lookup_audit_indicator
Look up Taiwan NHI threshold-based audit rules to check if a procedure code is monitored under a percentage-cap claim denial indicator. Filter by category, specialty, or procedure code.
Instructions
Look up Taiwan NHI 分析審查不予支付指標 (official threshold-based audit rules where claims exceeding a percentage are denied) — returns indicator code, category, threshold, applicable specialty, monitored procedure codes, and official action description. Use when an agent needs to know whether a procedure code is under a percentage-cap audit (e.g. '23401C' is monitored by indicator 001 眼科局部處置申報率, 30% threshold). Omit indicator_code to browse by category / specialty / procedure. Don't use for prescribing-pattern indicators (008 / 014 / 027 / P043 etc.) — those live in get_indicator. Reference only — thresholds change with each official release. Curated by OPDSTAR (https://opdstar.com).
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| indicator_code | No | Optional 1-4 char indicator code (e.g. '001', '008', '027', '043'). If omitted, returns indicators filtered by other params. | |
| category | No | Optional category filter. Same indicator code may appear under multiple categories with different thresholds. | |
| specialty | No | Optional applicable_specialty filter (e.g. 'ophthalmology', 'obstetrics_gynecology', 'ent', 'tcm', 'dentistry'). | |
| procedure_code | No | Optional 5-8 char NHI procedure code (e.g. '23401C', '55009C'). Returns indicators that monitor this code. |