Legal analysis: the basic medical insurance diagnosis and treatment items refer to the following conditions of the various medical technology labor projects and the use of instruments, equipment and medical materials for diagnosis and treatment:
(a) clinical diagnosis and treatment necessary, safe and effective, appropriate cost of diagnosis and treatment items;
(b) by the price, the health department has set the standard of charges for the diagnosis and treatment items;
(3) Diagnostic and therapeutic items within the scope of designated medical services provided by the designated medical institutions for the insured.
The scope of basic medical insurance treatment items is determined by the exclusion method, which stipulates that the basic medical insurance fund shall not pay for the cost and the scope of treatment items for which part of the cost is paid. The basic medical insurance fund shall not pay for the cost of the treatment items, which are not necessary for clinical diagnosis and treatment, and the effect is uncertain or belongs to the diagnosis and treatment items of the medical services for special needs. The basic medical insurance fund to pay part of the cost of medical treatment, mainly some clinical diagnosis and treatment is necessary, the effect of certain but expensive medical treatment.
Legal basis: "People's Republic of China *** and the State Social Insurance Law" Article 28 In line with the basic medical insurance drug list, diagnostic and therapeutic items, medical service facility standards, as well as emergency, rescue medical expenses, in accordance with state regulations from the basic medical insurance fund.