LIN TCH B Y T - B TI CHNH

Ph lc III
GI CC DCH V K THUT V XT NGHIM P DNG CHO CC HNG BNH VIN
(Ban hnh km theo Thng t lin tch s 37/2015/TTLT-BYT-BTC ngy 29/10/2015 ca B Y t - B Ti chnh

Gi p
dng t
01/3/2016
(gm chi
ph trc
tip v ph
cp c
th)

Gi p
dng t
01/7/2016
(gm chi
ph trc
tip, ph
cp c th
v tin
lng)

THM D BNG NG V PHNG X

(gi cha bao gm dc cht phng x v
Invivo kit)
iu tr bnh bng k thut min dch phng
04C7.447
x
nh lng CA 19-9 hoc CA 50 hoc CA 125
04C7.441 hoc CA 15-3 hoc CA 72-4 hoc PTH bng
k thut min dch phng x

537,000

728,000

226,000

271,000

1825

nh lng bng k thut min dch phng x:

LH hoc FSH hoc HCG hoc Insullin hoc
04C7.440 Testosteron hoc Prolactin hoc Progesteron
hoc Estradiol hoc CEA hoc AFP hoc PSA
hoc Cortisol

151,000

196,000

1826

nh lng bng k thut min dch phng x:

T3 hoc FT3 hoc T4 hoc FT4 hoc TSH
04C7.437
hoc Micro Albumin niu hoc khng th
khng Insullin hoc Calcitonin

131,000

176,000

1827

nh lng khng th khng Tg hoc ACTH

04C7.442 hoc GH hoc TRAb bng k thut min dch
phng x

316,000

361,000

tp trung I-131 tuyn gip

165,000

197,000

SPECT CT

805,000

886,000

SPECT no

335,000

416,000

SPECT phng x min dch (2 thi im)

480,000

561,000

SPECT ti mu c tim

472,000

553,000

SPECT tuyn cn gip vi ng v kp

535,000

616,000

Thn ng v

220,000

264,000

STT

I
1823
1824

1828
1829
1830
1831
1832
1833
1834

M dch
v

03C3.7.1.
13
04C7.446
03C3.7.1.
1
04C7.445
03C3.7.1.
2
04C7.443
03C3.7.1.
4

Tn dch v

1835

03C3.7.1.
X hnh bch mch vi Tc-99m HMPAO
31

235,000

316,000

1836

X hnh chn on chc nng co bp d dy

03C3.7.1.
vi Tc-99m Sulfur Colloid d dy vi Tc-99m
28
Sulfur Colloid

255,000

336,000

1837

X hnh chn on chc nng thc qun v

03C3.7.1.
tro ngc d dy - thc qun vi Tc-99m
27
Sulfur Colloid

365,000

446,000

1838

03C3.7.1.
X hnh chn on khi u
19

335,000

416,000

1839

03C3.7.1. X hnh chn on nhi mu c tim vi Tc24

99m Pyrophosphate

305,000

386,000

1840

03C3.7.1.
X hnh chn on ti tha Meckel vi Tc-99m
30

235,000

316,000

1841

03C3.7.1.
X hnh chn on u mu trong gan
9

305,000

386,000

1842

03C3.7.1. X hnh chn on xut huyt ng tiu ho

17
vi hng cu nh du Tc-99m

305,000

386,000

1843

03C3.7.1.
X hnh chc nng thn
3

285,000

366,000

1844

03C3.7.1. X hnh chc nng thn - tit niu sau ghp

5
thn vi Tc-99m MAG3

345,000

426,000

1845

03C3.7.1.
X hnh chc nng tim
23

335,000

416,000

1846

03C3.7.1.
X hnh gan mt
8

305,000

386,000

335,000

416,000

335,000

416,000

305,000

386,000

335,000

416,000

255,000

336,000

480,000

561,000

285,000

366,000

1847
1848
1849
1850
1851
1852
1853

03C3.7.1.
X hnh gan vi Tc-99m Sulfur Colloid
10
X hnh hch Lympho
03C3.7.1.
X hnh lch
11
03C3.7.1.
X hnh lu thng dch no tu
20
03C3.7.1.
X hnh no
29
04C7.444 X hnh phng x min dch (2 thi im)
03C3.7.1.
X hnh thn vi Tc-99m DMSA (DTPA)
6

1854

03C3.7.1.
X hnh thng kh phi
33

335,000

416,000

1855

03C3.7.1.
X hnh tnh mch vi Tc-99m MAA
16

335,000

416,000

1856

03C3.7.1.
X hnh ton thn vi I-131
18

335,000

416,000

1857

03C3.7.1.
X hnh ti mu phi
32

305,000

386,000

X hnh ti mu tinh hon vi Tc-99m

205,000

286,000

X hnh ty
X hnh tu xng vi Tc-99m Sulfur Colloid
hoc BMHP Sulfur Colloid hoc BMHP

490,000

535,000

355,000

436,000

490,000

535,000

1858
1859
1860

03C3.7.1.
14
04C7.439
03C3.7.1.
21

X hnh tuyn cn gip: vi Tc-99m MIBI hoc

vi Tc-99m - V- DMSA hoc vi ng v kp

1861

04C7.438

1862

03C3.7.1.
X hnh tuyn gip
12

185,000

266,000

1863

03C3.7.1.
X hnh tuyn nc bt vi Tc-99m
15

235,000

316,000

1864

03C3.7.1.
X hnh tuyn thng thn vi I-131 MIBG
7

335,000

416,000

1865

03C3.7.1.
X hnh tuyn v
34

305,000

386,000

1866

03C3.7.1.
X hnh xng
22

305,000

386,000

1867

03C3.7.1.
X hnh xng 3 pha vi Tc-99m MDP
35

335,000

416,000

1868

03C3.7.1. Xc nh i sng hng cu, ni phn hu

26
hng cu vi hng cu nh du Cr-51

305,000

386,000

1869

03C3.7.1. Xc nh th tch hng cu vi hng cu nh

25
du Cr-51

205,000

286,000

II

iu tr bng cht phng x (gi cha bao

gm dc cht phng x v cc thuc b
tr khc, nu c s dng)

1870

03C3.7.2. iu tr Basedow/ bu tuyn gip n thun/

36
nhn c tuyn gip bng I-131

472,000

700,000

1871

03C3.7.2.
iu tr ung th tuyn gip bng I-131
38

612,000

850,000

1872

iu tr bnh a hng cu nguyn pht/ bnh

03C3.7.2.
Leucose kinh/ gim au do ung th di cn vo
44
xng bng P-32

305,000

507,000

1873

03C3.7.2. iu tr gim au bng Sammarium 153 (1 t

46
iu tr 10 ngy)

522,000

723,000

1874

03C3.7.2. iu tr so li/ Eczema/ u mu nng bng P40

32 (tnh cho 1 ngy iu tr)

170,000

200,000

1875

03C3.7.2. iu tr trn dch mng bng/ mng phi do

1,285,000 1,681,000
43
ung th bng keo phng x

1876

03C3.7.2. iu tr u tuyn thng thn v u t bo thn

52
kinh bng I-131 MIBG

505,000

569,000

1877

03C3.7.2.
iu tr ung th gan bng keo Silicon P-32
49

642,000

775,000

1878

03C3.7.2. iu tr ung th gan nguyn pht bng I-131

47
Lipiodol

505,000

639,000

1879

03C3.7.2. iu tr ung th gan nguyn pht bng

48
Renium188

492,000

625,000

1880

03C3.7.2. iu tr ung th tin lit tuyn bng ht phng

51
x I-125

###

###

1881

03C3.7.2.
iu tr ung th v bng ht phng x I-125
50

###

###

1882

03C3.7.2.
iu tr vim bao hot dch bng keo phng x
42

372,000

448,000

1883

iu tr ung th gan bng ht vi cu phng x

###

###

1884

PET/CT bng bc x hm bnh nhn ung th

gan, ung th ng mt trong gan, ung th di 3,022,000 3,673,000
cn gan sau iu tr bng ht vi cu phng x

90

90

1885
1886
1887
Ghi ch:

Cc th thut cn li khc
Th thut loi c bit
Th thut loi I
Th thut loi II

372,000
215,000
151,000

471,000
285,000
187,000

vt t thay th thc hin dch v tr mt s trng hp c bit c

mu
nuccth.
s dng.
Trng
hpc
c sthu
dng
c
ghi ch
Bnh vin
khng
thm
cathanh
ngiton
bnhtheo
cc quy
chi
nh ti Thng t s 33/TT-BYT ngy 27/10/2014 ca B Y t quy nh
+
ccchi
thph
thut
v
baocho
gm
chixc
ph nh
thucgi
gy
t, n
an thn
tin ton
m,
giGi
tica
a v
phc
vic
mt
v mu
cha
bao gm
phmt
gyln
mphu
(tr mt
trng
hpton
ghi
pht sinh
trongchi
cng
thutsc
thanh
nhch
sau:c th).
+ Bng 50% gi ca cc dch v k thut pht sinh nu k thut vn

Ph lc III
HNG BNH VIN
ca B Y t - B Ti chnh)
n v:
ng

Ghi ch

Cha bao
gm b
dng c
cy (kim
cy,
tandem,
Ovoid,
Trachel,
Bronchial
,
Esophagu
s, Skin)

g hp c bit c
hanh
ngiton
bnhtheo
cc quy
chi
a B Y t quy nh
t, n
an thn
tin ton
m,
mt
v mu

n ghi
nhch
sau:c th).

nu k thut vn