) BPJS Kesehatan
48 Badan Penyelenggara Jaminan Sosial
No :328 /V-05/0320 Girebon, 03 Maret 2020
dengan Tindakan Persalinan
th. Direktur/Pimpinan FKRTL yang bekeriasama
di
Tempat
Terima kasih kami ucapkan kepada seluruh Fasilitas Kesehatan Rujukan Tingkat Lanjutan Mitra
BPIS Kesehatan yang telah memberikan pelayanan maksimal kepada Peserta JKN-KIS. Sehubungan
dengan pelayanan kesehatan bayi lahir dengan tindakan persalinan, bersama ini kami sampaikan hal
sebagai berikut:
1. Mengacu kepada Peraturan Menteri Kesehatan Nomor 76 Tahun 2016 tentang Pedoman
Indonesian Case Base Groups (INA CBGS) dalam Pelaksanaan Jaminan Kesehatan Nasional bahwa
aturan koding lainnya yang berlaku untuk INA CBGS antara lain:
"Dalam hal bayi baru lahir dengan tindakan persalinan menggunakan kode PO3.0 -PO3.6 maka
dapat dikdaimkan terpisah dari ibunyo”.
2. Kata "dapat pada pernyataan sesuai dengan poin 1 di atas secara terminologi menurut KKB!
merupakan bentuk kata sifat yang diartikan mampu, sanggup, bisa, boleh, mungkin. Sehingga
kalimat "maka dapat diklaimkan terpisah dari ibunya" dapat ditafsirkan adanya kondisi tertentu
yang memungkinkan ditagihkan terpisah dan sebaliknya ada kondisi tertentu yang menyebabkan
klaim tersebut satu paket dengan ibunya. Secara teknis hal ini dapat berupa pernyataan "dapat
diklaimkan terpisah dari ibunya bila kondisi bayi mengalami sakit (mortbiditas) akibat
dipengaruhi tindakan persalinan, sementara pada bayi yang tidak sakit/sehat maka tidak dapat
di klaimkan terpisah”.
3. Berkaltan dengan hal tersebut maka kami sampaikan untuk penjaminan bayi yang sakit akibat
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