Documente Academic
Documente Profesional
Documente Cultură
JOMBLO
KODING PROSEDUR INA-CBG
OLEH:
Teman Yang Tidak Mau Disebutkan Namanya
2014
To V
DAFTAR ISI
DAFTAR ISI............................................................................................................. 3
B-1-01 PROSEDUR PENCANGKOKAN HATI...........................................................14
B-1-10 PROSEDUR HATI DAN PANKREAS.............................................................15
B-1-11 PROSEDUR SALURAN EMPEDU KOMPLEK.................................................17
B-1-12 PROSEDUR CHOLESISTEKTOMI TANPA LAPAROSKOPIK............................19
B-1-13 PROSEDUR PANKREAS DAN HEPATOBILLIARI LAIN-LAIN..........................20
B-1-14 PROSEDUR CHOLESISTEKTOMI DENGAN LAPAROSKOPIK.........................21
B-2-10 PROSEDUR PADA HATI DAN PANKREAS....................................................22
B-2-11 PROSEDUR BESAR PADA SALURAN EMPEDU............................................23
B-2-12 PROSEDUR KOLESISTEKTOMI TANPA LAPAROSKOPI.................................24
B-2-13 PROSEDUR LAIN-LAIN PADA HEPATOBILIARI & PANKREAS.......................25
B-2-14 PROSEDUR KOLESISTEKTOMI DENGAN LAPAROSKOPI.............................26
B-3-10 PROSEDUR PADA PERKUTAN HATI & SALURAN EMPEDU..........................27
B-3-11 PROSEDUR ENDOSKOPI SALURAN EMPEDU.............................................28
B-3-12 PROSEDUR LAIN-LAIN PADA SISTEM HEPATOBILIARI DAN PANKREAS......29
C-3-10 PROSEDUR RADIOTERAPI........................................................................30
C-3-11 KEMOTERAPI PADA TUMOR PARU & KANDUNG KEMIH............................31
C-3-12 KEMOTERAPI PADA TUMOR KOLON.........................................................32
C-3-13 KEMOTERAPI PADA TUMOR PAYUDARA ATAU OVARIUM...........................33
C-3-14 KEMOTERAPI PADA TUMOR GASTROINTESTINAL...................................34
C-3-15 KEMOTERAPI PADA TUMOR MELANOMA, GINJAL ATAU PROSTAT.............35
C-3-16 KEMOTERAPI PADA TUMOR OTAK............................................................36
C-3-17 KEMOTERAPI PADA TUMOR KEPALA ATAU LEHER.....................................37
C-3-18 KEMOTERAPI PADA LEUKEMIA AKUT........................................................38
C-3-19 KEMOTERAPI PADA TUMOR LIMFOMA, MYELOMA ATAU TESTIS................39
C-3-20 KEMOTERAPI PADA TUMOR KULIT............................................................40
C-3-21 KEMOTERAPI PADA TUMOR GINEKOLOGI.................................................41
C-3-22 KEMOTERAPI PADA TUMOR METASTASE..................................................42
C-3-23 KEMOTERAPI PADA TUMOR LAIN-LAIN.....................................................43
D-1-10 PROSEDUR PENCANGKOKAN SUMSUM TULANG......................................44
D-1-11 PROSEDUR LIMPA...................................................................................45
D-1-20 PROSEDUR PADA DARAH DAN ORGAN PEMBENTUK DARAH LAIN-LAIN....46
D-2-10 PROSEDUR PENCANGKOKAN SUMSUM TULANG......................................48
3
13
14
15
16
17
18
B-1-12 PROSEDUR
CHOLESISTEKTOMI TANPA
LAPAROSKOPIK
- 5121 Other partial cholecystectomy Class II
- 5122 Cholecystectomy Class II
19
20
B-1-14 PROSEDUR
CHOLESISTEKTOMI DENGAN
LAPAROSKOPIK
- 5123 Laparoscopic cholecystectomy Class II
- 5124 Laparoscopic partial cholecystectomy Class II
21
22
23
B-2-12 PROSEDUR
KOLESISTEKTOMI TANPA
LAPAROSKOPI
- 5121 Other partial cholecystectomy Class II
- 5122 Cholecystectomy Class II
24
25
B-2-14 PROSEDUR
KOLESISTEKTOMI DENGAN
LAPAROSKOPI
- 5123 Laparoscopic cholecystectomy Class II
- 5124 Laparoscopic partial cholecystectomy Class II
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
68
69
70
71
73
74
75
76
77
78
79
80
81
82
83
84
85
86
G-3-13 PROSEDUR
ELEKROENSEFALOGRAFI EEG
- 8914 Electroencephalogram Class III
- 8919 Video and radio-telemetered electroencephalographic monitoring Class
III
87
89
90
93
98
100
102
- 1631 Removal of ocular contents with synchronous implant into scleral she
Class II
- 1639 Other evisceration of eyeball Class II
- 1641 Enucleation of eyeball with synchronous implant into tenon\s capsule
Class II
- 1642 Enucleation of eyeball with other synchronous implant Class II
- 1649 Other enucleation of eyeball Class II
- 1661 Secondary insertion of ocular implant Class II
- 1662 Revision and reinsertion of ocular implant Class II
- 1663 Revision of enucleation socket with graft Class II
- 1664 Other revision of enucleation socket Class II
- 1665 Secondary graft to exenteration cavity Class II
- 1669 Other secondary procedures after removal of eyeball Class II
- 1671 Removal of ocular implant Class II
- 1672 Removal of orbital implant Class II
- 1681 Repair of wound of orbit Class II
- 1682 Repair of rupture of eyeball Class II
- 1689 Other repair of injury of eyeball or orbit Class II
- 1692 Excision of lesion of orbit Class II
- 1693 Excision of lesion of eye, unspecified structure Class II
- 1698 Other operations on orbit Class II
- 1699 Other operations on eyeball Class II
103
105
106
107
108
109
110
111
112
113
H-2-37 PROSEDUR
PHOTOKOAGULASI DAN
KRIOTHERAPI PADA RETINA
- 1432 Repair of retinal tear by cryotherapy Class II
- 1433 Repair of retinal tear by xenon arc photocoagulation Class II
- 1434 Repair of retinal tear by laser photocoagulation Class II
- 1435 Repair of retinal tear by photocoagulation of unspecified type Class II
- 1439 Other repair of retinal tear Class II
- 1451 Repair of retinal detachment with diathermy Class II
- 1452 Repair of retinal detachment with cryotherapy Class II
- 1453 Repair of retinal detachment with xenon arc photocoagulation Class II
- 1454 Repair of retinal detachment with laser photocoagulation Class II
- 1455 Repair of retinal detachment with photocoagulation of unspecified ty
Class II
- 1459 Other repair of retinal detachment Class II
114
115
116
117
118
119
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
137
138
I-1-40 PROSEDUR
KARDIOVASKULAR PERKUTAN
- 3541 Enlargement of existing atrial septal defect Class II
- 3596 Percutaneous valvuloplasty Class II
- 3604 Intracoronary artery thrombolytic infusion Class II
- 3605 Multiple vessel (percutaneous) transluminal coronary angioplasty (pt
Class II
- 3606 Insertion of non-drug -eluting coronary artery stent(s) Class II
- 3607 Insertion of drug-eluting coronary artery stent(s) Class II
- 3609 Other specified removal of coronary artery obstruction Class II
- 3726 Catheter based invasive electrophysiologic testing Class II
- 3727 Cardiac mapping Class II
- 3734 Excision or destruction of lesion or tissue of heart, other approach Class
II
139
I-2-11 PEMASANGAN/PENYISIPAN
DEFIBRILATOR JANTUNG & SISTEM
BANTU JANTUNG
- 0051 Implantation of cardiac resynchronization defibrillation, total system
(CRT-D) Class II
- 3767 Implantation of cardiomyostimulation system Class II
- 3794 Implantation or replacement of automatic cardioverter/ defibrillator, total
system (AICD) Class II
- 3795 Implantation of automatic cardioverter/defibrillator leads(s) only Class II
- 3796 Implantation of automatic cardioverter/defibrillator pulse generator only
Class II
- 3797 Replacement of automatic cardioverter/defibrillator leads(s) only Class II
- 3798 Replacement of automatic cardioverter/defibrillator pulse generator only
Class II
140
141
142
I-2-14 PROSEDUR
PEMASANGAN/PENYISIPAN ALAT
PACU PERMANEN PADA JANTUNG
- 0050 Implantation of cardiac resynchronization pacemaker without mention of
defibrillation, total system (CRT-P) Class II
- 3770 Initial insertion of lead (electrode), not otherwise specified Class II
- 3771 Initial insertion of transvenous lead (electrode) into ventricle Class II
- 3772 Initial insertion of transvenous lead (electrodes) into atrium and ventricle
Class II
- 3773 Initial insertion of transvenous lead (electrode) into atrium Class II
- 3774 Insertion or replacement of epicardial lead (electrode) into epicardium
Class II
- 3776 Replacement of transvenous atrial and/or ventricular lead(s) (electrode)
Class II
- 3780 Insertion of permanent pacemaker, initial or replacement, type of device
not specified Class II
- 3781 Initial insertion of single-chamber device, not specified as rateresponsive Class II
- 3782 Initial insertion of single-chamber device, rate-responsive Class II
- 3783 Initial insertion of dual-chamber device Class II
- 3785 Replacement of any type of pacemaker device with single-chamber
device, not specified as rate responsive Class II
- 3786 Replacement of any type of pacemaker device with single-chamber
devive, rate responsive Class II
- 3787 Replacement of any type of pacemaker device with dual-chamber device
Class II
143
144
145
146
147
148
149
150
151
152
I-2-41 PROSEDUR
ELEKTROFISIOLOGIK
- 3726 Catheter based invasive electrophysiologic testing Class II
- 3727 Cardiac mapping Class II
- 3734 Excision or destruction of lesion or tissue of heart, other approach Class
II
153
154
155
156
157
I-3-13 PROSEDUR
EKOKARDIOGRAFI
- 8872 Diagnostic ultrasound of heart Class III
- 8955 Phonocardiogram with ECG lead Class III
- 8957 Apexcardiogram (with ECG lead) Class III
158
159
160
161
162
163
164
165
166
- 7771 Excision of bone for graft, scapula, clavicle, and thorax (ribs and
sternum) Class II
- 7781 Other partial ostectomy of scapula, clavicle, and thorax (ribs and
sternum) Class II
- 7791 Total ostectomy of scapula, clavicle, and thorax (ribs and sternum) Class
II
- 7801 Bone graft of scapula, clavicle, and thorax (ribs and sternum) Class II
- 7811 Application of external fixation device, scapula, clavicle, and thorax (ribs
and sternum) Class II
- 7841 Other repair or plastic operations on scapula, clavicle, and thorax (ribs
and sternum) Class II
- 7851 Internal fixation of bone without fracture reduction on scapula, clavicle,
and thorax (ribs and sternum) Class II
- 7861 Removal of implanted device from scapula, clavicle, and thorax (ribs and
sternum) Class II
- 7871 Osteoclasis of scapula, clavicle, and thorax (ribs and sternum) Class II
- 7881 Diagnostic procedures on scapula, clavicle, and thorax (ribs and
sternum) Class II
- 7891 Insertion of bone growth stimulator into scapula, clavicle, and thorax
(ribs and sternum) Class II
167
168
169
170
J-2-31 PROSEDUR
THORAKOSKOPI/MEDIASTINOSKOPI
- 3421 Transpleural thoracoscopy Class II
- 3422 Mediastinoscopy Class II
171
172
173
- 7781 Other partial ostectomy of scapula, clavicle, and thorax (ribs and
sternum) Class II
- 7791 Total ostectomy of scapula, clavicle, and thorax (ribs and sternum) Class
II
- 7801 Bone graft of scapula, clavicle, and thorax (ribs and sternum) Class II
- 7811 Application of external fixation device, scapula, clavicle, and thorax (ribs
and sternum) Class II
- 7841 Other repair or plastic operations on scapula, clavicle, and thorax (ribs
and sternum) Class II
- 7851 Internal fixation of bone without fracture reduction on scapula, clavicle,
and thorax (ribs and sternum) Class II
- 7861 Removal of implanted device from scapula, clavicle, and thorax (ribs and
sternum) Class II
- 7871 Osteoclasis of scapula, clavicle, and thorax (ribs and sternum) Class II
- 7881 Diagnostic procedures on scapula, clavicle, and thorax (ribs and
sternum) Class II
- 7891 Insertion of bone growth stimulator into scapula, clavicle, and thorax
(ribs and sternum) Class II
174
175
J-3-11 PROSEDUR
PEMASANGAN/PENYISIPAN TUBE
PADA DADA
- 3404 Insertion of intercostal catheter for drainage Class III
- 3405 Creation of pleuroperitoneal shunt Class III
176
177
178
179
180
181
182
183
184
185
186
187
188
- 4571 Open and other multiple segmental resection of large intestine Class I
- 4572 Open and other Cecectomy Class I
- 4573 Open and other Right hemicolectomy Class I
- 4574 Open and other Resection of transverse colon Class I
- 4575 Open and other Left hemicolectomy Class I
- 4576 Open and other Sigmoidectomy Class I
- 4579 Other and unspecified partial excision of large intestine Class I
- 458 Total intra-abdominal colectomy Class I
- 4590 Intestinal anastomosis, not otherwise specified Class I
- 4591 Small-to-small intestinal anastomosis Class I
- 4592 Anastomosis of small intestine to rectal stump Class I
- 4593 Other small-to-large intestinal anastomosis Class I
- 4594 Large-to-large intestinal anastomosis Class I
- 4595 Anastomosis to anus Class I
- 4601 Exteriorization of small intestine Class II
- 4602 Resection of exteriorized segment of small intestine Class II
- 4603 Exteriorization of large intestine Class II
- 4604 Resection of exteriorized segment of large intestine Class II
- 4610 Colostomy, not otherwise specified Class II
- 4611 Temporary colostomy Class II
- 4613 Permanent colostomy Class II
- 4620 Ileostomy, not otherwise specified Class II
- 4622 Continent ileostomy Class II
- 4623 Other permanent ileostomy Class II
- 4671 Suture of laceration of duodenum Class I
- 4672 Closure of fistula of duodenum Class II
- 4675 Suture of laceration of large intestine Class I
- 4676 Closure of fistula of large intestine Class II
191
192
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195
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
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215
216
217
218
219
220
221
222
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225
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229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
245
246
247
248
250
251
252
- 7849 Other repair or plastic operations on other bone, except facial bone Class
II
- 7850 Internal fixation of bone without fracture reduction, unspecified site
Class II
- 7859 Internal fixation of bone without fracture reduction on other bone, except
facial bone Class II
- 7870 Osteoclasis, unspecified site Class II
- 7879 Osteoclasis of other bone, except facial bone Class II
- 7880 Diagnostic procedures on bone, not elsewhere classified, unspecified site
Class II
- 7882 Diagnostic procedures on humerus, not elsewhere classified Class II
- 7883 Diagnostic procedures on radius and ulna, not elsewhere classified Class
II
- 7885 Diagnostic procedures on femur, not elsewhere classified Class II
- 7886 Diagnostic procedures on patella, not elsewhere classified Class II
- 7887 Diagnostic procedures on tibia and fibula, not elsewhere classified Class
II
- 7889 Diagnostic procedures on other bone, not elsewhere classified Class II
- 7890 Insertion of bone growth stimulator, unspecified site Class II
- 7899 Insertion of bone growth stimulator into other bone, except facial bone
Class II
- 7910 Closed reduction of fracture with internal fixation, unspecified site Class
II
- 7919 Closed reduction of fracture with internal fixation, other specified bone
Class II
- 7920 Open reduction of fracture without internal fixation, unspecified site
Class II
- 7929 Open reduction of fracture without internal fixation, other specified bone
Class II
- 7930 Open reduction of fracture with internal fixation, unspecified site Class II
- 7939 Open reduction of fracture with internal fixation, other specified bone
Class II
- 7940 Closed reduction of separated epiphysis, unspecified site Class II
255
257
258
- 7916 Closed reduction of fracture with internal fixation, tibia and fibula Class II
- 7926 Open reduction of fracture without internal fixation, tibia and fibula Class
II
- 7936 Open reduction of fracture with internal fixation, tibia and fibula Class II
- 7946 Closed reduction of separated epiphysis of tibia and fibula Class II
- 7956 Open reduction of separated epiphysis of tibia and fibula Class II
- 7966 Debridement of open fracture of tibia and fibula Class II
- 7986 Open reduction of dislocation of knee Class II
- 7987 Open reduction of dislocation of ankle Class II
- 7996 Unspecified operation on bone injury of tibia and fibula Class II
- 7997 Unspecified operation on bone injury of tarsals and metatarsals Class II
- 8016 Other arthrotomy of knee Class II
- 8017 Other arthrotomy of ankle Class II
- 8046 Division of joint capsule, ligament, or cartilage of knee Class II
- 8047 Division of joint capsule, ligament, or cartilage of ankle Class II
- 806 Excision of semilunar cartilage of knee Class II
- 8076 Synovectomy of knee Class II
- 8077 Synovectomy of ankle Class II
- 8087 Other local excision or destruction of lesion of ankle joint Class II
- 8096 Other excision of knee joint Class II
- 8097 Other excision of ankle joint Class II
- 8099 Other excision of joint of other specified site Class II
- 8111 Ankle fusion Class II
- 8112 Triple arthrodesis Class II
- 8122 Arthrodesis of knee Class II
- 8142 Five-in-one repair of knee Class II
- 8143 Triad knee repair Class II
- 8144 Patellar stabilization Class II
- 8145 Other repair of the cruciate ligaments Class II
259
260
265
266
267
268
269
270
271
272
273
275
276
277
278
279
280
282
283
284
285
286
288
289
291
293
295
298
299
300
301
303
304
305
- 9338 Combined physical therapy without mention of the components Class III
- 9339 Other physical therapy Class III
- 9826 Removal of foreign body from hand without incision Class III
- 9827 Removal of foreign body without incision from upper limb, except hand
Class III
- 9828 Removal of foreign body from foot without incision Class III
- 9829 Removal of foreign body without incision from lower limb, except foot
Class III
- 9986 Non-invasive placement of bone growth stimulator Class V
307
308
309
310
311
313
314
315
316
317
318
319
320
N-2-21 EXTRACORPOREAL
SHOCKWAVE LITHOTRIPSY ESWL
PADA SALURAN KEMIH
- 9851 Extracorporeal shockwave lithotripsy (ESWL) of the kidney, ureter and/or
bladder Class II
321
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
344
345
Q-5-16 VAKSINASI
- 9912 Immunization for allergy Class V
- 9913 Immunization for autoimmune disease Class V
- 9931 Vaccination against cholera Class V
- 9932 Vaccination against typhoid and paratyphoid fever Class V
- 9933 Vaccination against tuberculosis Class V
- 9934 Vaccination against plague Class V
- 9935 Vaccination against tularemia Class V
- 9936 Administration of diphtheria toxoid Class V
- 9937 Vaccination against pertussis Class V
- 9938 Administration of tetanus toxoid Class V
- 9939 Administration of diphtheria-tetanus-pertussis, combined Class V
- 9941 Administration of poliomyelitis vaccine Class V
- 9942 Vaccination against smallpox Class V
- 9943 Vaccination against yellow fever Class V
- 9944 Vaccination against rabies Class V
- 9945 Vaccination against measles Class V
- 9946 Vaccination against mumps Class V
- 9947 Vaccination against rubella Class V
- 9948 Administration of measles-mumps-rubella vaccine Class V
- 9951 Prophylactic vaccination against the common cold Class V
- 9952 Prophylactic vaccination against influenza Class V
- 9953 Prophylactic vaccination against arthropod-borne viral encephalitis Class
V
- 9954 Prophylactic vaccination against other arthropod- borne viral diseases
Class V
- 9955 Prophylactic administration of vaccine against other diseases Class V
- 9956 Administration of tetanus antitoxin Class V
346
347
348
349
350
351
352
353
354
355
356
357
360
361
363
364
365
366
367
368
369
371
372
373
374
376
377
378
379
381
382
383
384
385
387
388
389
390
392
393
394
395
396
397
399
400
V-2-15 SIRKUMSISI/SUNAT
- 640 Circumcision Class II
401
402
403
404
405
406
407
408
409
410
- 6561 Other removal of both ovaries and tubes at same operative episode
Class II
- 6562 Other removal of remaining ovary and tube Class II
- 6563 Laparoscopic removal of both ovaries and tubes at the same operative
episode Class II
- 6564 Laparoscopic removal of remaining ovary and tube Class II
- 6571 Other simple suture of ovary Class II
- 6572 Other reimplantation of ovary Class II
- 6573 Other salpingo-oophoroplasty Class II
- 6574 Laparoscopic simple suture of ovary Class II
- 6575 Laparoscopic reimplantation of ovary Class II
- 6576 Laparoscopic salpingo-oophoroplasty Class II
- 6579 Other repair of ovary Class II
- 6581 Laparoscopic lysis of adhesions of ovary and fallopian tube Class II
- 6589 Other lysis of adhesions of ovary and fallopian tube Class II
- 658 Lysis of adhesions of ovary and fallopian tube Class II
- 6591 Aspiration of ovary Class II
- 6592 Transplantation of ovary Class II
- 6593 Manual rupture of ovarian cyst Class II
- 6594 Ovarian denervation Class II
- 6595 Release of torsion of ovary Class II
- 6599 Other operations on ovary Class II
- 6601 Salpingotomy Class II
- 6602 Salpingostomy Class II
- 660 Salpingotomy and salpingostomy Class II
- 6611 Biopsy of fallopian tube Class II
- 664 Total unilateral salpingectomy Class II
- 6651 Removal of both fallopian tubes at same operative episode Class II
- 6652 Removal of remaining fallopian tube Class II
411
412
413
415
416
417
418
419
420
421
424
425
426
427
429
430
431
432
433
434
Z-3-11 EXTRACORPOREAL
SHOCKWAVE LITHOTRIPSY ESWL
SELAIN URINARI DAN SALURAN
EMPEDU
- 9859 Extracorporeal shockwave lithotripsy (ESWL) of other sites Class III
435
436
437
438
439
440
441
442
443
444
446
448
449
450
451
452
453
454
455
Z-3-30 FOTOTERAPI
- 9982 Ultraviolet light therapy Class III
- 9983 Other phototherapy Class III
456