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A New Health Care Policy in Korea Part 2: Expansion of Coverage by National Health Insurance on the Abdominal Ultrasound and MRI

새로운 건강보험 보장성 강화 대책 2부: 복부 초음파 및 MRI 급여 확대

  • Min Jae Jang (Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University) ;
  • Seong Jin Park (Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University)
  • 장민재 (경희대학교 의과대학 경희대학교병원 영상의학과) ;
  • 박성진 (경희대학교 의과대학 경희대학교병원 영상의학과)
  • Received : 2020.06.19
  • Accepted : 2020.08.17
  • Published : 2020.09.01

Abstract

Coverage by National Health Insurance (NHI) was expanded in the abdominal imaging area as follows: upper abdominal ultrasound on April 1, 2018, lower abdominal ultrasound on February 1, 2019, and abdominal MRI on November 1, 2019. Many patients can benefit from the expansion of NHI coverage. Newly included diseases for NHI coverage includes liver cirrhosis, gallbladder polyps, hepatic adenoma/dysplastic nodules, pancreatic cysts, autoimmune pancreatitis and bile duct stone disease. However, the expansion of coverage made each examination more complex, including indications, follow-up strategy, the number of examination per patients, the standard images to be acquired, and the standard forms of the radiological report. Therefore, more careful consideration is mandatory when an abdominal imaging examination is prescribed and conducted.

복부 영상 영역에서는 새로운 건강보험 보장성 강화 대책으로 인하여 2018년 4월 1일 상복부 초음파, 2019년 2월 1일 하복부 초음파와 2019년 11월 1일 복부 MRI가 순서대로 급여 확대되었다. 많은 환자들이 건강보험 급여 혜택을 보게 되었으며 간경화, 담낭용종, 간선종, 이형성 결절, 췌장 낭종과 자가면역성 췌장염, 담석 등이 건강보험에 포함되었다. 그러나 급여화로 인해 각 검사의 적응증, 추적검사 가능 질환과 적용 횟수 등이 보다 복잡해졌으며 획득하여야 할 표준영상과 판독소견서의 양식이 지정되었으며, 따라서 외래나 병실에서 검사를 처방하고 검사실에서 검사를 시행할 때 주의해야 할 필요가 있다.

Keywords

References

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