Decree No. 421 / 2016 Coll.
Decree amending Decree No. 134 / 1998 Coll., which publishes a list of health performance with points, as amended
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421
DECLARATION
of 14 December 2016
amending Decree No. 134 / 1998 Coll., issuing a list of health performance with points, as amended
According to Article 17 (4) of Act No. 48 / 1997 Coll., on Public Health Insurance and on the amendment and addition of certain related laws, as amended by Act No. 245 / 2006 Coll., Act No. 261 / 2007 Coll., Act No. 298 / 2011 Coll., Act No. 369 / 2011 Coll., the Constitutional Court's finding, published under Act No. 238 / 2013 Coll., and Act No. 200 / 2015 Coll.:
Decree No. 134 / 1998 Coll., which publishes the list of health performances with point values, as amended by Decree No. 55 / 2000 Coll., Decree No. 135 / 2000 Coll., Decree No. 449 / 2000 Coll., Decree No. 101 / 2002 Coll., Decree No. 291 / 2002 Coll., Decree No. 493 / 2005 Coll., Decree No. 620 / 2006 Coll., Decree No. 331 / 2007 Coll., Decree No. 439 / 2008 Coll., Decree No. 467 / 2012 Coll., Decree No. 472 / 2009 Coll., Decree No. 497 / 2010 Coll., Decree No. 411 / 2011 Coll., Decree No. 467 / 2012 Coll., Decree No. 467 / 2012 Coll.
1. In the Annex to Chapter 2, point 5 reads as follows:
"5. RESTRICTIONS ON FREQUENCY
The frequency limitation shall be based on one insured person, one or more time periods and one provider.
The rules for reporting performance over a period for which frequency limitations are specified are as follows:
Week: During a period of 7 days from the date of the last reporting of the performance, including that date, the performance shall not be reported more times than allows for the limitation of the frequency of the performance.
Month: During a period of 28 days from the date of the last declaration of performance, including that date, the performance shall not be deported more than the limit of the frequency of the power.
Quarterly, 3 months (e.g. 1 / 1 quarter or 1 / 3 months): During a period of 84 days from the date of the last reporting of power, including that date, the power shall not be reported more than the limit of the frequency of that power.
Semi-annual: During a period of 175 days from the date of the last reporting of the power, including that date, the power shall not be reported more than the limit of the frequency of the power in question.
Year: During a period of 350 days from the date of the last declaration of performance, including that date, the power shall not be reported more than once than allows for the limitation of the frequency of the power.
If the performance is reported by one provider per insured person more than allows for frequency limitation, the health insurance undertaking shall be entitled to pay the performance up to the level of frequency limitation, unless the revision doctor decides otherwise. ';
2. In the Annex to Chapter 2, point 6.1, the sentence "Index 2, symbol L2 shall also apply to doctors, dental practitioners and pharmacists who do not yet fulfil the conditions for completion of the baseline strain but have been included in specialisation training by 31 December 2007 at the latest. ';
3. In the Annex to Chapter 4, the following point 2a is inserted after point 2:
"22.006 - CLINICAL PHARMACEUTICAL
| Výkon číslo | název |
|---|---|
| 05751 | Komplexní zhodnocení míry rizikovosti pacienta klinickým farmaceutem |
can only be reported for a patient whose medical condition is at least one of the risk factors assessed
The risk factors assessed are:
• polypragmazie - there are 8 or more systemic medicines in the chronic treatment of the patient,
• a medicinal product with a narrow therapeutic window (vancomycin, aminoglycoside antibiotics, phenytoin, carbamazepine, valproic acid, warfarin, low molecular heparin at therapeutic dose (LMWH), ciclosporin, everolimus, tacrolimus, temsirolimus, digoxin, theophylline and, where appropriate, other medicinal products whose plasma levels need to be monitored for dosage adjustment when the function of the elimination organs is changed, for adverse effects or for drug interaction);
• a medicine with high interaction potential; a drug with the described / documented drug interactions described in the literature as very serious or serious (numbered or using letters according to the classification used),
• Renal insufficiency - glomerular filtration is equal to or less than 30 ml / min,
• Laboratory signs of hepatic insufficiency - albumin < 20 g / l, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GMT), bilirubin above three times the upper limit of normal,
• other significant changes in biochemical and / or haematological parameters,
• intensive care
• diabetes mellitus (according to MKN: E10 - E14) - for oral antidiabetic therapy (PAD) and / or insulin,
• epilepsy (according to MKN: G40, G41) for antiepileptic therapy,
• atrial fibrillation (I48),
• cancer (according to MKN: C) - curative or palliative pharmacotherapy,
• patients with long-term (longer than 1 week) treatment with systemic corticosteroids or other immunosuppressants, or
• Parkinsonian syndrome (according to MKN: G20, G21) '.
4. In the Annex to Chapter 4, point 19.1 is deleted.
Points 19.2. to 19.4 shall be renumbered 19.1. to 19.3.
5. In the Annex to Chapter 4, the following point 29.5 is added at the end of point 29:
"29.5.731 - Otorinolaryngology - group 3
| Výkon číslo | název |
|---|---|
| 71589 | Implantace aktivního středoušního implantátu |
may be reported in the patient on evidence of pathological hearing status:
| Patologický stav | Sluch |
|---|---|
| středně těžká až těžká nedoslýchavost, převodní nebo smíšená, bez známek progrese, pokud nelze dosáhnout účinné korekce konvenčním sluchadlem; středouší bez známek zánětu | převodní rezerva větší než 50 dB (průměrná ztráta sluchu max. 80 dB) ztráta 40 dB SRT a výše zisk s konvenčním sluchadlem menší 10 dB SRT zisk s vibračním sluchadlem menší než 10 dB SRT |
| percepční porucha sluchu, pokud nelze dosáhnout korekce konvenčním sluchadlem středouší bez známek zánětu | ztráta 40 - 85 dB dB SRT zisk s konvenčním sluchadlem méně než 10 dB SRT |
| stavy s patologií zevního a středního ucha znemožňující aplikaci sluchadel alergie, externí otitis, atresie zevního zvukovodu, porucha převodního systému, st. ablaci středouší pro tumor apod.; středouší bez známek zánětu | ztráta 40 - 85 dB dB SRT“. |
6. Point 37.2 of the Annex to Chapter 4 reads as follows:
"37.2. Diagnosis
The performance of the biopsy diagnosis (87511, 87517, 87523) and the cytological diagnosis (87513, 87519, 87525) applies to l, separately adjust or topographically determined sample. '
7. In the Annex to Chapter 5, point 1, the following entries 9, 10 and 11 are inserted after entry 8:
"9. 00015 is the Treatment day of subsequent ventilation care (NVP).
10. 00017 is Treatment day of subsequent intensive care (NIP).
11. 00020 is the Treatment day of long-term intensive nursing care (DIOP). "
Items 9 to 42 are renumbered 12 to 45.
8. In the Annex to Chapter 5, point 5.2, the following entries 00015, 00017 and 00020 are inserted after entry 00012:
| „00015 | 6150 |
| 00017 | 9364 |
| 00020 | 2201“. |
9. In the Annex to Chapter 5, the following point 7.1.8 is inserted after point 7.1.7:
"7.1.8. Obligatory content From long-term intensive care
It is from 00015, 00017 and 00020.
The obligator content of OD 00015 is:
1. Medical interventions (including optimization or weaning, if the patient is connected to the fan), pharmacotherapy, psychotherapy, nursing process, rehabilitation (physiotherapy, ergotherapy, psychotherapy, logopedia), treatment regime, medical documentation management.
2. Criteria for patient acceptance:
- the patient complies with the approved diagnostic spectrum;
- is after a critical condition in a stabilized state, dependent on artificial pulmonary ventilation with the possibility of DUPV for health or social reasons, which must be clearly documented in the medical documentation;
- PaO2 / FiO2 ≥ 250, PEEP ≤ 8 cm H2O, without the need for catecholamine support, dialysis or other elimination methodology is not required;
- comes from NIP bed or intensive bed (ARO or ICU). Patients are also admitted for DUPV failure.
The obligator content from 00017 is:
1. Medical interventions (including optimization or weaning, if the patient is connected to the fan), pharmacotherapy, psychotherapy, nursing process, rehabilitation (physiotherapy, ergotherapy, psychotherapy, logopedia), treatment regime, medical documentation management.
2. Criteria for patient acceptance:
- is after a critical disease in stabilized condition, ventilation parameters are PaO2 / FiO > 150, PEEP-10cm H2O;
- one or more life functions have not been fully restored;
- comes from an intensive bed (ARO or ICU);
- admission from another NIP is possible only with the consent of the patient or his legal representative.
The obligatory content of OD 00020 is:
1. Medical interventions (including optimization or weaning, if the patient is connected to the fan), pharmacotherapy, psychotherapy, nursing process, rehabilitation (physiotherapy, ergotherapy, psychotherapy, logopedia), treatment regime, medical documentation management.
2. Criteria for patient acceptance:
- comes from an intensive care bed of acute (ARO / ICU) or subsequent intensive care (NIP) and meets the criteria set out in the definition of workplace. "
10. In Chapter 6 (1) of the Annex, the fourth sentence is replaced by the following: "Patient Category 1 is reported on the day on which the day-old day (OD) is reported in bed, resuscitation or intensive care, follow-up ventilation care (NVP), follow-up intensive care (NIP) and long-term intensive nursing care (DIOP)."
11. In the Annex to Chapter 5, at the end of point 9, the following entry 23 is added:
"23. Selective pulmonary vasodilatation using nitric oxide. '
12. In the Annex to Chapter 7 (1), the first to eighth sentences are as follows:
"For the performance of the author's expertise 001, 002, 005, 006, 101, 102, 103, 104, 105, 106, 107, 108 (excluding nephrological haemolemination methods), 109, 110, 116, 201, 202, 204, 205, 206, 207, 208, 209, 210, 222, 301, 302, 303, 304, 305, 306, 309, 401, 402, 4303, 404, 405, 406, 407, 710, 720, 801, 802, 807, 808, 809, 812, 813, 814, 815, 816, 817, 818, 819, 823, 901, 902, 903, 904, 905, 910, 913, 917, 925, 931, 931, 931, 931, 931, 802, 802, 814, 818, 819, 819, 823, 823, 823, 901, 905, 910, 910, 910, 910 and 999, 910, 913, 925, 931 and 999, 931,
The performance of the author's expertise 115, 117, 215, 312, 413, 697, 806 and 810 is assigned a minute overhead rate of 4,54 points per minute of power.
In addition to the performance of the author's expertise 108 (only nephrological haematoelimination methods), 203, 501, 502, 503, 504, 505, 506, 507, 601, 602, 603, 604, 605, 606, 607, 701, 702, 704, 705, 706, 707, 708, 709, 799 and 780, a minute overhead rate of 3,62 points per minute of power time is assigned.
The performance of the author's expertise 511, 512, 513, 514, 515, 516, 517, 611, 612, 613, 614, 615, 616, 711, 714, 715, 716 and 717 is assigned a minute overhead rate of 5,44 points per minute of power.
The performance of the author's expertise 521, 522, 523, 524, 525, 526, 527, 621, 622, 623, 624, 625, 626, 721, 724, 725, 726, 727 and 728 is assigned a minute overhead rate of 7,27 points per minute of power.
The performance of the author's expertise 531, 532, 533, 534, 535, 536, 537, 631, 632, 633, 634, 635, 636, 731, 734, 735, 736 and 737 shall be assigned a minute overhead rate of 10,89 points per minute of power.
The performance of the author's expertise 911, 914, 916, 919, 921 and 927 is assigned a minute overhead rate of 2,2 points per minute of power time.
The performance of the author's expertise 014 and 015 shall be assigned a minute overhead rate of 3,79 points per minute of power. ';
13. In the Annex to Chapter 7, point 2.1, the words "between 30,27 and 98,33 'are replaced by the words" between 30,36 and 98,62'.
14. In the Annex to Chapter 7, point 2.2, "181,52 points' is replaced by" 182,06 points'.
15. In the first sentence of point 2.1.2 of the Annex to Chapter 8 of the Annex, the words "regional cities' are replaced by the words" in the seat of a higher local authority '.
16. In the Annex to Chapter 8, point 7 reads as follows:
"7. TRANSPORT PERFORMANCE
| číslo výkonu | Název výkonu Popis výkonu | body/1 km |
|---|---|---|
| 10 | Přeprava zdravotnického pracovníka v návštěvní službě | 13,37 |
| 12 | Přeprava lékaře v pohotovostní službě | 13,58 |
| 20 | Přeprava pacienta soukromým vozidlem | 4,77 |
| 40 | Přeprava pacienta v sídle vyššího územního samosprávného celku v pásmu 1 – 8 km | 27,88 |
| 45 | Přeprava pacienta v pásmu 1 – 30 km | 22,53 |
| 46 | Přeprava pacienta v pásmu 31 – 60 km | 20,86 |
| 47 | Přeprava pacienta v pásmu 61 – 130 km | 19,23 |
| 48 | Přeprava pacienta v pásmu 131 – 450 km | 18,58 |
| 49 | Přeprava pacienta v pásmu 451 a více km | 10,08 |
| 50 | Přeprava k pitvě a z pitvy | 38,37 |
| 60 | Přeprava transfuzních přípravků, speciálních léčivých přípravků, tkání, buněk a orgánů k transplantaci, přeprava lékaře nebo jiného zdravotnického pracovníka ke specializovanému a nezbytnému výkonu | 31,84 |
| 70 | Jízda vozidly zdravotnické záchranné služby | 41,83 |
| 72 | Přeprava patologického novorozence a novorozence s nízkou porodní hmotností k nejbližšímu specializovanému poskytovateli | 41,83 |
| 74 | Přeprava lékaře zdravotnické záchranné služby v setkávacím systému | 31,84 |
| 77 | Jízda vozidly přepravy pacientů neodkladné péče | 40,83 |
| 80 | Přeprava infekčního pacienta | 28,50 |
Power 40 The transport of a patient in a higher territorial unit in the 1 - 8 km band cannot be combined with the performance 45 Patient transport in the 1 - 30 km band. If the transport distance of the patient is greater than 8 km, the transport of the patient will be reported throughout the performance 45 Transport of the patient in the band 1 - 30 km. '
17. In the Annex to Chapter 001 - General practical medicine, the following power No 01185 is inserted after power No 01180:
"01185 PRE-OPERATIONAL INVESTIGATION BY PRACTICAL DOCTOR
Performing an internal pre-operative examination by a physician according to the recommended procedure of an internal pre-operative examination prior to surgery.
Category P - fully paid
OF 1 / 1 day
OM A - only outpatient
Performance time 15
Points 124
| Nositel | INDX | Čas |
|---|---|---|
| L3 | 3 | 15 |
ZUM
Not ZULP. "
18. The following performance No 02240 shall be added to the Annex at the end of Chapter 002 - Practical medicine for children and adolescents:
"02240 TIME PERFORMANCE OF AN AUTISTIC SPECTER IN THE ORDINATION OF PRACTICIC DOCTOR FOR KIDS AND DOSTANCES
Tests for early detection of autistic spectrum disturbances (PAS). The performance is performed as part of a preventive inspection at 18 months of age and is added to the performance of a preventive examination (02022). Evaluation of the questionnaire for parents, based on its evaluation followed by completion of the next questionnaire by the doctor along with the parent of the child, balance sheet of the next procedure according to the score achieved i.e.: normal development - without further action; some pathological features are present but do not meet the criteria for PAS - further evaluation at a distance of 6 months; According to the questionnaire, the child fulfils the criteria for suspected PAS - dispatch for professional examination. The performance includes the entry in the health file and the basis of the completed questionnaire in the health file.
Category P - fully paid
OF 1 / life, if necessary further evaluation 2 / life
OM A - only outpatient
Performance time 15
Point 116
| Nositel | INDX | Čas |
|---|---|---|
| L3 | 3 | 15 |
ZUM
Not ZULP. "
19. In the Annex, Chapter 005 - Hospital pharmaceuticals, as follows:
"Chapter 005 - Hospital pharmaceuticals
_
The preparation of parenteral bolus or eye drops containing a cytotoxic substance is carried out in vacuum safety boxes with laminar flow of the air purity class A located in the air purity class C space.
Category P - fully paid
OF 8 / 1 day
OM S - only in specialised workplace
Performance time 17
Points 160
| Nositel | INDX | Čas |
|---|---|---|
| L3 | 3 | 10 |
| S2 | 2 | 7 |
ZUM
ZULP
06553 PREPARATION OF INFUSION WITH THE CONTAINING OF THE SINGLE CYTOSTATIC SUBSTANCES FROM ORIGINAL SOLUTION WITHOUT RECONstiTATION
Preparation of an infusion containing one cytostatic substance from the original solution without reconstitution is carried out in vacuum safety boxes with vertical laminar flow of the air purity class A located in the air purity class C space.
Category P - fully paid
OF 5 / 1 day
OM S - only in specialised workplace
Performance time 25
Points 206
| Nositel | INDX | Čas |
|---|---|---|
| L3 | 3 | 10 |
| S2 | 2 | 15 |
ZUM
ZULP
06555 PREPARATION OF INFUSION OF THE CYTOSTATIC SUBSTANCES WITH MORE STANDARDISED MEDICINAL PRODUCTS (HVLP) OR OF DRY SUBSTANCE / LYOPHILISATE
Preparation of an infusion of a cytotoxic substance containing multiple HVLP or dry substance / lyophilisate is carried out in vacuum safety boxes with vertical laminar flow of air purity class A located in air purity class C.
Category P - fully paid
OF 4 / 1 day
OM S - only in specialised workplace
Performance time 28
Points 230
| Nositel | INDX | Čas |
|---|---|---|
| L3 | 3 | 10 |
| S2 | 2 | 18 |
ZUM
ZULP
06557 PREPARATION OF THE CHECKING INFUSION OF THE CYTOSTATIC SUBSTANCE INTO THE INFUSION
Preparation of continuous infusion of the cytostatic agent into the infusion tube is carried out in vacuum safety boxes with vertical laminar flow of the air purity class And placed in the air-purity class C space.
Category P - fully paid
OF 1 / 1 day
OM S - only in specialised workplace
Performance time 26
Points 219
| Nositel | INDX | Čas |
|---|---|---|
| L3 | 3 | 10 |
| S2 | 2 | 16 |
ZUM
Not ZULP. "
20. In the Annex, the following Chapter 006 - Clinical pharmacy is inserted after Chapter 005 - Hospital pharmacy:
"Chapter 006 - Clinical pharmacy
05751 COMPLETE EVALUATION OF THE PATIENT RISK ASSESSMENT BY THE CLINICAL GUIDE
Evaluation of the patient 's medication when entering a healthcare facility and determination of the patient' s risk ratio in relation to current or potential drug problems.
Category P - fully paid
OF 1 / 1 hospitalisation
OM H - only for hospitalisation
Performance time 15
Point 116
| Nositel | INDX | Čas |
|---|---|---|
| L3 | 3 | 15 |
ZUM
ZULP
05753 DETERMINATION OF THE RACIONALIZATION PLAN OF THE FARMATIC PATIENT
Setting up a plan to rationalise pharmacotherapy by a clinical pharmacist in a hospitalized patient with a high and moderate risk identified at its intake; or with a low risk identified at the time of receipt of the patient's health change; or establishing a plan to rationalise pharmacotherapy by a clinical pharmacist in a hospitalized patient on the basis of a specific requirement of the treating physician.
Category P - fully paid
OF 1 / 1 hospitalisation
OM H - only for hospitalisation
Performance time 20
Points 155
| Nositel | INDX | Čas |
|---|---|---|
| L3 | 3 | 20 |
ZUM
ZULP
05755 VERIFICATION OF THE EFFICIENCY OF THE REGULATORY RACIONALISATION PLAN OF PACIENTE'S FARMS
Continuous verification of the effectiveness of the established plan to rationalise the pharmacotherapy of the patient by a clinical pharmacist. It is reported in patients with a defined rationalisation plan for pharmacotherapy; patients with moderate and high reception risk; in patients with a low risk ratio and a defined plan for rationalising the pharmacotherapy of a patient by a clinical pharmacist when changing the state of health or in patients with a defined plan for rationalising the pharmacotherapy by a clinical pharmacist on the basis of a specific requirement of the treating physician.
Category P - fully paid
OF 2 / 1 hospitalisation
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Regulation Information
| Citation | Decree No. 421 / 2016 Coll., amending Decree No. 134 / 1998 Coll., issuing a list of health performance with points, as amended |
|---|---|
| Regulation Type | Order |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 21.12.2016 |
|---|---|
| Effective from | 01.01.2017 |
| Effective until | - |
| Status | Valid |
Legal Areas:
Administrative law
Health
The regulation text is for informational purposes only.
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