Beijing, January 11 (Reporter Sun Xiuyan) – To adapt to the new situation and requirements of medical insurance operations and to promote the high-quality development of the traditional Chinese medicine industry, the National Healthcare Security Administration recently revised the medical insurance coding rules for traditional Chinese medicine decoction pieces. This is equivalent to giving each traditional Chinese medicine decoction piece a new "medical insurance ID card."
Medical insurance codes are the "universal key" in the medical insurance field, playing a crucial role in billing, reimbursement, and fund supervision. Currently, the medical insurance drug database contains tens of thousands of codes for traditional Chinese medicine decoction pieces, covering more than 3,000 kinds of medicinal materials and encompassing 22 different effects. This truly achieves "one code for all nationwide use," not only improving the efficiency of medical insurance services and laying a solid data foundation for the standardized and regulated development of traditional Chinese medicine, but also saving the public a lot of trouble when getting prescriptions and reimbursing their medical expenses.
This revision avoids major overhauls. While retaining the four core elements—"TCM decoction piece identification code, standard classification code, efficacy classification code, and TCM decoction piece name code"—it adds two key code segments: "authentic medicinal material identification code" and "TCM decoction piece enterprise code." This fills the information gaps regarding "authenticity and production method," significantly improving transparency. The new authentic medicinal material identification code provides a geographical certification label for decoction pieces, making it easy to identify authentic varieties such as Yunnan Panax notoginseng and Sichuan Fritillaria cirrhosa. The new enterprise code enables precise identification of production responsibility, ensuring clear traceability of manufacturer information. This not only compels enterprises to fulfill their primary responsibilities but also lays a solid foundation for the centralized procurement of TCM decoction pieces. (People's Daily)
