;G1;N2”.
(in case of unavailability of a bid award
decision, number of the official dispatch sent to the social security agency
shall be specified)
12
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Numeric
1
Code of scope of drug coverage. To be specific:
(1): Drugs are covered by health insurance (i.e. they are in the list of
drugs covered by health insurance); (2): Drugs are not covered by health
insurance (i.e. they are not in the list of drugs covered by health
insurance)
13
TYLE_TT
Numeric
3
Coinsurance by the health insurance fund and
written as a percentage (%). This percentage is a positive whole number.
E.g.: If coinsurance percentage is 50%, the value
of this entry shall be “50”. With regard to drugs for which coinsurance
percentage is not provided for, the value of this entry shall be “100”. If
drugs are not covered by health insurance, the value of this entry shall be
“0”.
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SO_LUONG
Numeric
10
Actual amount of drugs used, rounded to the
nearest thousandth. A decimal point (“.”) shall be used to separate the
whole numbers (or units) and the first decimal number.
15
DON_GIA
Numeric
15
- Unit price of drugs which is the unit price
specified in the purchase invoice of the health facility, rounded to the
nearest thousandth. A decimal point (“.”) shall be used to separate the
whole numbers (or units) and the first decimal number. - In case of herbal
ingredients, unit price plus damage costs as prescribed by the Ministry of
Health shall be specified.
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THANH_TIEN
Numeric
15
= SO_LUONG * DON_GIA, rounded to the nearest hundredth.
A decimal point (“.”) shall be used to separate the whole numbers (or units)
and the first decimal number.
17
MUC_HUONG
Numeric
3
Coverage ratio in proportion to each type of
medical expenses
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E.g.: If a patient who is entitled to coverage
ratio of 80% has received inpatient treatment by inappropriate referral to a
central-level health facility (with coverage ratio of inappropriate referral
case as 40%), the value of this entry shall be 32.
- In case a patient has received medical
examination and treatment at an appropriate-level health facility with total
medical expense less than 15% of the statutory pay rate, or the patient has
received medical examination and treatment at a communal medical station, or
the patient is eligible for copayment exemption in a year, the value of this
entry shall be 100;
- In case a patient has received medical
examination and treatment at an inappropriate-level health facility with
total medical expense less than 15% of the statutory pay rate, the value of
this entry shall be the coverage ratio of inappropriate referral case in
corresponding with the professional and technical level of health facility.
18
T_NGUON KHAC
Numeric
15
Total amount of the patient’s medical expenses covered
by other financial sources, rounded to the nearest hundredth. A decimal point
(“.”) shall be used to separate the whole numbers (or units) and the first
decimal number.
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Numeric
15
Total amount self-paid by the patient for medical
services which are not covered by the health insurance fund, rounded to the
nearest hundredth. A decimal point (“.”) shall be used to separate the whole
numbers (or units) and the first decimal number.
20
T_BHTT
Numeric
15
Total amount of which payment request is
submitted to the social security agency according to the scope of coverage,
rounded to the nearest hundredth. A decimal point (“.”) shall be used
to separate the whole numbers (or units) and the first decimal number.
T_BHTT = (THANH_TIEN-T_BNTT-T_NGUONKHAC) x
MUC_HUONG/100 x TYLE_TT/100
...
...
...
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T_BNCCT
Numeric
15
Total amount co-paid by the patient according to
the health insurance coverage, rounded to the nearest hundredth. A decimal point
(“.”) shall be used to separate the whole numbers (or units) and the first
decimal number.
T_BNCCT = THANH_TIEN - T_NGUONKHAC - T_BNTT -
T_BHTT
22
T_NGOAIDS
Numeric
15
...
...
...
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23
MA_KHOA
String
15
Code of Department giving prescription to the
patient (referred to Table 7 herein)
24
MA_BAC_SI
String
255
...
...
...
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25
MA_BENH
String
255
Code of major disease (according to ICD 10) and/or
code of disease in traditional medicine as diagnosed by traditional medicine
doctor or physician; codes of other diseases shall be also added and
separated by semicolons (;)
26
NGAY_YL
String
12
...
...
...
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E.g.: Date of making physician order is at 15:20’
hrs., on March 31, 2017, it shall be represented as “201703311520”
27
MA_PTTT
Numeric
1
Code of payment method (0: Fee-for-service
payment; 1: Capitation payment; 2: Payment of non-capitated medical services;
3: Diagnosis-related group (DRG)-based payment)
Notes:
- Symbol (*) is the multiplication sign (x).
Table
3: Entries relating to medical technical services and medical supplies covered
by health insurance fund
...
...
...
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STT
Entry
Data type
Maximum length
Description
1
MA_LK
String
100
...
...
...
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2
STT
Numeric
6
Ordinal numbers starting at 1 in each data
transmission.
3
MA_DICH_VU
String
20
...
...
...
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- Patient transport service shall be specified as
VC.XXXXX, in which XXXXX is the code of initiating health facility.
- Code of hospital ranking-based cost of hospital
bed is provided in the “Set of code lists in healthcare sector” promulgated
by Ministry of Health;
4
MA_VAT_TU
String
255
- Code of medical supplies as specified in the
“Set of code lists in healthcare sector” promulgated by Ministry of Health;
only codes of medical supplies which are not included in the price of technical
services are specified;
- With respect to medical supplies used in
specific surgery or procedure and paid separately, code of surgery or
procedure shall be added to <MA_DICH_VU> field in front of
<MA_VAT_TU> field of code of medical supplies;
- With respect to medical supplies which are not
used in specific surgery or procedure, the <MA_DICH_VU> field
shall be left blank;
...
...
...
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5
MA_NHOM
Numeric
2
Used to classify and sort medical expenses into
corresponding sections (referred to Table 6 enclosed herewith)
Code of medical supplies applying payment ceiling
or percentage is 11.
6
GOI_VTYT
String
...
...
...
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Code of package of medical supplies used in each
medical service (such as G1 for the first medical service, G2 for the second
medical service, etc.)
7
TEN_VAT_TU
String
1024
Name of medical supply
8
TEN_DICH_VU
String
...
...
...
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Name of medical technical service or hospital
bed;
In case of medical technical service or case
requiring details about location and operation method or separation of different
prices, detailed description shall be specified in the square brackets [ ]
after the name of service.
9
DON_VI_TINH
String
50
Unit of calculation
10
PHAM_VI
...
...
...
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1
Code of scope of medical supplies coverage (1: Medical
supplies are covered by health insurance (i.e. they are in the list of
medical supplies covered by health insurance); 2: Medical supplies are not
covered by health insurance (i.e. they are not in the list of medical
supplies covered by health insurance)
11
SO_LUONG
Numeric
10
Actual amount of medical supplies used, rounded
to the nearest hundredth. A decimal point (“.”) shall be used to
separate the whole numbers (or units) and the first decimal number.
12
DON_GIA
...
...
...
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15
- Unit price of medical supplies which is the
unit price specified in the purchase invoice of the health facility, rounded
to the nearest thousandth. A decimal point (“.”) shall be used to
separate the whole numbers (or units) and the first decimal number.
- In case of reused medical supplies, the unit
price includes the cost of reprocessing of such reusable medical supplies as
prescribed by the Ministry of Health. E.g.: When purchasing medical equipment
with the unit price of VND 100,000 for use in two times with the reprocessing
cost of VND 10,000, the unit price specified in this entry shall be VND
55,000.
13
TT_THAU
String
25
Information about bid award decision is specified
according to the following format: XXXX.YY.Z (XXXX: Issued year of the bid
award decision, YY: number of procurement, Z: number of bid award decision)
(in case of unavailability of a bid award decision, number of the official
dispatch sent to the social security agency shall be specified).
14
...
...
...
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Numeric
3
Coinsurance written as a percentage (%) of
medical technical services or medical supplies covered by the health
insurance fund. This percentage is a positive whole number.
E.g.: If coinsurance percentage of medical
technical services or medical supplies is 50%, the value of this entry shall
be “50”. With regard to medical technical services or medical supplies for
which coinsurance percentage is not provided for, the value of this entry
shall be “100”. If medical technical services or medical supplies are not
covered by health insurance, the value of this entry shall be “0”.
- With regard to hospital bed cost, in case a
patient is transferred between two departments or more within one day:
+ code of hospital bed cost and unit price are
unchanged, quantity is 0.5, coinsurance percentage is 100, if the patient is
transferred between departments with highest and lowest hospital bed prices;
+ code of hospital bed cost and unit price are
unchanged, quantity is 0, if the patient is transferred to other departments
(if any).
- In case a patient is transferred between two
departments or more within one day and shares hospital beds with another
patients:
+ if 02 patients share a hospital bed: code of
hospital bed cost and unit price are unchanged, quantity is 0.5 and
coinsurance percentage is 50;
...
...
...
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15
THANH_TIEN
Numeric
15
= SO_LUONG * DON_GIA, rounded to the nearest hundredth.
A decimal point (“.”) shall be used to separate the whole numbers (or units)
and the first decimal number.
- In cases of special coinsurance percentages
specified in the Appendix 01 enclosed herewith, THANH_TIEN = SO_LUONG *
DON_GlA * TYLE_TT / 100, rounded to the nearest hundredth. A decimal point
(“.”) shall be used to separate the whole numbers (or units) and the first
decimal number.
16
T_TRANTT
Numeric
...
...
...
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Maximum costs of medical supplies as prescribed by
the Ministry of Health. In case of unavailability of maximum costs, this
entry shall be left blank.
17
MUC_HUONG
Numeric
3
Coverage ratio in proportion to each type of
medical expenses.
- In case a patient has received medical services
at an appropriate-level health facility, the coverage ratio shall be
specified as 80, or 95 or 100. In case a patient has received medical
services at an inappropriate-level health facility, the value of this entry
shall be the coverage ratio multiplied by the coverage ratio of inappropriate
referral case in corresponding with the professional and technical level of
health facility;
- In case a patient has received medical
examination and treatment at an appropriate-level health facility with total
medical expense less than 15% of the statutory pay rate, or the patient has
received medical examination and treatment at a communal medical station, or
the patient is eligible for copayment exemption in a year, the value of this
entry shall be 100;
- In case a patient has received medical
examination and treatment at an inappropriate-level health facility with
total medical expense less than 15% of the statutory pay rate, the value of
this entry shall be the coverage ratio of inappropriate referral case in corresponding
with the professional and technical level of health facility.
...
...
...
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T_NGUONKHAC
Numeric
15
Total amount of the patient’s medical expenses
covered by other financial sources, rounded to the nearest hundredth. A
decimal point (“.”) shall be used to separate the whole numbers (or units)
and the first decimal number.
19
T_BNTT
Numeric
15
Total amount self-paid by the patient for medical
services which are not covered by the health insurance fund, rounded to the nearest
hundredth. A decimal point (“.”) shall be used to separate the whole numbers
(or units) and the first decimal number.
...
...
...
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T_BHTT
Numeric
15
Total amount of which payment request is submitted
to the social security agency according to the scope of coverage, rounded to
the nearest hundredth. A decimal point (“.”) shall be used to separate
the whole numbers (or units) and the first decimal number.
T_BHTT = (THANH_TIEN-T_BNTT-T_NGUONKHAC) x
MUC_HUONG/100 x TYLE_TT/100
21
T_BNCCT
Numeric
15
...
...
...
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T_BNCCT = THANHTIEN - T_NGUONKHAC - T_BNTT -
T_BHTT
22
T_NGOAlDS
Numeric
15
T_NGOAlDS = T_BHTT, with respect to costs of
non-capitated medical services, rounded to the nearest hundredth. A decimal point
(“.”) shall be used to separate the whole numbers (or units) and the first
decimal number.
23
MA_KHOA
String
...
...
...
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Code of Department providing medical services
(referred to Table 7)
24
MA_GIUONG
String
14
Code of hospital bed at each treatment
department, comprising 4 characters and encoded as follows:
- For planned beds: H + the number of beds at
such treatment department (numbered from 001)
- For extra beds: T + the number of beds at such
treatment department (numbered from 001)
- For optional beds: C + the number of beds at
such treatment department (numbered from 001)
...
...
...
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* If a patient has been transferred between
multiples beds, codes of beds shall be separated by semicolons (;)
25
MA_BAC_SI
String
255
- Code of physician who has examined and given
orders to the patient (encoded according to number of practicing
certificate)/ code of practicing certificate of medical examination and
treatment practitioner
- With regard to a medical technical service,
code of doctor or healthcare employee providing such technical service; if a medical
service is provided by two healthcare employees or more, numbers of their
practicing certificates shall be specified and separated by semicolons (;).
26
MA_BENH
...
...
...
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255
Code of major disease (according to ICD 10) or
code of disease in traditional medicine as diagnosed by traditional medicine
doctor or physician. Codes of other diseases shall be also added and
separated by semicolons (;)
27
NGAY_YL
String
12
Date of giving physician order (comprising 12 characters,
according to the following format: yyyymmddHHmm = 4 characters of year + 2
characters of month + 2 characters of day + 2 characters of hour (24-hour
format) + 2 characters of minute).
- For surgery, procedures and interventions: time
of starting such surgery, procedure or intervention is specified.
- For hospital beds: time of starting using
hospital bed is specified
...
...
...
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28
NGAY_KQ
String
12
Results release date (comprising 12 characters,
according to the following format: yyyymmddHHmm = 4 characters of year + 2
characters of month + 2 characters of day + 2 characters of hour (24-hour
format) + 2 characters of minute).
- For surgery, procedures and interventions: time
of ending such surgery, procedure or intervention is specified.
- For hospital beds: time of ending use of each
type of hospital beds is specified.
E.g.: Result is released at 15:20’ hrs., on March
31, 2017, it shall be represented as “201703311520”
29
...
...
...
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Numeric
1
Code of payment method (0: Fee-for-service
payment; 1: Capitation payment; 2: Payment of non-capitated medical services;
3: Diagnosis-related group (DRG)-based payment)
Notes:
- In case medical supplies are used together with a
specific medical technical service, code of medical service is specified in the
entry 3 (MA_DICH_VU), and codes of medical supplies are specified in the entry
4 (MA_VAT_TU)
- Entry 15 (NGAY_YL):
+ With regard to date of using hospital beds,
health facilities are required to specify date of giving physician orders
according to the date of starting using or changing types of beds or bed
prices, or sharing beds with other patients or transferring between
departments.
+ For medical supplies, date of conducting surgery,
procedure or intervention with using medical supplies is specified so as to
determine the payment ceiling for medical supplies in each use of technical
services (if the cost of technical service does not include costs of medical
supplies).
- Symbol (*) is the multiplication sign (x).
...
...
...
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(Enclosed with
Decision No. 4210/QD-BYT dated September 20, 2017 by Minister of Health)
STT
Entry
Data type
Maximum length
Description
1
MA_LK
...
...
...
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100
Unique treatment code (for data connection
between table 1 and this table in each medical examination or treatment).
2
STT
Numeric
6
Ordinal numbers starting at 1 in each data
transmission
3
MA_DICH_VU
...
...
...
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15
Code of subclinical service according to the “Set
of code lists in healthcare sector” promulgated by Ministry of Health
4
MA_CHI_SO
String
50
Code of test index as specified in the “Set of
code lists in healthcare sector” promulgated by Ministry of Health
5
TEN_CHI_SO
...
...
...
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255
Name of test index as regulated by Ministry of
Health
6
GIA_TRI
String
50
Index value (test result)
7
MA_MAY
...
...
...
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50
Code of subclinical machinery (test machine,
X-ray machine, ultrasound machine, etc.), provisionally specified according
to the following format: XX.n.YYYYY.ZZZZZZ, in which:
- XX: Code of test machinery. E.g.: “HH” denotes
hematology analyzer; "VS” denotes microbiology testing machine; “SH”
denotes biochemistry analyzer; “SA” denotes ultrasound machine;
"XQ" denotes X-ray machine; "CL" denotes CT Scanner;
"MRI" denotes MRI equipment, etc.
- n: sign of source of funding for buying
subclinical machinery (1: state budget; 2: private sector contribution; 3:
other)
- YYYYY: Code of health facility
- ZZZZZZ: Serial number of subclinical machinery
(the last 06 digits). If it consists of less than 6 digits, zeroes shall be
added in the front.
8
MO_TA
String
...
...
...
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Description written by result reader (This entry
shall be left blank if test result description is unavailable)
9
KET_LUAN
String
1024
Conclusion announced by result reader (This entry
shall be left blank if test result description is unavailable)
10
NGAY_KQ
String
...
...
...
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Time of release of subclinical result (comprising
12 characters according to the following format: yyyymmddHHmm = 4 characters
of year + 2 characters of month + 2 characters of day + 2 characters of hour
(24-hour format) + 2 characters of minute) E.g.: Result is released at 15:20’
hrs., on March 31, 2017, it shall be represented as “201703311520”
Table
5: Entries relating to clinical progression
(Enclosed with
Decision No. 4210/QD-BYT dated September 20, 2017 by Minister of Health)
STT
Entry
Data type
Maximum length
Description
1
...
...
...
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String
100
Unique treatment code (for data connection
between table 1 and this table in each medical examination or treatment).
2
STT
Numeric
6
Ordinal numbers starting at 1 in each data
transmission
3
...
...
...
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String
1024
Disease progression at each examination
4
HOI_CHAN
String
n
Medical consultation results (if any)
5
...
...
...
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String
1024
Description of surgical procedure
6
NGAY_YL
String
12
Date of giving physician order (comprising 13
characters, according to the following format: yyyymmddHHmm = 4 characters of
year + 2 characters of month + 2 characters of day + 2 characters of hour
(24-hour format) + 2 characters of minute) E.g.: A physician order is given
at 15:20’ hrs., on March 31, 2017, it shall be represented as “201503311520”
Table
6: List of cost-based groups of medical services
...
...
...
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Code
Name of group
of medical services
Note
1
Testing
2
Medical imaging
...
...
...
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Function testing
4
Drugs in the list of drugs covered by health
insurance
5
Drugs which are not in the list of drugs covered by
health insurance
6
...
...
...
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7
Blood and blood products
8
Surgery and procedures
9
Medical technical services for which payment is made
according to coinsurance percentage
...
...
...
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10
Medical supplies in the list of medical supplies
covered by health insurance
11
Medical supplies for which payment is made
according to coinsurance percentage
12
Transport
...
...
...
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Medical examination
14
Days of day hospital bed
15
Days of inpatient hospital beds, including
post-operative beds
Table
7: List of Department’s codes
...
...
...
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STT
Name of
department
Code
1
Outpatient Department
K01
2
Intensive Care Department
K02
...
...
...
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General Medicine Department
K03
4
Cardiovascular Department
K04
5
Digestive Department
K05
6
...
...
...
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K06
7
Department of Internal Urology
K07
8
Endocrinology Department
K08
9
Department of Allergy
...
...
...
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10
Department of Clinical Hematology
K10
11
Infectious Disease Department
K11
12
Tuberculosis Department
K12
...
...
...
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Department of Dermatology
K13
14
Neurology Department
K14
15
Department of Mental Health
K15
16
...
...
...
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K16
17
Department of Geriatrics
K17
18
Pediatrics Department
K18
19
General Surgery Department
...
...
...
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20
Neurosurgery Department
K20
21
Thoracic Surgery Department
K21
22
Department of Digestive Surgery
K22
...
...
...
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Department of Urologic Surgery
K23
24
Trauma and Orthopedic Department
K24
25
Department of Burns
K25
26
...
...
...
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K26
27
Department of Obstetrics
K27
28
ENT Department
K28
29
Department of Odontology
...
...
...
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30
Department of Ophthalmology
K30
31
Department of Physiotherapy
and Rehabilitation
K31
32
Department of Nuclear Medicine
K32
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Department of Oncology (radiation therapy)
K33
34
Blood Transfusion Department
K34
35
Department of Blood Purification
K35
36
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K36
37
Department of Biochemistry
K37
38
Department of Microbiology
K38
39
Department of Medical Imaging
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40
Department of Functional Tests
K40
41
Department of Endoscopy
K41
42
Department of Pathology
K42
...
...
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Department of Infection Control
K43
44
Department of Pharmacy
K44
45
Department of Nutrition
K45
46
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K46
47
Laboratory Department
K47
48
Department of Intensive Care
K48
49
Department of Poisoning Control
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50
Respiratory Department
K50
Notes:
- Code of department begins with “K” character and
2 characters of ordinal numbers of department’s names as prescribed in the
hospital statutes promulgated by Ministry of Health with amendments
- In case of inter-department, department’s code
shall be specified according to the following format: Kxxyyzz..., in which xx
is ordinal number of the first department, yy is ordinal number of the second
department, zz is ordinal number of the third department, etc. according to the
abovementioned list.
- In case a department in the abovementioned list
is divided into smaller divisions, department's code is specified according to
the following format: KXY.Z (In which, KXY is the primary department, Z is
ordinal numbers ascending from 1 to n)
Department means a department or center of health
facility.
Table
8: List of codes of accidents and injuries
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Code
Name of group
of medical services
Note
0
Unidentified
1
Traffic accidents
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Occupational accidents
3
Underwater accidents
4
Burns
5
...
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6
Suicide
7
Poisoning of various types
8
Other
...
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Table
9: List of codes of procurements and drug categories
(Enclosed with
Decision No. 4210/QD-BYT dated September 20, 2017 by Minister of Health)
I. Drugs of which contractor selection plan
has been approved before July 01, 2016
Procurement
Procurement’s
code
Drug
category
Code of drug
category
Generic
G1
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N1
G1
EU-GMP or PIC/s-GMP out of ICH or franchised
drugs
N2
G1
GMP-WHO VN
N3
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G1
Drugs having evidence of bioequivalence
N4
G1
Other
N5
Proprietary
medicines
G2
...
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N1
G2
Rare drugs
N2
Oriental medicine
G3
WHO-GMP VN
N1
...
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G3
Other
N2
II. Drugs of which contractor selection plan has
been approved as of July 01, 2016 under provisions of the Circular No.
11/2016/TT-BYT
Procurement
Procurement’s
code
Drug
category
Code of drug
category
Generic
...
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Drugs manufactured by a manufacturing line that fulfill
EU-GMP or PIC/s-GMP requirements in a country that is a member state of ICH
or a plant in Australia
N1
G1
Drugs manufactured by a manufacturing line that
fulfill WHO-GMP VN requirements granted certificates of free sales in
Australia or a country that is a member state of ICH
N1
G1
Drugs manufactured by a manufacturing line that
fulfill EU-GMP or PIC/s-GMP requirements but not in Australia or a country
that is a member state of ICH
...
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G1
Drugs manufactured by a manufacturing line that
fulfill WHO-GMP VN requirements
N3
G1
Drugs having evidence of bioequivalence
N4
...
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Other
N5
Original brand
name drugs or equivalent drugs
G2
Original brand name drugs or equivalent drugs
N1
Traditional drugs/
herbal drugs
G3
Drugs manufactured by a manufacturing line that
fulfill WHO-GMP VN requirements
...
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G3
Other
N2
Herbal ingredients
G4
Herbal ingredients farmed and harvested in
accordance with GACP-WHO requirements
N1
...
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Other
N2
Traditional
ingredients
G5
Traditional ingredients processed by a qualified processing
facility as announced by Traditional Medicine Administration
N1
G5
Other
...
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