DAFTAR NAMA PENYAKIT YANG HARUS DAPAT

DITANGANI DI
No LAYANAN
DIA LEVELPRIMER (TIDAK BOLEH
Kode KODE
DIAGNOS
GN A
OS ASKES/BP
JS
A
ME
NU
RUT
KKI

SISTEM SARAF
1 Kejang demam 4A R56 CONVULSIONS, NOT
ELSEWHERE CLA

2 Tetanus 4A A35 OTHER TETANUS

3 HIV AIDS 4A B20 HIV DIS.RES.IN
INFEC.PARASITIC
tanpa
komplikasi

4 Tension 4A G44 OTHER HEADACHE

SYNDROMES
headache

5 Migren 4A G43 MIGRAINE

6 Bells’ palsy 4A G51 FACIAL NERVE

DISORDERS

Vertigo
(Benign
paroxysmal
positional
vertigo)
VERTIGINOUS
7 4A H82 SYNDROMES IN DISE.
PSIKIATRI
8 Gangguan 4A F45 SOMATOFORM
DISORDERS
somatoform

9 Insomnia 4A G47 SLEEP

DISORDERS

SISTEM INDERA
10 Benda asing di 4A T15 FOREIGN BODY
ON EXTERNAL
konjungtiva EYE

11 Konjungtivitis 4A H10 CONJUNCTIVITI

S

12 Perdarahan 4A H11 OTHER

DISORDERS OF
subkonjungtiva CONJUNCTIVA
13 Mata kering 4A H04 DISORDERS OF
LACRIMAL
SYSTEM

14 Blefaritis 4A H01 OTHER

INFLAMMATION
OF EYELID

15 Hordeolum 4A H00 HORDEOLUM AND

CHALAZION

16 Trikiasis 4A H02 OTHER

DISORDERS OF
EYELID

17 Episkleritis 4A H15 DISORDERS OF

SCLERA

18 Hipermetropia 4A H52 DISOR.OF

REFRACTION &
ringan ACCOMMO.

19 Miopia ringan 4A H52 DISOR.OF

REFRACTION &
ACCOMMO.
No D LEVEL Kode
KODE
DIAG
NOSA
I ASKE
S/BPJ
A S

G
N
O
S
A

M
E
N
U
R
U
T

K
20 AstigmatisK 4A H52
DISOR.OF
REFRACTION &
ACCOMMO.
m ringan

21 Presbiopia 4A H52
DISOR.OF
REFRACTION &
ACCOMMO.

22 Buta senja 4A E50

VITAMIN A
DEFICIENCY
23 Otitis 4A H60
OTITIS EXTERNA

eksterna

24 Otitis 4A H67
OTITIS MEDIA IN
DISEA.CLASS.E.
media akut

25 Serumen 4A H61
OTHER DISORDERS OF
EXTERN. EAR
prop

26 Mabuk 4A T75
EFFECTS OTHER
EXTERNAL CAUSES
perjalanan

27 Furunkel 4A J34
OTHER DISOR.NOSE
NASAL SINUSES
pada
hidung

28 Rhinitis 4A J30
VASOMOTOR &
ALLERGIC RHINITIS
akut
29 Rhinitis 4A J30
VASOMOTOR &
ALLERGIC RHINITIS
vasomotor

30 Rhinitis 4A J30
VASOMOTOR &
ALLERGIC RHINITIS
alergika

31 Benda asing 4A T17

FOREIGN BODY IN
RESPIRATORY T.
SISTEM
RESPIRASI
32 Epistaksis 4A R04
HAEMORRHAGE FROM
RESPIRATORY P

33 Influenza 4A J11
INFLUENZA,VIRUS NOT
IDENTIFIED

34 Pertusis 4A A37
WHOOPING COUGH

35 Faringitis 4A J02
ACUTE PHARYNGITIS

36 Tonsilitis 4A J03
ACUTE TONSILLITIS

37 Laringitis 4A J04
ACUTE LARYNGITIS &
TRACHEITIS

38 Asma 4A J45
ASTHMA

bronkial

39 Bronkitis 4A J20
ACUTE BRONCHITIS

akut

40 Pneumonia, 4A J18
PNEUMONIA,ORGANISM
UNSPECIFIED
bronkopneu
monia
41 Tuberkulosi 4A A15
RESPIRATORY
TUBERCOLOSIS, BACT
s paru
tanpa
komplikasi
KARDIOVASKULAR
42 Hipertensi 4A I10
ESSENTIAL (PRIMARY)
HYPERTENS.
esensial

SALURAN
PENCERNAAN
43 Kandidiasis 4A B37
CANDIDIASIS

mulut

44 Ulkus mulut 4A K12

STOMATITIS & RELATED
LESIONS
(aptosa,
herpes)

45 Parotitis 4A B26
MUMPS

46 Infeksi pada 4A P38

OMPHALITIS OF
NEWBORN WITH OR
umbilikus
47 Gastritis 4A K29
GASTRITIS &
DUODENITIS

48 Gastroenteriti 4A A09
DIARRHOEA AND
GASTROENTERITIS
s (termasuk
kolera,
giardiasis)

49 Refluks 4A K21
GASTRO-OESOPHAGEAL
REFLUX DIS.
gastroesofagu
s

50 Demam tifoid 4A A01

TYPHOID AND
PARATYPHOID FEVERS

51 Intoleransi 4A K90
INTESTINAL
MALABSORPTION
makanan
52 Alergi makanan 4A T78
ADVERSE EFFECTS, NOT
ELSEW.CL

53 Keracunan 4A T47
POISON.BY PRIMAR.
THE GASTROI.
makanan

54 Penyakit cacing 4A B76

HOOKWORM DISEASES

tambang

55 Strongiloidiasi 4A B78
STRONGYLOIDIASIS

56 Askariasis 4A B77
ASCARIASIS

57 Skistosomiasis 4A B65
SCHISTOSOMIASIS
(BILHARZIASIS)

58 Taeniasis 4A B68
TAENIASIS
59 Hepatitis A 4A B15
ACUTE HEPATITIS A

60 Disentri 4A A09
DIARRHOEA AND
GASTROENTERITIS
basiler,
disentri amuba

61 Hemoroid 4A I84
HAEMORRHOIDS

grade 1/2
SISTEM GINJAL,
SALURAN KEMIH
62 Infeksi saluran 4A N39
OTHER DISORDERS OF
URINARY SYS
kemih

63 Gonore 4A A54
GONOCOCCAL
INFECTION

64 Pielonefritis tanpa 4A N12

TUBULO-INTERSTITIAL
NEPHRITIS
komplikasi

65 Fimosis 4A N47
REDUNDANT PREPUCE,
PHIMOSIS AN

66 Parafimosis 4A N47
REDUNDANT PREPUCE,
PHIMOSIS AN
SISTEM
REPRODUKSI
Sindrom duh
(discharge)
genital (gonore
dan nongonore)

67 4A A54
GONOCOCCAL
INFECTION

68 Infeksi saluran 4A N39

OTHER DISORDERS
OF URINARY SYS
kemih bagian
bawah

69 Vulvitis 4A N76
OTHER
INFLAMMATION OF
VAGINA A
70 Vaginitis 4A N76
OTHER
INFLAMMATION OF
VAGINA A

71 Vaginosis 4A N76
FEMALE PELVIC
INFLAMMATORY DIS
bakterialis

72 Salpingitis 4A N70
SALPINGITIS AND
OOPHORITIS

73 Kehamilan 4A Z34
SUPERVISION OF
NORMAL
PREGNANC
normal

74 Aborsi spontan 4A O03

SPONTANEOUS
ABORTION
komplit
75 Anemia 4A D52
FOLATE DEFICIENCY
ANAEMIA
defisiensi besi
pada kehamilan

76 Ruptur perineum 4A O70

PERINEAL
LACERATION
DURING DEL
tingkat 1/2

Abses folikel
OTHER LOCAL
77 rambut atau 4A L08 INFECTIONS OF
SKIN
kelenjar sebasea
78 Mastitis 4A O91
INFECTION OF
BREAST
ASSOCIATED

79 Cracked nipple 4A O92

OTHER DISORDERS
OF BREAST AND

80 Inverted nipple 4A O92

OTHER DISORDERS
OF BREAST AND
SISTEM
ENDOKRIN,METAB
81 Diabetes 4A E10
INSULIN-DEPENDENT
DIABETES ME.
melitus tipe 1

82 Diabetes 4A E11
NON-INSULIN-
DEPENDENT DIABETES
melitus tipe 2

83 Hipoglikemia 4A R57
SHOCK, NOT
ELSEWHERE CLASSIFIE
ringan

84 Malnutrisi 4A E44
PROTEIN-ENERGY
MALNUTRITION OF
energi-protein

85 Defisiensi 4A E56
OTHER VITAMIN
DEFICIENCIES
vitamin
86 Defisiensi 4A E63
OTHER NUTRITIONAL
DEFICIENCIES
mineral

87 Dislipidemia 4A R79
OTHER ABNORMAL
FINDINGS OF BLO

88 Hiperurisemia 4A E79
DISORDERS OF PURINE
& PYRIMID.

89 Obesitas 4A E66
OBESITY
HEMATOL
OGI
90 DAN
Anem 4A D50
IRON
DEFICIE
NCY
ia ANAEMI
A
defisi
ensi
besi
91 Limfa 4A I88
NONSPE
CIFIC
deniti
LYMPHA
DENITIS
s
92 Dema 4A A91
DENGUE
HAEMOR
m
RHAGIC
FEVER
dengu
e,
DHF
93 Malar 4A B54
UNSPECI
FIED
MALARI
ia A

94 Lepto 4A A27
LEPTOSP
IROSIS
spiros
is
(tanp
a
kompl
ikasi)
95 Reaks 4A T78
ADVERS
E
EFFECTS,
i NOT
ELSEW.C
anafil L

aktik
SISTEM
MUSKULOS
96 Ulkus 4A L97
ULCER
OF
LOWE.
pada LIMB,
NOT
tungk ELSE.

ai

97 Lipom 4A D17
BENIGN
LIPOMAT
a
OUS
NEOPLAS
M

SISTEM
INTEGUME
98 Veruk 4A B07
VIRAL
WARTS
a
vulgar
is
99 Molus 4A B08
OTHER
VIRAL
INFECTI
kum ONS
CHARAC.
konta
giosu
m
100 Herp 4A B02
ZOSTER
(HERPES
ZOSTER)
es
zoste
r
tanpa
kompl
ikasi
101 Morbi 4A B05
MEASLE
S
li
tanpa
kompl
ikasi

102 Varis 4A B01

VARICEL
LA
(CHICKE
ela NPOX)

tanpa
kompl
ikasi

103 Herp 4A B00

HESPERV
IRAL
(HERPES
es SIMPLEX
)
simpl
eks
tanpa
kompl
ikasi

104 Impe 4A L01

IMPETIG
O
tigo
105 Impe 4A L02
IMPETIG
O
tigo
ulser
atif
(ekti
ma)
106 Foliku 4A L73
OTHER
FOLLICU
LAR
litis DISORDE
RS
super
fisiali
s
107 Furun 4A L02
CUTANE
OUS
ABSCESS
kel, ,FURUNC
LE & C
karbu
nkel
108 Eritr 4A L08
OTHER
LOCAL
INFECTI
asma ONS OF
SKIN

109 Erisip 4A A46

ERYSIPE
LAS
elas
110 Skrof 4A A18
TUBERC
OLOSIS
OF
ulode OTHER
ORGANS
rma
111 Lepra 4A A30
INTERMI
NATE
LEPROSY

112 Sifilis 4A A51

EARLY
SYPHILIS
stadi
um 1
dan 2

113 Tinea 4A B35

DERMAT
OPHYTO
SIS
kapiti
s
114 Tinea 4A B35
DERMAT
OPHYTO
SIS
barbe

115 Tinea 4A B35

DERMAT
OPHYTO
SIS
fasial
is
116 Tinea 4A B35
DERMAT
OPHYTO
SIS
korpo
ris
117 Tinea 4A B35
DERMAT
OPHYTO
SIS
manus

118 Tinea 4A B35

DERMAT
OPHYTO
SIS
ungui
um
119 Tinea 4A B35
DERMAT
OPHYTO
SIS
kruris

120 Tinea 4A B35

DERMAT
OPHYTO
SIS
pedis
121 Pitiri 4A B85
PEDICUL
OSIS
AND
asis PHTHIRI
ASIS
vesik
olor
122 Kandi 4A B35
DERMAT
OPHYTO
SIS
dosis
muko
kutan
ringa
n

123 Cutan 4A B74

FILARIAS
IS
eus
larva
migra
n
124 Filari 4A B74
FILARIAS
IS
asis
125 Pedik 4A B85
PEDICUL
OSIS
AND
ulosis PHTHIRI
ASIS
kapiti
s

126 Pedik 4A B85

PEDICUL
OSIS
AND
ulosis PHTHIRI
ASIS
pubis

127 Skabi 4A B86

SCABIES

es
128 Reaks 4A L25
UNSPECI
FIED
CONTAC
i T
DERMATI
gigita TIS

n
seran
gga

129 Derm 4A L24

IRRITAN
T
CONTAC
atitis T
DERMATI
konta TIS

k
iritan

130 Derm 4A L20

ATOPIC
DERMATI
TIS
atitis
atopi
k
(kecu
ali
recal
citran
t)

131 Derm 4A L20

ATOPIC
DERMATI
TIS
atitis
numul
aris
132 Napki 4A L22
DIAPER
(NAPKIN)
DERMATI
n TIS

ecze
ma
133 Derm 4A L21
SEBORR
HOEIC
DERMATI
atitis TIS

sebor
oik
134 Pitiri 4A L42
PITYRIAS
IS ROSEA
asis
rosea
135 Akne 4A L70
ACNE

vulgar
is
ringa
n
136 Hidra 4A L30
OTHER
DERMATI
TIS
deniti
s
supur
atif
137 Derm 4A L30
OTHER
DERMATI
atitis
TIS

perio
ral
138 Miliar 4A L30
OTHER
DERMATI
TIS
ia
139 Urtik 4A L50
URTICAR
IA
aria
akut
Exant
hema
tous
drug
erupt DERMATI
TIS
140 ion, 4A L27 SUBSTAN
CES
fixed TAKEN I.

drug
erupt
ion

141 Vulnu 4A T00

SUPERFI
CIAL
INJURIES
s INVOLVI
NG
lasera
tum,
punct
um

142 Luka 4A R12

HEARTB
URN
bakar
deraj
at 1
dan 2