Information on non-covered services at Team Doctor Orthopedic Clinic.
Information on non-covered services at Team Doctor Orthopedic Clinic
As of 2026. 10. 12
Category | Used by This Institution | Fee | Institution (Notes) | |||||
|---|---|---|---|---|---|---|---|---|
Subcategory | Detailed Category | Code | Non-Covered Item Code | Non-Covered Item Name | Healthcare Professional (Department) | Medical Devices (Equipment) | Submission Date | |
Ultrasound Fees (Diagnostic Ultrasound) | Ultrasound Fees (Diagnostic Ultrasound)/Musculoskeletal, Soft Tissue-Joint Ultrasound/Finger | EB4610000 | SONO-fin | Musculoskeletal/ Soft Tissue-Joint Ultrasound-Finger (Unilateral) | 70000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria) | 26.10.12 |
Ultrasound Fees (Diagnostic Ultrasound) | Ultrasound Fees (Diagnostic Ultrasound)/Musculoskeletal, Soft Tissue-Joint Ultrasound/Toe | EB4620000 | SONO-toe | Musculoskeletal/ Soft Tissue-Joint Ultrasound-Toe (Unilateral) | 70000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria) | 26.10.12 |
Ultrasound Fees (Diagnostic Ultrasound) | Ultrasound Fees (Diagnostic Ultrasound)/Musculoskeletal, Soft Tissue-Joint Ultrasound/Elbow | EB4630000 | SONO-elbow | Musculoskeletal/ Soft Tissue-Joint Ultrasound-Elbow (Unilateral) | 100000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria)/2 or more sites | 26.10.12 |
Ultrasound Fees (Diagnostic Ultrasound) | Ultrasound Fees (Diagnostic Ultrasound)/Musculoskeletal, Soft Tissue-Joint Ultrasound/Knee | EB4640000 | SONO-knee | Musculoskeletal/ Soft Tissue-Joint Ultrasound-Knee (Unilateral) | 100000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria)/2 or more sites | 26.10.12 |
Ultrasound Fees (Diagnostic Ultrasound) | Ultrasound Fees (Diagnostic Ultrasound)/Musculoskeletal, Soft Tissue-Joint Ultrasound/Hip | EB4650000 | SONO-hip | Musculoskeletal/ Soft Tissue-Joint Ultrasound-Hip (Unilateral) | 100000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria)/2 or more sites | 26.10.12 |
Ultrasound Fees (Diagnostic Ultrasound) | Ultrasound Fees (Diagnostic Ultrasound)/Musculoskeletal, Soft Tissue-Joint Ultrasound/Shoulder | EB4660000 | SONO-shoul | Musculoskeletal/ Soft Tissue-Joint Ultrasound-Shoulder (Unilateral) | 100000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria)/2 or more sites | 26.10.12 |
Ultrasound Fees (Diagnostic Ultrasound) | Ultrasound Fees (Diagnostic Ultrasound)/Musculoskeletal, Soft Tissue-Joint Ultrasound/Wrist | EB4670000 | SONO-wrist | Musculoskeletal/ Soft Tissue-Joint Ultrasound-Wrist (Unilateral) | 100000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria)/2 or more sites | 26.10.12 |
Ultrasound Fees (Diagnostic Ultrasound) | Ultrasound Fees (Diagnostic Ultrasound)/Musculoskeletal, Soft Tissue-Joint Ultrasound/Ankle | EB4680000 | SONO-ankle | Musculoskeletal/ Soft Tissue-Joint Ultrasound-Ankle (Unilateral) | 100000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria)/2 or more sites | 26.10.12 |
Ultrasound Fees (Diagnostic Ultrasound) | Ultrasound Fees (Diagnostic Ultrasound)/Musculoskeletal, Soft Tissue-Joint Ultrasound/General | EB4700000 | SONO-tissu | Musculoskeletal/ Soft Tissue-Joint Ultrasound-General/Detailed | 100000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria) | 26.10.12 |
Ultrasound Fees (Basic Ultrasound) | Simple Ultrasound | EB4010000 | EB401 | Simple Ultrasound (I) | 60000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria) | 26.10.12 |
Ultrasound Fees (Basic Ultrasound) | Simple Ultrasound | EB4020000 | EB402 | Simple Ultrasound (II) | 60000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria) | 26.10.12 |
Ultrasound Fees (Diagnostic Ultrasound) | Head & Neck-Neck Ultrasound | EB4140000 | EB414 | Head & Neck-Neck Ultrasound-Thyroid·Parathyroid | 100000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria) | 26.10.12 |
Ultrasound Fees (Diagnostic Ultrasound) | Chest-Breast·Axillary Ultrasound (General) | EB4210000 | EB421 | Chest-Breast·Axillary Ultrasound (General) | 150000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria) | 26.10.12 |
Ultrasound Fees (Diagnostic Ultrasound) | Chest-Breast·Axillary Ultrasound (Detailed) | EB4230000 | EB423 | Chest-Breast·Axillary Ultrasound (Detailed) | 165000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria) | 26.10.12 |
Ultrasound Fees (Guided Ultrasound) | Guided Ultrasound | EB5610000 | EB561 | Guided Ultrasound (I) | 500000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria) | 26.10.12 |
Ultrasound Fees (Guided Ultrasound) | Guided Ultrasound | EB5620000 | EB562 | Guided Ultrasound (II) | 100000 | Specialist | Diagnostic ultrasound imaging system (Non-covered when performed outside coverage criteria) | 26.10.12 |
Physical Therapy Fees | Manual Therapy | MX1220000 | mt1 | Postural Correction / Fatigue & Malaise Management-30 min | 50000 | Physical Therapist | NaN | 26.10.12 |
Physical Therapy Fees | Manual Therapy | MX1220000 | mt2 | Postural Correction / Fatigue & Malaise Management-60 min | 100000 | Physical Therapist | NaN | 26.10.12 |
Physical Therapy Fees | Spray and Stretch Therapy | MZ0070000 | cryo1 | Spray and Stretch Therapy 1 | 43000 | Physical Therapist | Medical cooling device | 26.10.12 |
Physical Therapy Fees | Prolotherapy | MY1420000 | PROLO | Prolotherapy | 100000 | Specialist | Per attending physician's judgment/Multiple sites | 26.10.12 |
Physical Therapy Fees | Prolotherapy | MY1420000 | PROLO3 | Prolotherapy | 30000 | Specialist | Per attending physician's judgment/Unilateral-Complex, Bilateral-Simple | 26.10.12 |
Physical Therapy Fees | Prolotherapy | MY1420000 | PROLO4 | Prolotherapy | 40000 | Specialist | Per attending physician's judgment/Unilateral-Special, Bilateral-Compound | 26.10.12 |
Physical Therapy Fees | Prolotherapy | MY1420000 | PROLO5 | Prolotherapy | 50000 | Specialist | Per attending physician's judgment/Bilateral-Complex | 26.10.12 |
Physical Therapy Fees | Prolotherapy | MY1420000 | PROLO6 | Prolotherapy | 60000 | Specialist | Per attending physician's judgment/Bilateral-Compound | 26.10.12 |
Physical Therapy Fees | Prolotherapy | MY1420000 | PROLO7 | Prolotherapy | 70000 | Specialist | Per attending physician's judgment/Bilateral-Special | 26.10.12 |
Physical Therapy Fees | Prolotherapy | MY1420000 | PROLO8 | Prolotherapy | 80000 | Specialist | Per attending physician's judgment/Multiple sites | 26.10.12 |
Physical Therapy Fees | Prolotherapy | MY1420000 | PROLO9 | Prolotherapy | 90000 | Specialist | Per attending physician's judgment/Multiple sites | 26.10.12 |
Procedure & Surgery Fees (Musculoskeletal) | Extracorporeal Shockwave Therapy [Musculoskeletal Disorders] | SZ0840000 | ESWT-2K | Extracorporeal Shockwave Therapy [Musculoskeletal Disorders] | 90000 | Physical Therapist | Extracorporeal shockwave therapy device | 26.10.12 |
Procedure & Surgery Fees (Musculoskeletal) | Extracorporeal Shockwave Therapy [Musculoskeletal Disorders] | SZ0840000 | ESWT-4K | Extracorporeal Shockwave Therapy [Musculoskeletal Disorders] | 160000 | Physical Therapist | Extracorporeal shockwave therapy device | 26.10.12 |
Functional Test Fees (Skin and Musculoskeletal Function Tests) | Dynamic Plantar Pressure Measurement | EZ7770000 | footscan | Dynamic Plantar Pressure Measurement | 120000 | Physical Therapist | Medical pressure gauge and podoscope | 26.10.12 |
Vaccination Fees | Shingles (Herpes Zoster) | 3Z5200303 | shingrix | Shingrix Inj. [Herpes Zoster Vaccine (Recombinant)] | 250000 | Medical personnel or nurse assistant (Clinical support duties) | NaN | 26.10.12 |
Medical Certificate Fees | Medical Certificate | PDZ010000 | report1 | Medical Certificate | 20000 | NaN | NaN | 26.10.12 |
Medical Certificate Fees | Medical Certificate | PDZ010002 | report1-2 | Medical Certificate/For Work Capability Assessment | 10000 | NaN | NaN | 26.10.12 |
Medical Certificate Fees | Medical Certificate for Disability Grade Assessment | PDZ070001 | report7 | Medical Certificate for Disability Grade Assessment | 15000 | NaN | NaN | 26.10.12 |
Medical Certificate Fees | Medical Certificate for Military Service | PDZ080000 | Report1-4 | Medical Certificate/Medical Certificate for Military Service | 20000 | NaN | NaN | 26.10.12 |
Medical Certificate Fees | Injury Certificate | PDZ020001 | report1-10 | Injury Certificate (Under 3 Weeks) | 100000 | NaN | NaN | 26.10.12 |
Medical Certificate Fees | Injury Certificate | PDZ020002 | report1-15 | Injury Certificate (3 Weeks or More) | 150000 | NaN | NaN | 26.10.12 |
Medical Certificate Fees | Medical Certificate in English | PDE010001 | reportE | Medical Certificate in English | 20000 | NaN | NaN | 26.10.12 |
Medical Certificate Fees | Confirmation Letter | PDZ090007 | report3 | Confirmation of Treatment | 3000 | NaN | NaN | 26.10.12 |
Medical Certificate Fees | Copy of Certificate | PDZ160000 | report1-1 | Copy | 1000 | NaN | NaN | 26.10.12 |
Medical Certificate Fees | Copy of Medical Records | PDZ110101 | report4 | Copy of Medical Records (Per Page, Up to 5 Pages) | 1000 | NaN | NaN | 26.10.12 |
Medical Certificate Fees | Copy of Medical Records | PDZ110102 | report5 | Copy of Medical Records (Per Page, 6 Pages or More) | 100 | NaN | NaN | 26.10.12 |
Medical Certificate Fees | Medical Imaging Records | PDZ110004 | copyCD | Imaging Records CD Copy | 10000 | NaN | CD | 26.10.12 |
Medical Certificate Fees | Medical Imaging Records | PDZ110006 | copyUSB | Imaging Records USB Copy | 12000 | NaN | USB (Includes Device Cost) | 26.10.12 |
90 Yeonbuk-ro, Jeju-si, Body Building, 2F–3F | Representative : Dr. Kim Se-jun ｜ Medical Institution : Team Doctor Orthopedic Clinic
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