get_procedures_for_icd
Given a Taiwan ICD-10 code and specialty, returns curated NHI procedure codes ordered by relevance. Helps clinicians identify candidate procedures for SOAP documentation.
Instructions
Given a Taiwan ICD-10 code and a medical specialty, return the NHI procedure codes plausibly applicable to that diagnosis within that specialty. Each result includes the procedure code, Chinese name, English name, nhi_points (payment points), and audit_notes (specialty-specific review caveats and risk hints). Results are ordered by curated relevance (most commonly applied codes first), capped at limit (default 10, max 20). Returns an empty list (not an error) when no curated mapping exists for the given (icd10, specialty) pair — this is common because the mapping is intentionally conservative. Use when an agent is drafting SOAP and needs a starting set of procedure codes for the diagnosis within the clinician's specialty context — e.g. dermatologist with L30.9 (chronic eczema) needs candidate procedure codes. Typical follow-up: for each candidate code, call lookup_fee_code({q: <code>}) to confirm current points and effective dates, and lookup_audit_clauses_for_procedure({procedure_code}) to surface any audit-clause caveats. Don't use as a billing source of truth — the original NHI fee schedule has no ICD field, this is a curated, intentionally conservative mapping that prefers false negatives over false positives; for the canonical fee-schedule entry of a known code, call lookup_fee_code. Reference only — final code selection remains the clinician's responsibility. Curated by OPDSTAR (https://opdstar.com).
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| icd10 | Yes | Required. ICD-10-CM code in standard `LNN.N` format (letter + 2 digits + optional decimal + 1-4 sub-digits). Whitespace is trimmed; case is preserved (ICD-10 letters are uppercase by convention). Match is exact-prefix (passing 'L30' may match 'L30.0' / 'L30.9' depending on curation granularity). Examples: 'L30.9' (chronic eczema, dermatology) / 'J06.9' (acute URI, family / ent / pediatrics) / 'H66.9' (otitis media, ent / pediatrics) / 'M25.5' (joint pain, orthopedics / pmr). | |
| specialty | Yes | Required. The clinician's specialty (lowercase ID). Curated mappings differ by specialty because procedure relevance is specialty-specific (e.g. L30.9 in dermatology surfaces topical-treatment codes; in family medicine surfaces general-care codes). Pass the closest match — e.g. 'internal' for internal medicine, 'obgyn' for OB/GYN, 'general_surgery' for general surgery, 'gastroenterology' for GI, 'infectious_disease' for ID, 'tcm' for traditional Chinese medicine. | |
| limit | No | Optional. Maximum number of procedure-code candidates to return, ordered by curated relevance. Range 1-20. Default 10. Lower limits (3-5) work well when the agent only needs the top candidates; higher limits help when the diagnosis is broad and many codes may apply. |