DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

A15.00 Tuberculosis of lung, with previously treated confirmation sputum microscopy with or without
culture (IM)
A15.10 Tuberculosis of lung, with previously treated confirmation culture only (IM)
A15.11 Tuberculosis of lung, confirmed by biomoleculer examination (IM)
A15.12 Tuberculosis of lung, with previously treated confirmed by biomoleculer examination (IM)
A15.21 Tuberculosis of lung, with previously treated confirmed histologically (IM)
A15.50 Tuberculosis of larynx, trachea & bronchus confirmation by biomoleculer examination (IM)
A15.80 Other respiratory tuberculosis, with previously treated with confirmation bacteriology or
histologically (IM)
A15.81 Other respiratory tuberculosis confirmation by biomoleculer examination (IM)
A16.20
Tuberculosis of lung, with previously treated without confirmation bacteriology or histologically (IM)
A16.80 Latent baccili tuberculosis infection (IM)
A16.81 Other respiratory tuberculosis, with previously treated without confirmation bacteriology or
histologically (IM)
A91.0 Dengue hemorrhagic fever, with shock (IM)
A91.1 Dengue hemorrhagic fever, without shock (IM)
A91.9 Dengue hemorrhagic fever, unspecified (IM)
B18.10 Chronic viral hepatitis B without delta-agent (IM)
B18.19 Chronic hepatitis B, unspecified delta agent status (IM)
B35.7 Tinea faciei (IM)
B37.00 Acute pseudomembranous candidal stomatitis (IM)
B37.01 Acute erythematous (atrophic) candidal stomatitis (IM)
B37.02 Chronic hyperplastic candidal stomatitis (IM)
B37.03 Chronic erythematous (atrophic) candidal stomatitis (IM)
B37.04 Mucocutaneous candidiasis (IM)
B37.05 Oral candidal granuloma (IM)
B37.06 Angular cheilitis (IM)
B37.08 Other specified candidal stomatitis (IM)
B37.09 Candidal stomatitis, unspecified (IM)
B39.6 Histoplasma limphadenopathy (IM)
B44.81 Allergic Broncho Pulmonary Aspergillosis (ABPA) (IM)
B69.2 Cysticercosis of skin (IM)
B74.80 Filaria limphadenopathy (IM)
B78.8 Other strongyloidiasis (IM)
B83.10 Gnathostomiasis of central nervous system (IM)
B83.11 Gnathostomiasis of eye (IM)
B83.12 Gnathostomiasis of skin (IM)
B83.18 Gnathostomiasis of other sites (IM)
B83.19 Gnathostomiasis, unspecified (IM)
B86.0 Scabies due to Sarcoptes scabiei (IM)
B86.8 Other scabies / norwegian scabies (IM)
B86.9 Scabies, unspecified (IM)
C02.10 Malignant neoplasm of tip of tongue (IM)
C02.11 Malignant neoplasm of lateral border of tongue (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

C02.19 Malignant neoplasm of border of tongue, unspecified (IM)
C06.10 Malignant neoplasm of vestibule mouth: upper labial sulcus (IM)
C06.11 Malignant neoplasm of vestibule mouth: upper buccal sulcus (IM)
C06.12 Malignant neoplasm of vestibule mouth: lower labial sulcus (IM)
C06.13 Malignant neoplasm of vestibule mouth: lower buccal sulcus (IM)
C06.14 Malignant neoplasm of vestibule mouth: upper sulcus, unspecified (IM)
C06.15 Malignant neoplasm of vestibule mouth: lower sulcus, unspecified (IM)
C06.19 Malignant neoplasm of vestibule mouth, unspecified (IM)
C06.20 Malignant neoplasm of mouth: maxillary tuberosity (IM)
C06.21 Malignant neoplasm of mouth: mandibular retromolar area (IM)
C06.29 Malignant neoplasm of mouth: retromolar area, unspecified (IM)
C41.00 Malignant neoplasm of maxilla, sarcoma (IM)
C41.01 Malignant neoplasm of maxilla, malignant odontogenic tumour (IM)
C41.02 Malignant neoplasm of maxilla, malignant intraosseous salivary gland tumour (IM)
C41.08 Malignant neoplasm of other bone of skull and face (IM)
C41.09 Malignant neoplasm of bone of skull and face, unspecified (IM)
C41.10 Malignant neoplasm of mandible, sarcoma (IM)
C41.11 Malignant neoplasm of mandible, malignant odontogenic tumour (IM)
C41.19 Malignant neoplasm of mandible, unspecified (IM)
C64.1 Malignant neoplasm of right kidney, except renal pelvis (IM)
C64.2 Malignant neoplasm of left kidney, except renal pelvis (IM)
C64.9 Malignant neoplasm of unspecified kidney, except renal pelvis (IM)
C65.1 Malignant neoplasm of right renal pelvis (IM)
C65.2 Malignant neoplasm of left renal pelvis (IM)
C65.9 Malignant neoplasm of unspecified renal pelvis (IM)
C66.1 Malignant neoplasm of right ureter (IM)
C66.2 Malignant neoplasm of left ureter (IM)
C66.9 Malignant neoplasm of unspecified ureter (IM)
D03.30 Melanoma in situ: skin of lip (IM)
D03.38 Melanoma in situ: other facial skin (IM)
D03.39 Melanoma in situ: facial skin, unspecified (IM)
D10.00 Benign neoplasm of upper lip, vermilion border (IM)
D10.01 Benign neoplasm of upper lip, labial mucosa (IM)
D10.02 Benign neoplasm of upper lip, vermilion border with mucosa (IM)
D10.03 Benign neoplasm of lower lip, vermilion border (IM)
D10.04 Benign neoplasm of lower lip, labial mucosa (IM)
D10.05 Benign neoplasm of lower lip, vermilion border with mucosa (IM)
D10.06 Benign neoplasm of both lips, vermilion border (IM)
D10.07 Benign neoplasm of both lips, labial mucosa (IM)
D10.08 Benign neoplasm of both lips, vermilion border with mucosa (IM)
D10.09 Benign neoplasm of lip, unspecified (IM)
D10.10 Benign neoplasm of base of tongue (posterior to terminal sulcus) (IM)
D10.11 Benign neoplasm of dorsal surface of tongue (IM)
D10.12 Benign neoplasm of borders and tip of tongue (IM)
D10.13 Benign neoplasm of ventral surface of tongue (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

D10.14 Benign neoplasm of lingual tonsil (IM)
D10.19 Benign neoplasm of tongue, unspecified (IM)
D10.30 Benign neoplasm of mouth, buccal mucosa (IM)
D10.31 Benign neoplasm of mouth, buccal mucosal commissure (IM)
D10.32 Benign neoplasm of mouth, buccal sulcus (IM)
D10.33 Benign neoplasm of mouth, gingiva and edentulous alveolar ridge (IM)
D10.34 Benign neoplasm of mouth, hard palate (IM)
D10.35 Benign neoplasm of mouth, soft palate (IM)
D10.36 Benign neoplasm of mouth, vula (IM)
D10.37 Benign neoplasm of mouth, retromolar area (IM)
D10.38 Benign neoplasm of mouth, tuberosity benign (IM)
D10.39 Benign neoplasm of mouth, unspecified (IM)
D16.40 Benign neoplasm of maxilla, bone and articular cartilage (IM)
D16.41 Benign neoplasm of maxilla, odontogenic tissues (IM)
D16.48 Benign neoplasm of other bones of skull and face (IM)
D16.49 Benign neoplasm of maxilla, unspecified (IM)
D16.50 Benign neoplasm of mandible, bone and cartilage (IM)
D16.51 Benign neoplasm of mandible, odontogenic tissue (IM)
D16.59 Benign neoplasm of mandible, unspecified (IM)
D18.00 Haemangioma, skin and subcutaneous tissues (IM)
D18.01 Haemangioma, intracranial structures (IM)
D18.02 Haemangioma, liver (IM)
D18.03 Haemangioma, intestine (IM)
D18.04 Haemangioma, ear, nose, mouth and throat (IM)
D18.07 Haemangioma, multiple sites (IM)
D18.08 Haemangioma, other sites (IM)
D18.09 Haemangioma, unspecified (IM)
D25.7 Leiomyoma of uterus, multiple sites (IM)
D29.8 Beningn neolasm of other specified male genital organs (IM)
D40.8 Neoplasm of uncertain behavior of other specified male genital organs (IM)
D49.5 Neoplasm of unspecified behavior of other genitourinary organs (IM)
D59.40 Other nonimmune hemolytic anemias, chemical (IM)
D59.41 Other nonimmune hemolytic anemias, infectious (IM)
D59.42 Other nonimmune hemolytic anemias, microangiopathic (IM)
D59.43 Other nonimmune hemolytic anemias, physical (IM)
D59.48 Other nonimmune hemolytic anemias, other (IM)
D63.1 Anaemia due to liver and endocrine disorders (IM)
E03.6 Hypothyroidism from Hashimoto's thyroiditis (IM)
E06.6 Transient painless thyroiditis,sporadic (IM)
E66.20 Sleep related hypoventilation disorder (IM)
E66.21 Sleep related hypoxemia disorder (IM)
E74.30 Glucose malabsorption (IM)
E74.38 Other disorders of intestinal carbohydrate metabolism (IM)
F44.88 Other specified dissociative [conversion] disorders (IM)
F45.39 Somatoform autonomic dysfunction, unspecified organ or system (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

F45.80 Other somatoform disorders: Dysphagia (psychogenic), including globus hystericus (IM)
F45.81 Other somatoform disorders: Torticollis (psychogenic) (IM)
F45.82 Other somatoform disorders: Teeth-grinding [bruxism] (IM)
F45.88 Other somatoform disorders: Other somatoform disorders (IM)
F60.38 Other emotionally unstable personality disorder (IM)
F60.39 Emotionally unstable personality disorder, unspecified (IM)
G04.3 Viral transverse myelitis, unspecified (IM)
G47.31 Central sleep anoea synddrome (IM)
G47.32 Obstructive sleep apnoea syndrome (IM)
H61.4 Hematoma or seroma of external ear (IM)
H61.5 Hematoma of middle ear or paranasal sinus (IM)
H90.00 Conductive hearing loss, bilateral, moderate-severe (IM)
H90.01 Conductive hearing loss, bilateral, mild (IM)
H90.10 Conduct hearing loss, unilateral with unrestricted hearing on the contralateral side, mild (IM)
H90.11
Conduct hearing loss, unilateral with unrestricted hearing on the contralateral side, mod-sev (IM)
H90.30 Sensorineural hearing loss, bilateral, mild (IM)
H90.31 Sensorineural hearing loss, bilateral, mod-sev (IM)
H90.32 Sensorineural hearing loss, bilateral, profound (IM)
H90.40 Sensorineural hear loss unilat unrestricted hearing contralateral side, mild (IM)
H90.41 Sensorineural hear loss unilat unrestricted hearing contralateral side, mod-sev (IM)
H90.42 Sensorineural hear loss unilat unrestricted hearing contralateral side, profoud (IM)
H90.60 Mixed conductive and sensorineural hearing loss, bilateral, mild (IM)
H90.61 Mixed conductive and sensorineural hearing loss, bilateral, mod-sev (IM)
H90.62 Mixed conductive and sensorineural hearing loss, bilateral, profound (IM)
H90.70 Mix conductive and sensorineural hearing loss, unilateral unrestricted hearing on the contralateral
side, mild (IM)
H90.71 Mix conductive and sensorineural hearing loss, unilateral unrestricted hearing on the contralateral
side, mod-sev (IM)
H90.72 Mix conductive and sensorineural hearing loss, unilateral unrestricted hearing on the contralateral
side, profound (IM)
H91.4 Congenital hearing loss with inability to speak (IM)
I49.00 Ventricular fibrillation and flutter with structural heart diseases (IM)
I49.01 Ventricular fibrillation and flutter without structural heart diseases (idiopathic)(Bugrada sy (IM)
I49.09 Ventricular fibrillation and flutter, unspecified (IM)
I70.10 Atherosclerosis of renal artery without gangrene (IM)
I70.11 Atherosclerosis of renal artery with gangrene (IM)
I70.3 Atherosclerosis of carotid arteries (IM)
I95.3 Neural-mediated hypotension (IM)
J15.81 Pneumonia due to Rhodococcus equi (IM)
J15.88 Other bacterial pneumonia (IM)
J37.2 Chronic laryngitis with gastric acid reflux (IM)
J44.2 Wheezing ascociated respiratory illness (IM)
J44.3 Obstruction syndrome post tuberculosis (IM)
J44.90 Asthma COPD overlap syndrome (ACOS) (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

J45.2 Bronchial hiperresponsiveness (IM)
J45.3 Asthma with exacerbation (IM)
J45.4 Cough variant asthma (IM)
J45.5 Exercise induced bronchospasm (IM)
J47.0 Stable bronchiectasis (IM)
J47.1 Bronchiectasis with exacerbation (IM)
J95.6 Postprocedural chylothorax (IM)
J98.7 Trapped lung (IM)
K00.09 Anodontia, unspecified (IM)
K00.10 Supernumerary teeth, Incisor and canine regions (IM)
K00.11 Supernumerary teeth, Premolar region (IM)
K00.12 Supernumerary teeth, Molar region (IM)
K00.19 Supernumerary teeth, unspecified (IM)
K00.20 Macrodontia (IM)
K00.21 Microdontia (IM)
K00.22 Concrescence (IM)
K00.23 Fusion and gemination (IM)
K00.24 Dens evaginatus, [occlusal tuberculum] (IM)
K00.25 Dens invaginatus [dens in dente] [dilated odonoma] & incisor anomalies (IM)
K00.26 Premolarization (IM)
K00.27 Abnormal tubercula & enamel pearls [enameloma] (IM)
K00.28 Taurodontism (IM)
K00.29 Other & unspec abnormalities of size & form of teeth (IM)
K00.30 Endemic (fluoride) mottling of enamel [dental fluorosis] (IM)
K00.31 Non-endemic mottling of enamel [non-fluoride enamel opacities] (IM)
K00.39 Mottled teeth, unspecified (IM)
K00.40 Enamel hypoplasia (IM)
K00.41 Prenatal enamel hypoplasia (IM)
K00.42 Neonatal enamel hypoplasia (IM)
K00.43 Aplasia and hypoplasia of cementum (IM)
K00.44 Dilaceration (IM)
K00.45 Odontodysplasia [regional odontodysplasia] (IM)
K00.46 Turner’s tooth (IM)
K00.48 Other specified disturbances in tooth formation (IM)
K00.49 Disturbances in tooth formation, unspecified (IM)
K00.50 Amelogenesis imperfecta (IM)
K00.51 Dentinogenesis imperfecta (IM)
K00.52 Odontogenesis imperfecta (IM)
K00.58 Other hereditary disturbances in tooth structure (IM)
K00.59 Hereditary disturbances in tooth structure, unspec (IM)
K00.60 Natal teeth (IM)
K00.61 Neonatal teeth (IM)
K00.62 Premature eruption[dentia praecox] (IM)
K00.63 Retained [persistent] primary [deciduous] teeth (IM)
K00.64 Late eruption (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

K00.65 Premature shedding of primary [deciduous] teeth (IM)
K00.68 Other specified disturbances in tooth eruption (IM)
K00.69 Disturbances in tooth eruption, unspecified (IM)
K00.80 Colour changes during tooth formation due to blood type incompatibility (IM)
K00.81 Colour changes during tooth formation due to malformation of biliary system (IM)
K00.82 Colour changes during tooth formation due to porphyria (IM)
K00.83 Colour changes during tooth formation due to tetracyclines (IM)
K00.88 Other specified disorders of tooth development (IM)
K01.10 Impacted teeth, Maxillary incisor (IM)
K01.11 Impacted teeth, Mandibular incisor (IM)
K01.12 Impacted teeth, Maxillary canine (IM)
K01.13 Impacted teeth, Mandibular canine (IM)
K01.14 Impacted teeth, Maxillary premolar (IM)
K01.15 Impacted teeth, Mandibular premolar (IM)
K01.16 Impacted teeth, Maxillary molar (IM)
K01.17 Impacted teeth, Mandibular molar (IM)
K01.18 Impacted teeth, Supernumerary tooth (IM)
K01.19 Impacted tooth, unspecified (IM)
K03.00 Excessive attrition of teeth Occlusal (IM)
K03.01 Excessive attrition of teeth Approximal (IM)
K03.08 Other specified attrition of teeth (IM)
K03.09 Attrition of teeth, unspecified (IM)
K03.10 Dentrifice (IM)
K03.11 Habitual abrasion of teeth (IM)
K03.12 Occupational abrasion of teeth (IM)
K03.13 Traditioanal abrasion of teeth (IM)
K03.18 Other specified abrasion of teeth (IM)
K03.19 Abrasion of teeth, unspecified (IM)
K03.20 Occupational erosion of teeth (IM)
K03.21 Erosion of teeth due to persistent regurgitating or vomiting (IM)
K03.22 Erosion of teeth due to diet (IM)
K03.23 Erosion of teeth due to drugs and medicaments (IM)
K03.24 Idiopathic erosion of teeth (IM)
K03.28 Other specified erosion of teeth (IM)
K03.29 Erosion of teeth, unspecified (IM)
K03.30 External resorption of teeth (IM)
K03.31 Internal [internal granuloma] [pink spot] resorption of teeth (IM)
K03.39 Pathological resorption of teeth, unspecified (IM)
K03.60 Pigmented film (IM)
K03.61 Deposits on teeth due to tobacco habit (IM)
K03.62 Deposits on teeth due to betel-chewing habit (IM)
K03.63 Other gross soft deposits (IM)
K03.64 Supragingival calculus (IM)
K03.65 Subgingival caluculus (IM)
K03.66 Dental plaque (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

K03.68 Other specified deposits on teeth (IM)
K03.69 Deposit [accretions] on teeth, unspecified (IM)
K03.70 Posterupt col chng of dent hard tiss due to metats & met comp (IM)
K03.71 Posterupt col chng of dent hard tiss due to pulpal bleeding (IM)
K03.72 Posterupt col chng of dent hard tiss due to chewing habit (IM)
K03.78 Other spec posterupt col chng of dent hard tiss (IM)
K03.79 Posterupt col chng of dent hard tiss, unspec (IM)
K03.80 Sensitive dentine (IM)
K03.81 Changes of enamel due to irradiation (IM)
K03.88 Other spec diseases of hard tissues of teeth (IM)
K04.80 Apical and lateral radicular cyst (IM)
K04.81 Residual radicular cyst (IM)
K04.82 Inflammatory paradental radicular cyst (IM)
K04.89 Radicular cyst, unspecified (IM)
K05.00 Acute streoptococcal gingivostomatitis (IM)
K05.08 Other specified acute gingivitis (IM)
K05.09 Acute gingivitis, unspecified (IM)
K05.10 Chronic gingivitis, Simple marginal (IM)
K05.11 Chronic gingivitis, Hyperplastic (IM)
K05.12 Chronic gingivitis, Ulcerative (IM)
K05.13 Chronic gingivitis, Desquamative (IM)
K05.18 Other specified chronic gingivitis (IM)
K05.19 Chronic gingivitis, unspecified (IM)
K05.20 Periodontal abscess of gingival origin wo sinus (IM)
K05.21 Periodontal abscess of gingival origin w sinus (IM)
K05.22 Acute pericoronitis (IM)
K05.28 Other specified acute periodontitis (IM)
K05.29 Acute periodontitis, unspecified (IM)
K05.30 Chronic periodontitis, Simplex (IM)
K05.31 Chronic periodontitis, Complex (IM)
K05.32 Chronic periodontitis, Chronic pericoronitis (IM)
K05.33 Chronic periodontitis, Thickened follicle (IM)
K05.38 Other specified chronic periodontitis (IM)
K05.39 Chronic periodontitis,unspecified (IM)
K06.00 Localized gingival recession (IM)
K06.01 Generalized gingival recession (IM)
K06.09 Gingival recession, unspecified (IM)
K06.10 Gingival fibromatosis (IM)
K06.18 Other specified gingival enlargement (IM)
K06.19 Gingival enlargement, unspecified (IM)
K06.20 Gingival and edentulous alveolar ridgelesions associated with trauma, Due to traumatic occlusion
(IM)
K06.21
Gingival and edentulous alveolar ridgelesions associated with trauma, Due to toothbrushing (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

K06.22 Gingival and edentulous alveolar ridgelesions associated with trauma, Frictional [functional]
keratosis (IM)
K06.28 Gingival and edentulous alveolar ridgelesions associated with trauma, Other spec gingival &
edentulous alveolar ridge lesions ass w trauma (IM)
K06.29 Gingival & edentulous alveolar ridge lesions ass w trauma, unspec (IM)
K06.80 Gingival cyst of adult (IM)
K06.81 Peripheral giant cell granuloma [giant cell epulis] (IM)
K06.82 Fibrous epulis (IM)
K06.83 Pyogenic granuloma (IM)
K06.84 Flabby ridge (IM)
K06.85 Other specified disorders of gingival (IM)
K06.86 Other specified disorders of edentulous alveolar ridge (IM)
K07.00 Maxillary macrognthism [maxillary hyperplasia] (IM)
K07.01 Mandibular macrognathism [mandibular hyperplasia] (IM)
K07.02 Macrognathism, both jaws (IM)
K07.03 Maxillary micrognathism [maxiliary hypoplasia] (IM)
K07.04 Mandibular micrognathism [mandibular hypoplasia] (IM)
K07.05 Micrognathism, both jaws (IM)
K07.08 Other specified major anomalies of jaw size (IM)
K07.09 Anomaly of jaw size, unspecified (IM)
K07.10 Asymmetry of jaw (IM)
K07.11 Mandibular prognathism (IM)
K07.12 Maxillary prognathism (IM)
K07.13 Mandibular retrognathism (IM)
K07.14 Maxillary retrognathism (IM)
K07.18 Other spec anomalies of jaw-cranial base relationship (IM)
K07.19 Anomaly of jaw-cranial base relationship, unspec (IM)
K07.20 Disto-occlusion (IM)
K07.21 Mesio-occlusion (IM)
K07.22 Excessive overjet [horizontal overbite] (IM)
K07.23 Excessive overbite [vertical overbite] (IM)
K07.24 Openbite (IM)
K07.25 Crossbite (anterior, posterior) (IM)
K07.26 Midline deviation (IM)
K07.27 Posterior lingual occlusion of mandibular arch (IM)
K07.28 Other spec anomalies of dental arch relationship (IM)
K07.29 Anomaly of dental arch relationship, unspec (IM)
K07.30 Crowding (IM)
K07.31 Displacement (IM)
K07.32 Rotation (IM)
K07.33 Spacing (IM)
K07.34 Transposition (IM)
K07.38 Other specified anomalies of tooth position (IM)
K07.39 Anomaly of tooth position, unspecified (IM)
K07.50 Abnormal law closure (IM)
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KODE ICD 10 DESKRIPSI

K07.51 Maloclusion due to abnormal swallowing (IM)
K07.54 Malocclusion due to mouth breathing (IM)
K07.55 Malocclusion due to tongue, lip or finger habits (IM)
K07.58 Other spec dentofacial functional abnormalities (IM)
K07.59 Dentofacial functional abnormality, unspecified (IM)
K07.60 TM joint-pain-dysfunction [Costen's] syndrome (IM)
K07.61 Clicking (snapping) jaws (IM)
K07.62 Recurrent dislocation & subluxation of TM joint (IM)
K07.63 Pain in TM joint, not elsewhere classified (IM)
K07.64 Stiffness of TM joint, not elsewhere classified (IM)
K07.65 Osteophyte of temporomandibular joint (IM)
K07.68 Other spec temporomandibular joint disorders (IM)
K07.69 Temporomandibular joint disorder, unspecified (IM)
K08.80 Toothache NOS (IM)
K08.81 Irregular alveolar process (IM)
K08.82 Enlargement of alveolar ridge NOS (IM)
K08.88 Other spec disorders of teeth & supporting structures (IM)
K09.00 Developmental odontogenic cysts, eruption (IM)
K09.01 Developmental odontogenic cysts, gingival (IM)
K09.02 Dev odontogen cysts, keratocyst [primordial] (IM)
K09.03 Dev odontogen cysts, follicular [dentigerous] (IM)
K09.04 Dev odontogen cysts, lateral periodontal (IM)
K09.10 Dev (nonodontogen) cysts of oral region globulomaxillary (IM)
K09.12 Dev (nonodontogen) cysts of oral region, nasopalatine [incisive canal] (IM)
K09.13 Dev (nonodontogen) cysts of oral region, palatine papilla (IM)
K09.19 Developmental cyst of oral region, unspecified (IM)
K09.20 Aneurysmal bone cyst (IM)
K09.21 Solitary bone [traumatic] [haemorrhagic] cyst of jaw (IM)
K09.22 Epithelial jaw cyst not idenifiable as odontogenic or nonodontogenic (IM)
K09.28 Other specified cysts of jaw (IM)
K09.29 Cyst of jaw, unspecified (IM)
K09.80 Dermoid cyst (IM)
K09.81 Epidermoid cyst (IM)
K09.82 Gingival cyst of newborn (IM)
K09.83 Palatal cyst of newborn (IM)
K09.84 Nasoalveolar [nasolabial] cyst (IM)
K09.85 Lymphoepidermoid cyst (IM)
K09.88 Other specified cysts of oral region (IM)
K10.00 Torus mandibularis (IM)
K10.01 Torus palatinus (IM)
K10.02 Latent bone cyst (IM)
K10.08 Other specified developmental disorders of jaws (IM)
K10.09 Developmental disorder of jaws, unspecified (IM)
K10.20 Osteitis of jaw (IM)
K10.21 Osteomyelitis of jaw (IM)
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KODE ICD 10 DESKRIPSI

K10.22 Periostitis of jaw (IM)
K10.23 Chronic periostitis of jaw (IM)
K10.24 Neonatal osteomyelitis of maxilla [neonatal maxillitis] (IM)
K10.25 Sequestrum (IM)
K10.26 Osteoradionecrosis (IM)
K10.28 Other specified inflammatory conditions of jaws (IM)
K10.29 Inflammatory conditions of jaws, unspecified (IM)
K10.80 Cherubism (IM)
K10.81 Unilateral condylar hyperplasia of mandible (IM)
K10.82 Unilateral condylar hypoplasia of mandible (IM)
K10.83 Fibrous dysplasia of jaw (IM)
K10.88 Other specified disease of jaws (IM)
K11.60 Mucous retention cyst (IM)
K11.61 Mucous extravasation cyst (IM)
K11.69 Mucocele of salivary gland, unspecified (IM)
K11.70 Hyposecretion (IM)
K11.71 Xerostomia (IM)
K11.72 Hypersecretion [ptyalism] (IM)
K11.78 Other spec disturbances of salivary secretion (IM)
K11.79 Disturbance of salivary secretion, unspecified (IM)
K11.80 Benign lymphoepithelial lesion of salivary gland (IM)
K11.81 Mikulicz, disease (IM)
K11.82 Stenosis [stricture] of salivary duct (IM)
K11.83 Sialectasia (IM)
K11.85 Necrotizing sialometaplasia (IM)
K11.88 Other specified disease of salivary glands (IM)
K12.00 Recurrent (minor) aphthae (IM)
K12.01 Periadenitis mucosa necrotica recurrens (IM)
K12.02 Stomatis herpetiformis [herpetiform eruption] (IM)
K12.03 Bednar’s aphthae (IM)
K12.04 Traumatic ulcer (IM)
K12.08 Other specified recurrent oral aphthae (IM)
K12.09 Recurrent oral aphthae, unspecified (IM)
K12.11 Geographic stomatitis (IM)
K12.12 Denture stomatitis (IM)
K12.13 Papillary hyperplasia of palate (IM)
K12.14 Contact stomatitis (IM)
K12.18 Other specified forms of stomatitis (IM)
K12.19 Stomatitis, unspecified (IM)
K12.20 Buccal abscess (IM)
K12.21 Submandibular abscess (IM)
K12.22 Anterior-visceral abscess (IM)
K13.00 Angular cheilitis (IM)
K13.01 Cheilitis glandularis apostematosa (IM)
K13.02 Cheilitis, exfoliative (IM)
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KODE ICD 10 DESKRIPSI

K13.03 Cheilitis NOS (IM)
K13.04 Cheilodynia (IM)
K13.08 Other specified disease of lips (IM)
K13.09 Disease of lips, unspecified (IM)
K13.20 Leukoplakia, idiopathic (IM)
K13.21 Leukoplakia, tobacco-associated (IM)
K13.22 Erythroplakia (IM)
K13.23 Leukoedema (IM)
K13.24 Smoker’s palate [leukokeratosis nicotina palati] [nicotina palati] (IM)
K13.28 Other spec leukoplakia & disturbances of oral epith,including tongue (IM)
K13.29 Leukoplakia & disturbances of oral epithelium,unspec (IM)
K13.40 Pyogenic granuloma (IM)
K13.41 Eosinophilic granuloma of oral mucosa (IM)
K13.42 Verrucous xanthoma [histiocytosis Y] (IM)
K13.48 Other spec granuloma & granuloma-like lesions of oral mucosa (IM)
K13.49 Granuloma & granuloma-like lesions of oral mucosa, unspec (IM)
K13.70 Excessive melanin pigmentation (IM)
K13.71 Oral fistula (IM)
K13.72 Deliberate tattoo (IM)
K13.73 Focal oral mucinosis (IM)
K13.78 Other specified lesions of oral mucosa (IM)
K13.79 Lesion of oral mucosa, unspecified (IM)
K14.00 Abscess of tongue (IM)
K14.01 Traumatic ulceration of tongue (IM)
K14.08 Other specified glossitis (IM)
K14.09 Glossitis, unspecified (IM)
K14.30 Coated tongue (IM)
K14.31 Hairy tongue (IM)
K14.32 Hypertrophy of foliate papillae (IM)
K14.38 Other specified hypertrophy of tongue papillae (IM)
K14.39 Hypertrophy of tongue papillae, unspecified (IM)
K14.40 Atrophy of tongue papillae due to tongue cleaning habit (IM)
K14.41 Atrophy of tongue papillae due to systemic disorder (IM)
K14.42 Atrophic glossitis NOS (IM)
K14.48 Other specified atrophy of tongue papillae (IM)
K14.49 Atrophy of tongue papillae, unspecified (IM)
K14.60 Glossopyrosis [burning tongue] (IM)
K14.61 Glossodynia [painful tongue] (IM)
K14.68 Other specified glossodynia (IM)
K14.69 Glossodynia, unspecified (IM)
K14.80 Crenated tongue [lingua indentata] (IM)
K14.81 Hypertrophy of tongue (IM)
K14.82 Atrophy of tongue (IM)
K14.88 Other specified diesease of tongue (IM)
K52.20 Allergic and dietetic gastroenteritis and colitis due to cow's milk protein (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

K52.28 Other allergic and dietetic gastroenteritis and colitis (IM)
K52.29 Allergic and dietetic gastroenteritis and colitis, unspecified (IM)
K65.00 Primary peritonitis (IM)
K65.01 Secondary bacterial peritonitis (IM)
K83.6 Stenosis of sphincter of Oddi (IM)
K91.20 Post surgical malabsorption, post massive bowel resection (IM)
K91.28 Other postsurgical malabsorption (IM)
K91.29 Postsurgical malabsorption, unspecified (IM)
L24.80 Irritant contact dermatitis due to dyes (IM)
L24.81 Paederus dermatitis (IM)
L24.88 Irritant contact dermatitis due to other agents (IM)
L27.10 Fixed drug eruption (IM)
L27.18 Other specified localized skin eruption due to drugs and medicaments (IM)
L27.19 Localized skin eruption due to drugs and medicaments, unspecified (IM)
L70.80 Acne cosmetica (IM)
L70.81 Acne scar (IM)
L70.82 Steroid acne (IM)
L70.83 Acne fulminans (IM)
L70.88 Other acne (IM)
L81.80 Nevus fuscocaeruleus (Nevus of Hori) (IM)
L81.81 Ochronosis, pigmented colloid milium (IM)
L81.82 Cosmetic tattoo (IM)
L81.83 Traumatic tattoo (IM)
L81.88 Other specified disorders of pigmentation (IM)
N17.91 Acute kidney injury stage 1 (IM)
N17.92 Acute kidney injury stage 2 (IM)
N17.93 Acute kidney injury stage 3 needed renal support (IM)
N17.94 Acute kidney injury superimposed on chronic kidney disease (IM)
N17.95 Acute kidney injury superimposed on chronic kidney disease needed renal support (IM)
N18.6 End stage renal disease (IM)
N26.2 Page kidney (IM)
N36.4 Urethral functional and muscular disorders (IM)
N36.5 Urethral false passage (IM)
N40.0 Benign prostatic hyperplasia without lower urinary tract symptoms (IM)
N40.1 Benign prostatic hyperplasia with lower urinary tract symptoms (IM)
N40.2 Nodular prostate without lower urinary tract symptoms (IM)
N40.3 Nodular prostate with lower urinary tract symptoms (IM)
N41.4 Granulomatous prostatitis (IM)
N44.0 Torsion of testis (IM)
N44.1 Cyst of tunica albuginea testis (IM)
N44.2 Benign cyst of testis (IM)
N44.8 Other noninflammatory disorders of the testis (IM)
N45.1 Epididymitis (IM)
N45.2 Orchitis (IM)
N45.3 Epididymoorchitis (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

N45.4 Abscess of epididymis or testis (IM)
N46.0 Azoospermia (IM)
N46.1 Oligospermia (IM)
N46.8 Other male infertility (IM)
N46.9 Male infertility, unspecified (IM)
N47.0 Adherent prepuce, newborn (IM)
N47.1 Phimosis (IM)
N47.2 Paraphimosis (IM)
N47.3 Deficient foreskin (IM)
N47.4 Benign cyst of prepuce (IM)
N47.5 Adhesions of prepuce and glans penis (IM)
N47.7 Other inflammatory diseases of prepuce (IM)
N47.8 Other disorders of prepuce (IM)
N49.3 Fournier gangrene (IM)
N50.3 Cyst of epididymis (IM)
N52.0 Vasculogenic erectile dysfunction (IM)
N52.1 Erectile dysfunction due to diseases classified elsewhere (IM)
N52.2 Drug-induced erectile dysfuntion (IM)
N52.3 Postprocedural erectile dysfunction (IM)
N52.8 Other male erectile dysfunction (IM)
N52.9 Male erectile dysfunction, unspecified (IM)
N53.1 Ejaculatory dysfunction (IM)
N53.8 Other male sexual dysfunction (IM)
N53.9 Unspecified male sexual dysfunction (IM)
N70.2 Tubo-ovarian abscess (IM)
N80.7 Pelvic endometriosis (IM)
N81.7 Cystorectocele (IM)
N93.00 Contact bleeding (IM)
N93.01 Postcoital bleeding (IM)
N97.5 Female infertility associated with peritoneal factors (IM)
Q38.30 Aglossia (IM)
Q38.31 Bifid tongue (IM)
Q38.32 Adhesion of tongue, congenital (IM)
Q38.33 Fissure of tongue, congenital (IM)
Q38.34 Fissure of tongue, congenital (IM)
Q38.38 Microglossia (IM)
Q38.39 Other specified congenital malformations of tongue (IM)
Q38.40 Absence of salivary gland or duct (IM)
Q38.41 Accessory salivary gland or duct (IM)
Q38.42 Atresia of salivary gland or duct (IM)
Q38.43 Congenital fistula of salivary gland (IM)
Q38.48 Other specified congenital malformations of salivary glands and ducts (IM)
Q38.49 Congenital malformation of salivary glands and ducts, unspecified (IM)
Q38.59 Congenital malformation of palate, unspecified (IM)
Q40.4 Congenital microvillous atrophy (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

Q41.00 Duodenal web (IM)
Q41.08 Other congenital absence, atresia and stenosis of duodenum (IM)
Q41.09 Congenital absence, atresia and stenosis of duodenum, unspecified (IM)
Q44.70 Alagille Syndrome (IM)
Q44.71 Progressive familial intrahepatic cholestasis (IM)
Q44.78 Other congenital malformations of liver (IM)
Q44.79 Congenital malformations of liver, unspecified (IM)
Q67.40 Hemifacial atrophy (IM)
Q67.41 Hemifacial hypertrophy (IM)
Q67.48 Other specified congenital deformities of skull, face and jaw (IM)
Q67.49 Congenital deformity of skull, face or jaw, unspecified (IM)
Q68.80 Congenital deformity of clavicle (IM)
Q68.81 Congenital deformity of elbow (IM)
Q68.82 Congenital deformity of forearm (IM)
Q68.83 Congenital deformity of scapula (IM)
Q68.84 Congenital dislocation of elbow (IM)
Q68.85 Congenital dislocation of shoulder (IM)
Q68.88 Other specified congenital musculoskeletal deformities (IM)
Q71.30 Congenital absence of hand (IM)
Q71.31 Congenital absence of finger(s) (IM)
Q71.32 Congenital absence of thumb (IM)
Q71.33 Congenital hypoplastic thumb (IM)
Q71.38 Other congenital absence of hand and finger(s) (IM)
Q72.30 Congenital absence of foot (IM)
Q72.31 Congenital absence of toe(s) (IM)
Q75.00 Acrocephaly (IM)
Q75.01 Imperfect fusion of skull (IM)
Q75.02 Oxycephaly (IM)
Q75.03 Trigonocephaly (IM)
Q76.20 Congenital spondylolisthesis (IM)
Q76.21 Congenital spondylolysis (IM)
Q87.00 Acrocephalosyndactyly [Apert] (IM)
Q87.01 Golddnhar's syndrome (IM)
Q87.02 Moebius' syndrome (IM)
Q87.03 Oro-facial-digital syndrome (IM)
Q87.05 Robin's syndrome (IM)
Q87.08 Other congenital malformation syndrome predominantly affecting facial appearance (IM)
Q89.20 Persistent thyroglossal or thyrolingual duct (IM)
Q89.21 Thyroglossal cyst (IM)
Q89.22 Thyroglossal fistula (IM)
Q89.23 Lingual thyroid (IM)
Q89.28 Congenital malformations of other endocrine glands (IM)
R04.20 Massive hemoptysis (IM)
R10.40 Idiopathic recurrent abdominal pain of childhood (IM)
R10.48 Other abdominal pain (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

R10.49 Abdominal pain, unspecified (IM)
R11.0 Cyclic vomiting (IM)
R11.9 Nausea and vomiting, unspecified (IM)
R17.0 Cholestatic jaundice (IM)
R17.1 Obstructive jaundice (IM)
R17.8 Other jaundice (IM)
R17.9 Jaundice, unspecified (IM)
R31.0 Gross hematuria (IM)
R31.1 Benign essential microscopic hematuria (IM)
R31.2 Other microscopic hematuria (IM)
R33.0 Drug induced retention of urine (IM)
R36.0 Urethral discharge without blood (IM)
R36.1 Hematospermia (IM)
R37 Sexual dysfunction, unspecified (IM)
R39.9 Unspecified symptoms and signs involving the genitourinary (IM)
R40.9 Alteration of consciousness, unspecified (IM)
R51.0 Headache, unspecified (IM)
R51.1 Facial pain, unspecified (IM)
R73.1 Impaired fasting glucose (IM)
R87.60 Atypical squamous cells [ASC] (IM)
R87.61 Low-grade squamous intraepithelial lesion [LSIL] (IM)
R87.62 High-grade squamous intraepithelial lesion [HSIL] (IM)
R87.63 Atypical glandular cells [AGC] (IM)
R87.68 Other abnormal cytologic finding in specimens from female genital organs (IM)
R87.69 Abnormal cytologic finding in specimens from female genital organs, unspecified (IM)
S00.50 Superficial injury of internal cheek (IM)
S00.51 Superficial injury of other parts of mouth ,including tongue (IM)
S00.52 Superficial injury of lip (IM)
S00.59 Superficial injury of lip and oral cavity, unspecified (IM)
S01.40 Open wound of cheek (IM)
S01.41 Open wound of temporomandibular area (IM)
S01.47 Open wound of cheek with open wound of temporomandibular area (IM)
S01.50 Open wound of oral cavity (IM)
S01.51 Open wound of lip (IM)
S01.57 Open wound of oral cavity with open wound of lip (IM)
S02.400 Closed Fracture of maxillary alveolar process (IM)
S02.401 Closed Fracture of malar bone [zygoma] (IM)
S02.402 Closed Fracture of maxillary bones (IM)
S02.407 Multiple closed fracture of malar and maxillary bones (IM)
S02.410 Open Fracture of maxillary alveolar process (IM)
S02.411 Open Fracture of malar bone [zygoma] (IM)
S02.412 Open Fracture of maxillary bones (IM)
S02.417 Multiple open fracture of malar and maxillary bones (IM)
S02.601 Closed Fracture of body of mandible (IM)
S02.602 Closed Fracture of condyle (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

S02.603 Closed Fracture of coronoid process (IM)
S02.604 Closed Fracture of ramus (IM)
S02.605 Closed Fracture of symphysis (IM)
S02.606 Closed Fracture of angle (IM)
S02.607 Multiple closed fractures of mandible (IM)
S02.609 Closed Fracture of mandible, part unspecified (IM)
S02.610 Open Fracture of alveolar process (IM)
S02.611 Open Fracture of body of mandible (IM)
S02.612 Open Fracture of condyle (IM)
S02.613 Open Fracture of coronoid process (IM)
S02.614 Open Fracture of ramus (IM)
S02.615 Open Fracture of symphysis (IM)
S02.616 Open Fracture of angle (IM)
S02.617 Multiple open fractures of mandible (IM)
S02.619 Open Fracture of mandible, part unspecified (IM)
S03.20 Luxation of tooth (IM)
S03.21 Intrusion or extrusion of tooth (IM)
S03.22 Avulsion of tooth [exarticulation] (IM)
S03.29 Dislocation of tooth, unspecified (IM)
S04.80 Injury of olfactory nerve (IM)
S04.81 Injury of glossopharyngeal nerve (IM)
S04.82 Injury of vagus nerve (IM)
S04.83 Injury of hypoglossal nerve (IM)
S09.00 Injury of anterior nasal arteries (IM)
S09.01 Injury of posterior nasal arteries (IM)
S12.200 Closed fracture of 3rd cervical vertebra (IM)
S12.201 Closed Fracture of 4th cervical vertebra (IM)
S12.202 Closed Fracture of 5th cervical vertebra (IM)
S12.203 Closed Fracture of 6th cervical vertebra (IM)
S12.204 Closed Fracture of 7th cervical vertebra (IM)
S12.208 Closed Fracture of other cervical vertebra (IM)
S12.210 Open fracture of 3rd cervical vertebra (IM)
S12.211 Open Fracture of 4th cervical vertebra (IM)
S12.212 Open Fracture of 5th cervical vertebra (IM)
S12.213 Open Fracture of 6th cervical vertebra (IM)
S12.214 Open Fracture of 7th cervical vertebra (IM)
S12.218 Open Fracture of other cervical vertebra (IM)
S13.10 Dislocation of C1/C2 vertebra (IM)
S13.11 Dislocation of C2/C3 vertebra (IM)
S13.12 Dislocation of C3/C4 vertebra (IM)
S13.13 Dislocation of C4/C5 vertebra (IM)
S13.14 Dislocation of C5/C6 vertebra (IM)
S13.15 Dislocation of C6/C7 vertebra (IM)
S13.16 Dislocation of C7/T1 vertebra (IM)
S13.18 Dislocation of other,cervical vertebra (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

S13.19 Dislocation of cervical vertebra, part unspecified (IM)
S22.000 Closed Fracture of thoracic vertebra, compression type (IM)
S22.001 Closed Fracture of thoracic vertebra, burst type (IM)
S22.002 Closed Fracture of thoracic vertebra, seat-belt type (IM)
S22.003 Closed Fracture of thoracic vertebra, flexion-rotation type (IM)
S22.004 Closed Fracture of thoracic vertebra, shear type (IM)
S22.005 Closed Fracture of thoracic vertebra, flexion-distraction type (IM)
S22.009 Closed Fracture of thoracic vertebra, mechanism unspecified (IM)
S22.010 Open Fracture of thoracic vertebra, compression type (IM)
S22.011 Open Fracture of thoracic vertebra, burst type (IM)
S22.012 Open Fracture of thoracic vertebra, seat-belt type (IM)
S22.013 Open Fracture of thoracic vertebra, flexion-rotation type (IM)
S22.014 Open Fracture of thoracic vertebra, shear type (IM)
S22.015 Open Fracture of thoracic vertebra, flexion-distraction type (IM)
S22.019 Open Fracture of thoracic vertebra, mechanism unspecified (IM)
S22.100 Multiple closed fractures of thoracic spine, T1-T6 level (IM)
S22.101 Multiple closed fractures of thoracic spine, T7-T12 level (IM)
S22.102 Multiple closed fractures of thoracic and lumbar spine [T and L spine] (IM)
S22.108 Multiple closed fractures of thoracic spine, other specified (IM)
S22.109 Multiple closed fractures of thoracic spine, unspecified (IM)
S22.110 Multiple open fractures of thoracic spine, T1-T6 level (IM)
S22.111 Multiple open fractures of thoracic spine, T7-T12 level (IM)
S22.112 Multiple open fractures of thoracic and lumbar spine [T and L spine] (IM)
S22.118 Multiple open fractures of thoracic spine, other specified (IM)
S22.119 Multiple open fractures of thoracic spine, unspecified (IM)
S27.32 Laceration of lung (IM)
S27.33 Contusio and hematoma of lung (IM)
S32.000 Closed Fracture of lumbar vertebra, compression type (IM)
S32.001 Closed Fracture of lumbar vertebra, burst type (IM)
S32.002 Closed Fracture of lumbar vertebra, seat-belt type (IM)
S32.003 Closed Fracture of lumbar vertebra, flexion-rotation type (IM)
S32.004 Closed Fracture of lumbar vertebra, shear type (IM)
S32.005 Closed Fracture of lumbar vertebra, flexion-distraction type (IM)
S32.009 Closed Fracture of lumbar vertebra, mechanism unspecified (IM)
S32.010 Open Fracture of lumbar vertebra, compression type (IM)
S32.011 Open Fracture of lumbar vertebra, burst type (IM)
S32.012 Open Fracture of lumbar vertebra, seat-belt type (IM)
S32.013 Open Fracture of lumbar vertebra, flexion-rotation type (IM)
S32.014 Open Fracture of lumbar vertebra, shear type (IM)
S32.015 Open Fracture of lumbar vertebra, flexion-distraction type (IM)
S32.019 Open Fracture of lumbar vertebra, mechanism unspecified (IM)
S32.600 Closed Fracture of pelvis, stable type (IM)
S32.601 Closed Fracture of pelvis, rotary unstable type (IM)
S32.602 Closed Fracture of pelvis, vertical shear type (IM)
S32.608 Closed Fracture of pelvis, other types (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

S32.609 Closed Fracture of pelvis, unspecified type (IM)
S32.610 Open Fracture of pelvis, stable type (IM)
S32.611 Open Fracture of pelvis, rotary unstable type (IM)
S32.612 Open Fracture of pelvis, vertical shear type (IM)
S32.618 Open Fracture of pelvis, other types (IM)
S32.619 Open Fracture of pelvis, unspecified type (IM)
S40.80 Abrasion of shoulder and arm (IM)
S40.81 Blister of shoulder and arm (IM)
S40.82 Insect bite of shoulder and arm (IM)
S40.83 Superficial foreign body of shoulder and arm (IM)
S40.88 Other superficial injuries of shoulder and arm (IM)
S42.000 Closed Fracture of clavicle, sternal end (IM)
S42.001 Closed Fracture of clavicle, shaft (IM)
S42.002 Closed Fracture of clavicle, acromial end (IM)
S42.007 Closed Fracture of clavicle, multiple fractures (IM)
S42.009 Closed Fracture of clavicle, unspecified part (IM)
S42.010 Open Fracture of clavicle, sternal end (IM)
S42.011 Open Fracture of clavicle, shaft (IM)
S42.012 Open Fracture of clavicle, acromial end (IM)
S42.017 Open Fracture of clavicle, multiple fractures (IM)
S42.019 Open Fracture of clavicle, unspecified part (IM)
S42.100 Closed Fracture of scapula, body (IM)
S42.101 Closed Fracture of scapula, acromion process (IM)
S42.102 Closed Fracture of scapula, coracoid (IM)
S42.103 Closed Fracture of scapula, glenoid and neck of scapula (IM)
S42.107 Closed Fracture of scapula, multiple fractures (IM)
S42.109 Closed Fracture of scapula, unspecified part (IM)
S42.110 Open Fracture of scapula, body (IM)
S42.111 Open Fracture of scapula, acromion process (IM)
S42.112 Open Fracture of scapula, coracoid (IM)
S42.113 Open Fracture of scapula, glenoid and neck of scapula (IM)
S42.117 Open Fracture of scapula, multiple fractures (IM)
S42.119 Open Fracture of scapula, unspecified part (IM)
S42.200 Closed Fracture of proximal humerus, non-displaced (IM)
S42.201 Closed Fracture of proximal humerus, 2 parts (IM)
S42.202 Closed Fracture of proximal humerus, 3 parts (IM)
S42.203 Closed Fracture of proximal humerus, 4 parts (IM)
S42.204 Closed Fracture of proximal humerus, with articular involvement (IM)
S42.205 Closed Fracture of epiphysis of proximal humerus (IM)
S42.208 Closed Fracture of proximal humerus, others (IM)
S42.209 Closed Fracture of proximal humerus, unspecified (IM)
S42.210 Open Fracture of proximal humerus, non-displaced (IM)
S42.211 Open Fracture of proximal humerus, 2 parts (IM)
S42.212 Open Fracture of proximal humerus, 3 parts (IM)
S42.213 Open Fracture of proximal humerus, 4 parts (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

S42.214 Open Fracture of proximal humerus, with articular involvement (IM)
S42.215 Open Fracture of epiphysis of proximal humerus (IM)
S42.218 Open Fracture of proximal humerus, others (IM)
S42.219 Open Fracture of proximal humerus, unspecified (IM)
S42.300 Closed Fracture of shaft of humerus, simple fracture (IM)
S42.301 Closed Fracture of shaft of humerus, butterfly fracture (IM)
S42.302 Closed Fracture of shaft of humerus, comminuted fracture (IM)
S42.307 Multiple closed fractures of shaft of humerus (IM)
S42.309 Closed Fracture of shaft of humerus, unspecified (IM)
S42.310 Open Fracture of shaft of humerus, simple fracture (IM)
S42.311 Open Fracture of shaft of humerus, butterfly fracture (IM)
S42.312 Open Fracture of shaft of humerus, comminuted fracture (IM)
S42.317 Multiple open fractures of shaft of humerus (IM)
S42.319 Open Fracture of shaft of humerus, unspecified (IM)
S42.400 Closed Fracture of distal humerus, supracondylar (IM)
S42.401 Closed Fracture of distal humerus, lateral condyle (IM)
S42.402 Closed Fracture of distal humerus, medial condyle (IM)
S42.403 Closed Fracture of distal humerus, other parts of condyle and epicondyle (IM)
S42.404 Closed Fracture of distal humerus, T-shape intraarticular fracture (IM)
S42.405 Closed Fracture of distal humerus, multifragment intraarticular fracture (IM)
S42.406 Closed Fracture of physis and apophysis of distal humerus (IM)
S42.407 Multiple closed fractures of distal humerus (IM)
S42.408 Closed Fracture of distal humerus, others (IM)
S42.409 Closed Fracture of distal humerus, unspecified (IM)
S42.410 Open Fracture of distal humerus, supracondylar (IM)
S42.411 Open Fracture of distal humerus, lateral condyle (IM)
S42.412 Open Fracture of distal humerus, medial condyle (IM)
S42.413 Open Fracture of distal humerus, other parts of condyle and epicondyle (IM)
S42.414 Open Fracture of distal humerus, T-shape intraarticular fracture (IM)
S42.415 Open Fracture of distal humerus, multifragment intraarticular fracture (IM)
S42.416 Open Fracture of physis and apophysis of distal humerus (IM)
S42.417 Multiple open fractures of distal humerus (IM)
S42.418 Open Fracture of distal humerus, others (IM)
S42.419 Open Fracture of distal humerus, unspecified (IM)
S43.00 Dislocation of shoulder joint, anterior (IM)
S43.01 Dislocation of shoulder joint, posterior (IM)
S43.02 Dislocation of shoulder joint, inferior (IM)
S43.08 Dislocation of shoulder joint, other (IM)
S43.09 Dislocation of shoulder joint, unspecified (IM)
S50.80 Abrasion of elbow and forearm (IM)
S50.81 Blister of elbow and forearm (IM)
S50.82 Insect bite of elbow and forearm (IM)
S50.83 Superficial foreign body of elbow and forearm (IM)
S50.88 Other superficial injuries of elbow and forearm (IM)
S51.1 Open wound of forearm (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

S52.000 Closed Fracture of proximal ulna, olecranon (IM)
S52.001 Closed Fracture of proximal ulna, coronoid process (IM)
S52.002 Closed Fracture of proximal ulna, with dislocation of radial head (IM)
S52.003 Closed Fracture of epiphysis of proximal ulna (IM)
S52.007 Closed Fracture of proximal ulna, multiple fracture (IM)
S52.008 Closed Fracture of proximal ulna, others (IM)
S52.009 Closed Fracture of proximal ulna, unspecified (IM)
S52.010 Open Fracture of proximal ulna, olecranon (IM)
S52.011 Open Fracture of proximal ulna, coronoid process (IM)
S52.012 Open Fracture of proximal ulna, with dislocation of radial head (IM)
S52.013 Open Fracture of epiphysis of proximal ulna (IM)
S52.017 Open Fracture of proximal ulna, multiple fracture (IM)
S52.018 Open Fracture of proximal ulna, others (IM)
S52.019 Open Fracture of proximal ulna, unspecified (IM)
S52.100 Closed Fracture of head of radius (IM)
S52.101 Closed Fracture of neck of radius (IM)
S52.102 Closed Fracture of epiphysis of upper end of radius (IM)
S52.107 Closed Fracture of upper end of radius, multiple fractures (IM)
S52.108 Closed Fracture of upper end of radius, others (IM)
S52.109 Closed Fracture of upper end of radius, unspecified (IM)
S52.110 Open Fracture of head of radius (IM)
S52.111 Open Fracture of neck of radius (IM)
S52.112 Open Fracture of epiphysis of upper end of radius (IM)
S52.117 Open Fracture of upper end of radius, multiple fractures (IM)
S52.118 Open Fracture of upper end of radius, others (IM)
S52.119 Open Fracture of upper end of radius, unspecified (IM)
S52.200 Closed Fracture of shaft of ulna, simple fracture (IM)
S52.201 Closed Fracture of shaft of ulna, butterfly fracture (IM)
S52.202 Closed Fracture of shaft of ulna, comminuted fracture (IM)
S52.203 Closed Fracture of shaft of ulna, with dislocation of radial head (IM)
S52.207 Closed Fracture of shaft of ulna, bifocal and segmental and multiple fractures (IM)
S52.209 Closed Fracture of shaft of ulna, unspecified (IM)
S52.210 Open Fracture of shaft of ulna, simple fracture (IM)
S52.211 Open Fracture of shaft of ulna, butterfly fracture (IM)
S52.212 Open Fracture of shaft of ulna, comminuted fracture (IM)
S52.213 Open Fracture of shaft of ulna, with dislocation of radial head (IM)
S52.217 Open Fracture of shaft of ulna, bifocal and segmental and multiple fractures (IM)
S52.219 Open Fracture of shaft of ulna, unspecified (IM)
S52.300 Closed Fracture of shaft of radius, simple fracture (IM)
S52.301 Closed Fracture of shaft of radius, butterfly fracture (IM)
S52.302 Closed Fracture of shaft of radius, comminuted fracture (IM)
S52.303 Closed Fracture of shaft of radius, with dislocation of head of ulna (IM)
S52.307 Closed fracture of shaft of radius, bifocal and segmental and multiple fractures (IM)
S52.309 Closed Fracture of shaft of radius, unspecified (IM)
S52.310 Open Fracture of shaft of radius, simple fracture (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

S52.311 Open Fracture of shaft of radius, butterfly fracture (IM)
S52.312 Open Fracture of shaft of radius, comminuted fracture (IM)
S52.313 Open Fracture of shaft of radius, with dislocation of head of ulna (IM)
S52.317 Open fracture of shaft of radius, bifocal and segmental and multiple fractures (IM)
S52.319 Open Fracture of shaft of radius, unspecified (IM)
S52.500 Closed Fracture of distal radius, extraarticular with dorsal angulation (IM)
S52.501 Closed Fracture of distal radius, extraarticular with volar angulation (IM)
S52.502 Closed Fracture of distal radius, partial intraarticular (IM)
S52.503 Closed Fracture of distal radius, complete intraarticular (IM)
S52.504 Closed Fracture of epiphysis of distal radius (IM)
S52.507 Closed Fracture of distal radius, multiple fractures (IM)
S52.508 Closed Fracture of distal radius, others (IM)
S52.509 Closed Fracture of distal radius, unspecified (IM)
S52.510 Open Fracture of distal radius, extraarticular with dorsal angulation (IM)
S52.511 Open Fracture of distal radius, extraarticular with volar angulation (IM)
S52.512 Open Fracture of distal radius, partial intraarticular (IM)
S52.513 Open Fracture of distal radius, complete intraarticular (IM)
S52.514 Open Fracture of epiphysis of distal radius (IM)
S52.517 Open Fracture of distal radius, multiple fractures (IM)
S52.518 Open Fracture of distal radius, others (IM)
S52.519 Open Fracture of distal radius, unspecified (IM)
S52.700 Closed Fracture both bones of proximal part of radius and ulna (IM)
S52.708 Multiple closed fractures of forearm, others (IM)
S52.709 Multiple closed fractures of forearm, unspecified (IM)
S52.710 Open fracture of proximal part of both ulna and radius (IM)
S52.718 Multiple open fractures of forearm, others (IM)
S52.719 Multiple open fractures of forearm, unspecified (IM)
S53.00 Dislocation of radial head (IM)
S53.01 Subluxation of radial head (IM)
S53.02 Pulled elbow in children (IM)
S53.10 Dislocation of elbow, anterior (IM)
S53.11 Dislocation of elbow, posterior (IM)
S53.12 Dislocation of elbow, medial (IM)
S53.13 Dislocation of elbow, lateral (IM)
S53.14 Dislocation of elbow, divergen (IM)
S53.15 Dislocation of elbow, with associated fracture (IM)
S53.18 Dislocation of elbow, other (IM)
S53.19 Dislocation of elbow, unspecified (IM)
S60.80 Abrasion of wrist and hand (IM)
S60.81 Blister of wrist and hand (IM)
S60.82 Insect bite of wrist and hand (IM)
S60.83 Superficial foreign body of wrist and hand (IM)
S60.88 Other superficial injuries of wrist and hand (IM)
S62.100 Closed Fracture of lunate [semilunar] (IM)
S62.101 Closed Fracture of triquetrum [cuneiform] (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

S62.102 Closed Fracture of pisiform (IM)
S62.103 Closed Fracture of trapezium [greater multangular] (IM)
S62.104 Closed Fracture of trapezoid [lesser multangular] (IM)
S62.105 Closed Fracture of capitate [os magnum] (IM)
S62.106 Closed Fracture of hamate [unciform] (IM)
S62.107 Closed Fracture of other carpal bones, multiple fractures (IM)
S62.109 Closed Fracture of other carpal bones, unspecified (IM)
S62.110 Open Fracture of lunate [semilunar] (IM)
S62.111 Open Fracture of triquetrum [cuneiform] (IM)
S62.112 Open Fracture of pisiform (IM)
S62.113 Open Fracture of trapezium [greater multangular] (IM)
S62.114 Open Fracture of trapezoid [lesser multangular] (IM)
S62.115 Open Fracture of capitate [os magnum] (IM)
S62.116 Open Fracture of hamate [unciform] (IM)
S62.117 Open Fracture of other carpal bones, multiple fractures (IM)
S62.119 Open Fracture of other carpal bones, unspecified (IM)
S63.00 Dislocation of wrist, distal radioulnar joint (IM)
S63.01 Dislocation of wrist, radiocarpal joint (IM)
S63.02 Dislocation of wrist, midcarpal joint (IM)
S63.03 Dislocation of wrist, carpometacarpal joint (IM)
S63.08 Dislocation of wrist, other (IM)
S63.09 Dislocation of wrist, unspecified joint (IM)
S63.10 Dislocation of metacarpophalangeal joint (MCP) of thumb and fingers (IM)
S63.11 Dislocation of interphalangeal joint of thumb and finger (IM)
S63.19 Dislocation of thumb and finger, unspecified joint (IM)
S70.80 Abrasion of hip and thigh (IM)
S70.81 Blister of hip and thigh (IM)
S70.82 Insect bite of hip and thigh (IM)
S70.83 Superficial foreign body of hip and thigh (IM)
S70.88 Other superficial injuries of hip and thigh (IM)
S72.000 Closed Fracture of neck of femur, undisplaced intracapsular fracture (IM)
S72.001 Closed Fracture of neck of femur, displaced intracapsular fracture (IM)
S72.002 Closed Fracture of neck of femur, impacted intracapsular fracture (IM)
S72.003 Closed Fracture of neck of femur, midcervical shear fracture (IM)
S72.004 Closed Fracture of neck of femur, base of neck (cervicotrochanteric) (IM)
S72.005 Closed Fracture of head of femur (IM)
S72.006 Closed Fracture of epiphysis of upper femur (IM)
S72.007 Closed Fracture of neck of femur, multiple (IM)
S72.008 Closed Fracture of neck of femur, others (IM)
S72.009 Closed Fracture of neck of femur, unspecified (IM)
S72.010 Open Fracture of neck of femur, undisplaced intracapsular fracture (IM)
S72.011 Open Fracture of neck of femur, displaced intracapsular fracture (IM)
S72.012 Open Fracture of neck of femur, impacted intracapsular fracture (IM)
S72.013 Open Fracture of neck of femur, midcervical shear fracture (IM)
S72.014 Open Fracture of neck of femur, base of neck (cervicotrochanteric) (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

S72.015 Open Fracture of head of femur (IM)
S72.016 Open Fracture of epiphysis of upper femur (IM)
S72.017 Open Fracture of neck of femur, multiple (IM)
S72.018 Open Fracture of neck of femur, others (IM)
S72.019 Open Fracture of neck of femur, unspecified (IM)
S72.100 Closed Intertrochanteric fracture of femur, stable type (IM)
S72.101 Closed Intertrochanteric fracture of femur, unstable type (IM)
S72.108 Closed Fracture of trochanteric region of femur, others (IM)
S72.109 Closed Intertrochanteric fracture of femur, stable type (IM)
S72.110 Open Intertrochanteric fracture of femur, stable type (IM)
S72.111 Open Intertrochanteric fracture of femur, unstable type (IM)
S72.118 Open Fracture of trochanteric region of femur, others (IM)
S72.119 Open Intertrochanteric fracture of femur, stable type (IM)
S72.300 Closed Fracture of shaft of femur, simple fracture (IM)
S72.301 Closed Fracture of shaft of femur, butterfly fracture (IM)
S72.302 Closed Fracture of shaft of femur, comminuted fracture (IM)
S72.307 Closed Fracture of shaft of femur, bifocal and segmental and (IM)
S72.309 Closed Fracture of shaft of femur, unspecified (IM)
S72.310 Open Fracture of shaft of femur, simple fracture (IM)
S72.311 Open Fracture of shaft of femur, butterfly fracture (IM)
S72.312 Open Fracture of shaft of femur, comminuted fracture (IM)
S72.317 Open fracture of shaft of femur, bifocal and segmental and multiple (IM)
S72.319 Open Fracture of shaft of femur, unspecified (IM)
S72.400 Closed Fracture of distal femur, supracondylar (IM)
S72.401 Closed Fracture of distal femur, lateral condyle (IM)
S72.402 Closed Fracture of distal femur, medial condyle (IM)
S72.403 Closed Fracture of distal femur, other parts of condyle and epicondyle (IM)
S72.404 Closed Fracture of distal femur, T-shape intraarticular fracture (IM)
S72.405 Closed Fracture of distal femur, multifragment intraarticular fracture (IM)
S72.406 Closed Fracture of distal femur, multiple fractures (IM)
S72.407 Closed Fracture of distal femoral epiphysis (IM)
S72.408 Closed Fracture of distal femur, others (IM)
S72.409 Closed Fracture of distal femur, unspecified (IM)
S72.410 Open Fracture of distal femur, supracondylar (IM)
S72.411 Open Fracture of distal femur, lateral condyle (IM)
S72.412 Open Fracture of distal femur, medial condyle (IM)
S72.413 Open Fracture of distal femur, other parts of condyle and epicondyle (IM)
S72.414 Open Fracture of distal femur, T-shape intraarticular fracture (IM)
S72.415 Open Fracture of distal femur, multifragment intraarticular fracture (IM)
S72.416 Open Fracture of distal femur, multiple fractures (IM)
S72.417 Open Fracture of distal femoral epiphysis (IM)
S72.418 Open Fracture of distal femur, others (IM)
S72.419 Open Fracture of distal femur, unspecified (IM)
S73.00 Dislocation of hip, anterior (IM)
S73.01 Dislocation of hip, posterior type with or without minor fracture (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

S73.02 Dislocation of hip, posterior type with large single fracture (IM)
S73.03 Dislocation of hip, posterior type with comminution of rim (IM)
S73.04 Dislocation of hip, posterior type with fracture of the acetabular (IM)
S73.05 Dislocation of hip, posterior type with fracture of head of femur (IM)
S73.08 Dislocation of hip, other (IM)
S73.09 Dislocation of hip, unspecified (IM)
S80.80 Abrasion of knee and leg (IM)
S80.81 Blister of knee and leg (IM)
S80.82 Insect bite of knee and leg (IM)
S80.83 Superficial foreign body of knee and leg (IM)
S80.88 Other superficial injuries of knee and leg (IM)
S81.1 Open wound of leg (IM)
S82.100 Closed Fracture of proximal tibia, extraarticular (IM)
S82.101 Closed Fracture of proximal tibia, medial condyle (IM)
S82.102 Closed Fracture of proximal tibia, lateral condyle [split] (IM)
S82.103 Closed Fracture of proximal tibia, bicondyle (IM)
S82.104 Closed Fracture of proximal tibia, with ligamentous injury (IM)
S82.105 Closed Isolated fracture of tibial spine and intercondylar eminence (IM)
S82.106 Closed Fracture of epiphysis of proximal tibia (IM)
S82.107 Closed Fracture of proximal tibia, multiple fractures (IM)
S82.108 Closed Fracture of proximal tibia, others (IM)
S82.109 Closed Fracture of proximal tibia, unspecified (IM)
S82.110 Open Fracture of proximal tibia, extraarticular (IM)
S82.111 Open Fracture of proximal tibia, medial condyle (IM)
S82.112 Open Fracture of proximal tibia, lateral condyle [split] (IM)
S82.113 Open Fracture of proximal tibia, bicondyle (IM)
S82.114 Open Fracture of proximal tibia, with ligamentous injury (IM)
S82.115 Open Isolated fracture of tibial spine and intercondylar eminence (IM)
S82.116 Open Fracture of epiphysis of proximal tibia (IM)
S82.117 Open Fracture of proximal tibia, multiple fractures (IM)
S82.118 Open Fracture of proximal tibia, others (IM)
S82.119 Open Fracture of proximal tibia, unspecified (IM)
S82.200 Closed Fracture of shaft of tibia with intact fibula (IM)
S82.201 Closed Fracture of shaft of tibia with fracture of fibula at same level (IM)
S82.202 Closed Fracture of shaft of tibia with fracture of fibula at different level (IM)
S82.207 Closed Fracture of shaft of tibia, bifocal and segmental and multiple (IM)
S82.208 Closed Fracture of shaft of tibia, others (IM)
S82.209 Closed Fracture of shaft of tibia, unspecified (IM)
S82.210 Open Fracture of shaft of tibia with intact fibula (IM)
S82.211 Open Fracture of shaft of tibia with fracture of fibula at same level (IM)
S82.212 Open Fracture of shaft of tibia with fracture of fibula at different level (IM)
S82.217 Open Fracture of shaft of tibia, bifocal and segmental and multiple (IM)
S82.218 Open Fracture of shaft of tibia, others (IM)
S82.219 Open Fracture of shaft of tibia, unspecified (IM)
S82.300 Closed Fracture of distal tibia, extraarticular (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

S82.301 Closed Fracture of distal tibia, nondisplaced intraarticular (IM)
S82.302 Closed Fracture of distal tibia, displaced intraarticular (IM)
S82.303 Closed Fracture of epiphysis of distal tibia (IM)
S82.307 Closed Fracture of distal tibia, multiple fractures (IM)
S82.308 Closed Fracture of distal tibia, others (IM)
S82.309 Closed Fracture of distal tibia, unspecified (IM)
S82.310 Open Fracture of distal tibia, extraarticular (IM)
S82.311 Open Fracture of distal tibia, nondisplaced intraarticular (IM)
S82.312 Open Fracture of distal tibia, displaced intraarticular (IM)
S82.313 Open Fracture of epiphysis of distal tibia (IM)
S82.317 Open Fracture of distal tibia, multiple fractures (IM)
S82.318 Open Fracture of distal tibia, others (IM)
S82.319 Open Fracture of distal tibia, unspecified (IM)
S83.50 Avulsion of anterior cruciate ligament (ACL) (IM)
S83.51 Avulsion of posterior cruciate ligament (PCL) (IM)
S83.59 Sprain and strain involving cruciate ligament of knee, unspecified (IM)
S87.9 Crushing injury of unspecified parts of knee and leg (IM)
S90.80 Abrasion of ankle and foot (IM)
S90.81 Blister of ankle and foot (IM)
S90.82 Insect bite of ankle and foot (IM)
S90.83 Superficial foreign body of ankle and foot (IM)
S90.88 Other superficial injuries of ankle and foot (IM)
S91.9 Open wound of ankle and foot, unspecified (IM)
S92.300 Closed Metatarsal fracture, one metatarsal (IM)
S92.301 Closed Metatarsal fracture, two metatarsals (IM)
S92.302 Closed Metatarsal fracture, three or more metatarsals (IM)
S92.309 Closed Metatarsal fracture, unspecified number of metatarsals (IM)
S92.310 Open Metatarsal fracture, one metatarsal (IM)
S92.311 Open Metatarsal fracture, two metatarsals (IM)
S92.312 Open Metatarsal fracture, three or more metatarsals (IM)
S92.319 Open Metatarsal fracture, unspecified number of metatarsals (IM)
T19.4 Foreign body in penis (IM)
T21.06 Burn of unspecifeid degree of male genital region (IM)
T21.16 Burn of first degree of male genital region (IM)
T21.26 Burn of second degree of male genital region (IM)
T21.36 Burn of third degree of male genital region (IM)
T21.46 Corrosion of unspecified degree of male genital region (IM)
T63.00 Toxic effect of snake venom, haematotoxin (IM)
T63.01 Toxic effect of snake venom, neurotoxin (IM)
T63.02 Toxic effect of snake venom, muscular toxin (IM)
T63.03 Toxic effect of snake venom, mixed haematomuscular and neurotoxin (IM)
T63.08 Toxic effect of other specified snake venom (IM)
T63.09 Toxic effect of snake venom, unspecified (IM)
T79.70 Subcutaneous emphysema without trauma (IM)
T81.50 Amalgam tattoo (IM)
 DAFTAR KODE ICD 10 INA - MODIFICATION (IM)

KODE ICD 10 DESKRIPSI

T81.58 Other specified foreign body accidentally left in body cavity or operation wound following a
procedure (IM)
T81.59 Unspecified foreign body accidentally left in body cavity or operation wound following a procedure
(IM)
T83.7 Complications due to implanted mesh and other prosthetic materials (IM)
U08 Tuberculoma of lung (IM)
U82.20 Respiratory diseases with resistance of betalactamase (ESBL) resistance (IM)
U82.80 Respiratory diseases with resistance of betalactam antibiotics (IM)
U83.3 Respiratory diseases with resistance to other antibiotics (IM)
U84.10 Respiratory diseases with resistance to antifungal drugs (IM)
U84.20 Respiratory diseases with resistance to antiviral drugs (IM)
U84.31 Tuberculosis with multidrug resistance (IM)
U84.32 Tuberculosis with pre extreme drug resistance (IM)
U84.33 Tuberculosis with extreme drug resistance (IM)
U84.34 Tuberculosis with poly drug resistance (IM)
U84.35 Tuberculosis with mono drug resistance (IM)
U85.0 Respiratory diseases with resistance to antineoplastic drugs (IM)
 DAFTAR KODE ICD 9CM INA - MODIFICATION (IM)

KODE ICD 9CM DESKRIPSI

02.20 Endoscopic ventriculostomy (IM)
04.420 Decompression of optic nerve (IM)
04.421 Decompression of facial nerve with or without graft (IM)
06.32 Endoscopic thyroidectomy (IM)
06.96 Percutaneous ablation of thyroid lesion or tissue (IM)
12.75 Glaucoma implant (IM)
17.25 Laparoscopic repair inguinal hernia (IM)
18.13 Microscopic examination of external ear (IM)
18.14 Endoscopic examination of external ear (IM)
18.22 Extraction of external cholesteatoma (IM)
20.33 Electrical evoked auditory brain stem response (IM)
20.34 Electrical compound action potential (IM)
20.35 Electrical stapedial reflex threshold (IM)
20.73 Temporal bone resection (IM)
21.23 Nasoendoskopi (IM)
21.290 Peak nasal inspiratory flowmetry (PNIF) (IM)
21.291 Smell test (IM)
21.292 Blue light fluorescein test (IM)
21.50 Functional septoplasty (IM)
22.20 Uncinectomy (IM)
22.200 Uncinectomy sinistra (IM)
22.201 Uncinectomy dextra (IM)
22.410 Frontal sinusotomy sinistra (IM)
22.411 Frontal sinusotomy dextra (IM)
22.420 Frontal sinusectomy sinistra (IM)
22.421 Frontal sinusectomy dextra (IM)
22.510 Ethmoidotomy sinistra (IM)
22.511 Ethmoidotomy dextra (IM)
22.520 Sphenoidotomy sinistra (IM)
22.521 Sphenoidotomy dextra (IM)
22.630 Ethmoidectomy sinistra (IM)
22.631 Ethmoidectomy dextra (IM)
22.640 Sphenoidectomy sinistra (IM)
22.641 Sphenoidectomy dextra (IM)
23.12 Odontectomy NOS (IM)
23.13 Removal of impacted tooth (IM)
23.14 Tooth extraction with elevationof mucoperiosteal flap (IM)
27.74 Uvuloplasty (IM)
29.13 Flexible endoscopic evaluation of swallowing (FEES) (IM)
29.910 Repair of choanal atresia intranasal (IM)
29.911 Repair of choanal atresia transpalatal (IM)
31.420 Stroboscopy (IM)
 DAFTAR KODE ICD 9CM INA - MODIFICATION (IM)

KODE ICD 9CM DESKRIPSI

31.50 Excision tracheal stenosis and anastomosis; cervical (IM)
31.51 Excision tracheal stenosis and anastomosis; cervicothoracic (IM)
31.52 Excision of tracheal tumor or carcinoma; cervical (IM)
31.53 Excision of tracheal tumor or carcinoma; thoracic (IM)
31.711 Suture of tracheal wound or injury; cervical (IM)
31.712 Suture of tracheal wound or injury; intrathoracic (IM)
31.76 Tracheoplasty; intrathoracic (IM)
33.230 Rigid bronchoscopy procedure (IM)
33.240 Endobronchoscopy ultrasound during bronchoscopic theurapetic intervention or diagnostic (IM)
33.481 Carinal reconstruction (IM)
33.94 Bronchial dilatation with bronchoscopy (rigid) with or without baloon (IM)
33.95 Insertion or replacement of bronchial stent using bronchoscopy (IM)
34.281 Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit (IM)
34.282 Thoracoscopy, surgical; with thoracic sympathectomy (IM)
34.283 Thoracoscopy, surgical; with pleurodesis (e.g., mechanical or chemical) (IM)
34.284 Thoracoscopy, surgical; with control of traumatic hemorrhage (IM)
34.285 Thoracoscopy, diagnostic; mediastinal space, with biopsy (IM)
34.286 Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass (IM)
34.291 Mediastinotomy with exploration or biopsy; cervical approach (IM)
34.292 Mediastinotomy with exploration or biopsy; transthoracic approach (IM)
34.41 Radical resection of sternum (IM)
34.75
Reconstructive repair of pectus, minimally invasive approach (nuss procedure), with thoracoscopy (IM)
35.29 Multiple valve repair / replacement (IM)
36.100 Aortocoronary bypass for heart revascularization with surgical ventricular restoration (IM)
36.101 Aortocoronary bypass for heart revascularization with IVS Rupture Repair (IM)
36.18 Aortocoronary bypass for heart revascularization with valve procedure (IM)
38.850 PDA stenting/PDA closure with device in newborn (IM)
39.270 Insertion of peritoneal dialysis catheter with laparoscopy technique (IM)
39.271 Laparoscopic replacement of indwelling peritoneal catheter for dialysis (IM)
39.272 Insertion of peritoneal dialysis catheter: peritoneoscopy technique (IM)
39.273 Insertion of peritoneal dialysis catheter: percutaneous technique (IM)
39.274 Insertion of peritoneal dialysis catheter: open technique (IM)
39.590 Direct anastomosis for renal artery repair (IM)
39.591 Direct anastomosis for renal vein repair (IM)
39.951 Prolonged intermitent renal replacement therapy (IM)
39.952 Continuous renal replacement therapy (IM)
40.55 Modified radical neck dissection, unilateral (IM)
40.56 Modified radical neck dissection, bilateral (IM)
48.631 Laparoscopic anterior resection of rectum (IM)
48.632 Laparoscopic low anterior resection of rectum (IM)
50.40 Laparoscopic liver resection (IM)
 DAFTAR KODE ICD 9CM INA - MODIFICATION (IM)

KODE ICD 9CM DESKRIPSI

51.120 Laparoscopic biopsy gonad (IM)
52.60 Laparoscopic pancreatectomy (IM)
52.70 Laparoscopic pancreaticoduodenectomy (IM)
54.980 Insertion of peritoneal dialysis catheter with laparoscopy technique (IM)
54.981 Laparoscopic replacement of indwelling peritoneal catheter for dialysis (IM)
54.982 Insertion of peritoneal dialysis catheter: peritoneoscopy technique (IM)
54.983 Insertion of peritoneal dialysis catheter: percutaneous technique (IM)
54.984 Insertion of peritoneal dialysis catheter: open technique (IM)
55.38 Renal cyst laparoscopic excision (IM)
55.40 Laparoscopic partial nephrectomy (IM)
55.510 Laparoscopic nephroureterectomy (IM)
55.511 Laparoscopic complete (radical) nephrectomy (IM)
55.520 Living donor nephrectomy (IM)
55.521 Deceased donor nephrectomy (cadaver) (IM)
55.70 Laparoscopic nephropexy (IM)
55.88 Laparoscopic pyeloplasty (IM)
56.20 Laparoscopic ureterolithotomy or ureteral exploration (IM)
56.21 Laparoscopic ureterolithotomy with previous ureteral surgery (IM)
56.22 Open ureteral exploration (IM)
56.23 Open ureterolithotomy with previous ureteral surgery (IM)
56.36 Semi rigid ureterorenoscopy without stone fragmentation (IM)
56.37 Flexible ureterorenoscopy without stone fragmentation (IM)
56.410 Laparoscopic partial ureterectomy (IM)
56.420 Laparoscopic complete ureterectomy (IM)
56.43 Endoscopy ureterocele resection (IM)
56.510 Laparoscopic ureter transplantation ino intestine (IM)
56.610 Laparoscopic ureter transplantation into skin (IM)
56.620 Laparoscopic ureterostomy revision (IM)
56.740 Laparoscopic ureteroneocystostomy (IM)
56.750 Laparascopic ureteral transplantation into other ureter (IM)
56.751 Laparoscopic ureteral re-implantation into bladder (IM)
56.752 Open ureteral re-implantation into bladder (IM)
56.753 Ureteral re-implantation into bladder with psoas hitch (IM)
56.87 Laparoscopic divided ureteral repair (IM)
56.870 Open divided ureteral repair (IM)
56.910 Endoscopic ureteral dilation (IM)
56.911 Endoscopic destruction of bladder lesion / tissue (IM)
56.912 Endoscopic laser destruction of bladder lesion / tissue (IM)
56.950 Laparoscopic ligation of ureter (IM)
56.96 Endoscopic incision of external urethral sphincter (IM)
56.97 Endoscopic ureteric stent replacement (IM)
57.00 Endoscopic blood clots evacuation from bladder (IM)
 DAFTAR KODE ICD 9CM INA - MODIFICATION (IM)

KODE ICD 9CM DESKRIPSI

57.13 Endoscopic bladder neck incision (IM)
57.190 Laparoscopic cystostomy or cystolithotomy (IM)
57.60 Laparoscopic partial cystectomy (IM)
57.710 Laparoscopic cystectomy (IM)
57.72 Cystectomy with formation of cutaneous uretero-ileostomy (incontinent intestinal urine reservoir
formation) (IM)
57.73 Cystectomy with laparoscopic ureter transplantation into intestine (IM)
57.74 Cystectomy with intestinal urinary diversion (continent intestinal urine reservoir formation) (IM)
57.75 Cystectomy with continent valve formation (IM)
57.76 Cystectomy with orthotopic neobladder (IM)
57.77 Repair of bladder exstrophy with osteotomy for bladder exstrophy (IM)
57.790 Laparoscopic other total cystectomy (IM)
57.820 Laparoscopic vesicointestinal fistula closure (IM)
57.821 Laparoscopic vesicovaginal fistula closure (IM)
57.822 Open vesicointestinal fistula closure (IM)
57.823 Open cutaneous vesical fistula closure (IM)
57.824 Abdominal vesicovaginal fistula closure (IM)
57.825 Laparoscopic cutaneous vesical fistula closure (IM)
57.850 Other laparoscopic bladder neck repair (IM)
57.860 Bladder exstrophy repair with ureteral re-implantation (IM)
57.861 Cloacal exstrophy repair (IM)
57.870 Laparoscopic bladder enlargement (IM)
57.871 Open bladder enlargement (IM)
57.890 Laparoscopic ruptured bladder repair (IM)
57.940 Open replacement of indwelling peritoneal catheter for dialysis (IM)
57.960 Stimulation of bladder (non-implant) (IM)
58.390 Complete urethrectomy (IM)
58.391 Partial urethrectomy (IM)
58.450 Single stage repair for hypospadias or epispadias (IM)
58.451 First stage of hypospadias or epispadias staged repair (IM)
58.452 Second stage of hypospadias or epispadias staged repair (IM)
58.453 Hypospadias repair post urethral fistula operation (IM)
58.454 Redo repair for hypospadia or epispadias (IM)
58.455 Repair of epispadias with ureteric re-implantation (IM)
58.456 Granuloplasty for hypospadias (IM)
58.490 Urethroplasty with graft (IM)
58.491 Urethroplasty with flap (IM)
58.492 Urethroplasty with pubectomy (IM)
59.80 Endoscopic urethral stent insertion (IM)
60.22 Transurethral needle ablation prostate (IM)
60.23 Cryoablation of prostate (IM)
60.24 Transurethral electric vaporization prostate (IM)
 DAFTAR KODE ICD 9CM INA - MODIFICATION (IM)

KODE ICD 9CM DESKRIPSI

60.25 High intensity focused ultrasound prostate (IM)
60.290 Transurethral resection of ejaculatory duct (TURED) (IM)
60.50 Laparoscopic radical prostatectomy (IM)
62.00 Exploration scrotal contents and testis, unilateral (IM)
62.30 Orchidectomy with insertion testicular prosthesis unilateral (IM)
62.31 Laparoscopic orchiectomy (IM)
62.410 Orchidectomy with insertion testicular prosthesis bilateral (IM)
62.411 Radical orchidectomy (IM)
62.43 Subcapsular orchidectomy (IM)
62.50 Laparoscopic orchidopexy (IM)
62.51 Revision orchidopexy for undescended testis (IM)
62.52 Laparoscopic orchidopexy fowler stephen (IM)
62.93 Artifical erection of penis with injection (IM)
63.02 Percutaneous epididymal sperm aspiration (PESA) (IM)
63.03 Microsurgical epididymal sperm aspiration (MESA) (IM)
63.04 Excision of spermatocele (IM)
63.05 Excision of epididymal cyst (IM)
63.10 Microligation for varicocele (IM)
63.11 Laparoscopic varicocele ligation (IM)
63.12 Penile dorsal vein ligation (IM)
63.96 Testicular sperm aspiration (TESA) (IM)
63.97 Testicular sperm extraction (TESE) (IM)
64.20 Excision of sclerofibromatosis penis (IM)
64.30 Partial amputation of penis (IM)
64.440 Reconstruction of buried penis (IM)
64.46 Repair fracture penis (IM)
64.490 Phalloplasty (IM)
64.940 Correction of chordee of penis with graft (IM)
64.970 Revision artificial erection device (IM)
65.96 Transposition of ovarium (IM)
65.97 Laparoscopy, transposition of ovarium (IM)
65.98 Laparoscopy ovarian drilling (IM)
66.03 Laparoscopy salpingotomy (IM)
66.04 Laparoscopy salpingostomy (IM)
66.18 Laparoscopy, other diagnostic procedures on fallopian tubes (IM)
66.40 Laparoscopy, total unilateral salpingectomy (IM)
66.50 Laparoscopy, removal of both fallopian tubes at same operative episode (IM)
66.60 Laparoscopy, salpingectomy with removal of tubal pregnancy (IM)
66.68 Laparoscopy, other partial salpingectomy (IM)
69.40 Laparoscopic reconstructive surgery of uterus (IM)
69.90 Uterine compression suture (B-Lynch) (IM)
70.70 Laparoscopic reconstructive surgery of pelvic floor (IM)
 DAFTAR KODE ICD 9CM INA - MODIFICATION (IM)

KODE ICD 9CM DESKRIPSI

76.32 Partial maxillectomy/open medial maxillectomy (IM)
76.33 Total maxillectomy (IM)
76.34 Endoscopic medial maxillectomy (IM)
80.55 Microdissectomy (endoscopic/microscopic) (IM)
83.15 Escharotomy (IM)
85.110 MR-guided stereotactic biopsy/localization of lesion or tissue of breast (IM)
85.111 Mammography-guided stereotactic biopsy/localization of lesion or tissue of breast (IM)
85.700 Total reconstruction of breast, not otherwise specified (IM)
85.701 Superomedial thigh flap (IM)
85.702 Lateral arm free (IM)
85.703 Superficial Inferior Epigastric Arteri (SIEA) flap, free (IM)
85.704 Fibular flap, free (IM)
85.705 Lymph node transfer flap, free (IM)
85.706 Lymphovenous anastomosis (IM)
85.707 Groin flap, free (IM)
85.708 Jejunal flap, free (IM)
85.709 Dorsalis pedis flap, free (IM)
85.710 Latissimus dorsi myocutaneous flap (IM)
86.060 Lnsertion prostatic stent/coil with ultrasound control (IM)
86.061 Lnsertion prostatic stent/coil with visual (IM)
86.090 Other incision of skin and subcutaneous tissue (IM)
86.12 Skin prick test (IM)
86.13 Skin end-point titration test (IM)
86.630 Full thickness skin graft of genitals (IM)
86.631 Small split skin graft of genitals (IM)
86.710 Tongue flap (IM)
86.740 Cross leg flap (IM)
86.741 Deltopectoral flap (IM)
86.742 Omental flap (IM)
86.743 Simple & small local skin flap, genitals (IM)
86.87 Fat graft of skin and subcutaneous tissue (IM)
88.70 Videourodynamic (IM)
88.760 Doppler scrotal ultrasound (IM)
88.761 Transrectal ultra sound (IM)
88.790 Diagnostic doppler ultrasound of breast (IM)
88.791 Diagnostic elastography ultrasound of breast (IM)
88.792 Diagnostic grayscale ultrasound of breast (IM)
88.793 Saline infusion sonography (IM)
89.370 Six minute walking test (IM)
89.380 Cardio pulmonary exercise test (IM)
89.381 Difusion lung capacity test (IM)
89.382 Peak expiratory flow rate examination (IM)
 DAFTAR KODE ICD 9CM INA - MODIFICATION (IM)

KODE ICD 9CM DESKRIPSI

89.383 Bronchodilator (reversibility) examination (IM)
89.384 Thoracic gas volume examination (IM)
89.385 Residual lung volume examination (IM)
89.390 Bronchial provocation test (IM)
89.391 Exhaled substance breath test (IM)
92.150 Lung perfusion scan (IM)
93.390 Vestibular rehabilitation therapy (IM)
93.391 Canalith repositioning therapy (IM)
93.960 High flow nasal canule oxygenation (IM)
94.270 Electroconvulsive therapy (ECT), conventional (IM)
94.271 Electroconvulsive therapy (ECT), with premedication (IM)
94.28 Transcranial magnetic stimulation (TMS) (IM)
95.410 Pure tone audiometry (IM)
95.411 Speech audiometry (IM)
95.412 Impedance audiometry/tympanometry (IM)
95.413 Stapedial reflex response (IM)
95.414 Eustachian tube function test (IM)
95.415 Free field test (visual reinforcement audiometry, behavioral observational audiometry, play
audiometry) (IM)
95.418 Other audiometry test (SISI test, ABLB test, tinnitogram, decay) (IM)
95.440 Simple vestibular test (IM)
95.441 Dix-halpike test/positional nystagmus test (IM)
95.442 Visual head impulse test (IM)
95.460 Oto acoustic emission (OAE) (IM)
95.461 Automatic BERA (IM)
95.462
Brainstem evoked response audiometry/auditory potential (BERA/BAEP) for hearing assessment (IM)
95.463 Auditory steady state response (ASSR) (IM)
95.464 Late latency auditory evoked potential (P300, N100) (IM)
95.465 Vestibular evoked myogenic potential (IM)
96.010 Surfactant administration (IM)
97.66 Endoscopic ureteric stent removal (IM)
99.960 Microsurgical testicular sperm extraction (micro-TESE) (IM)
99.980 Early initiation of breast feeding (IM)
99.981 Kangaroo care (IM)