附表三：
重大燒燙傷給付條件：（依全民健保重大燒燙傷定義，申請者應註明燒燙傷面積）
(一)二度燒燙傷面積占身體面積 20%以上。
(二)三度燒燙傷面積占身體面積 10%以上。
(三)顏面燒燙傷合併五官功能障礙。（符合行政院衛生署最新刊印之「國際疾病傷害 及死因分類標準」中，國際號碼第 940 或 941.5 號所列之傷病，詳如下表所示）。
中文疾病名稱 ICD-9-CM
碼 英文疾病名稱
1.眼及其附屬器官之燒傷 940 Burn confined to eye and adnexa
眼瞼及眼周區之化學燒傷 940.0 Chemical burn of eyelids and periocular area 眼瞼及眼周區之其他燒傷 940.1 Other burns of eyelids and periocular area 角膜及結膜囊之鹼性化學燒傷 940.2 Alkaline chemical burn of cornea and
conjunctival sac
角膜及結膜囊之酸性化學燒傷 940.3 Acid chemical burn of cornea and conjunctival sac
角膜及結膜囊之其他燒傷 940.4 Other burn of cornea and conjunctival sac 引起眼球破裂及損壞之燒傷 940.5 Burn with resulting rupture and destruction of
eyeball
眼及附屬器官未明示之燒傷 940.9 Unspecified burn of eye and adnexa 2.臉及頭之燒傷，深部組織壞死（深
三度），伴有身體部位損害
941.5 Burn of face and head,deep necrosis of underlying tissues (deep third degree)with loss of a body part
臉及頭之燒傷，未明示位置之深部 組織壞死（深三度），伴有身體部 位損害
941.50 Burn of face and head,unspecified site deep necrosis of underlying tissues (deep third degree)with loss of a body part
耳（任何部位）之燒傷，深部組織 壞死（深三度），伴有身體部位損 害
941.51 Burn of ear(any part) deep necrosis of underlying tissues(deep third degree)with loss of a body part
眼（伴有臉，頭及頸其他部位）之 燒傷，深部組織壞死（深三度），
伴有身體部位損害
941.52 Burn of eye(with other parts of face,head,and neck) deep necrosis of underlying tissues (deep third degree)with loss of a body part
唇之燒傷，深部組織壞死（深三 度），伴有身體部位損害
941.53 Burn of lip(s) deep necrosis of underlying tissues (deep third degree)with loss of a body part
顎（下巴）之燒傷，深部組織壞死
（深三度），伴有身體部位損害
941.54 Burn of chin deep necrosis of underlying tissues (deep third degree)with loss of a body part 鼻（中隔）之燒傷，深部組織壞死
（深三度），伴有身體部位損害
941.55 Burn of nose(septum) deep necrosis of
underlying tissues(deep third degree)with loss of a body part
頭皮（任何部位）之燒傷，深部組 織壞死（深三度），伴有身體部位 損害
941.56 Burn of scalp(any part) deep necrosis of underlying tissues(deep third degree)with loss of a body part
前額及頰之燒傷，深部組織壞死（深 三度），伴有身體部位損害
941.57 Burn of forehead and cheek deep necrosis of underlying tissues (deep third degree)with loss of a body part
頸之燒傷，深部組織壞死（深三 度），伴有身體部位損害
941.58 Burn of neck deep necrosis of underlying tissues (deep third degree)with loss of a body part 臉，頭及頸多處位置（眼除外）之
燒傷，深部組織壞死（深三度），
伴有身體部位損害
941.59 Burn of multiple sites(except with eye) of face,head,and neck deep necrosis of underlying tissues (deep third degree)with loss of a body part
