TARIF INA-CBG BEDAH SARAF RS TIPE B & C (REGIONAL 1)

RS TIPE B RS TIPE C
DIAGNOSA DX INA-CBG DX SEKUNDER TINDAKAN
KELAS 1 KELAS 2 KELAS 3 KELAS 1 KELAS 2 KELAS 3
VASKULER
- Intracerebral haemorrhage Other craniotomy 01.24 23,641,700 20,264,400 16,887,000 15,238,700 13,061,000 10,884,800
in brain stem I61.3
- Intracerebral haemorrhage Compression of brain G93.5 Decompression 04.42
in cerebellum I61.4 Hemiplegia G81.9 Other physical therapy 93.39
- Intracerebral haemorrhage, Cerebral oedema G93.6 Manitol
intraventricular I61.5 Anemia post hemoragi D62 Transfusi PRC 99.04
- Intracerebral haemorrhage, Shock unspecified R57.9 27,835,700 23,859,200 19,882,700 17,942,000 15,378,900 12,815,700
ICH Thalamus, Basal unspecified I61.9
ganglia Encephalopathy G93.4
Bacterial meningitis G00.9 Kultur LCS
Shock Cardiogenic R57.0
Shock hypovolemic R57.1 R/ Loading cairan
Syok durante T81.1 Bukti klinis, Terapi loading
Perdarahan Akut gastritis
K29.0 Hematemesis/Melena
Phlebitis I80.8 Debridement atau Ab
Akut perdarahan saluran
pencernaan K28.0 Hematemesis/Melena
HT + Cardiomagali I11.0
Other Cerebral Infark I63.8-9 Radiologis
Cardiac Arrest I46.9 CPR
Edema Paru J81 Sesak, takikardi, ronki,
Terapi O2, diuretic
Pneumonie J18.9 Thorak photo + 2 klinis :
Demam/Tax>38, ronki
Dahak purulent, batuk
Leukosit >10rb/<4.5rb 30,669,100 26,287,800 21,906,500 19,768,300 16,944,300 14,120,200

Acute respiratory failure J96.0 Ventilation > 96 hours 96.72 90,159,400 77,279,500 64,399,600 71,028,100 60,881,200 50,734,400
Kriteria salah satu dibawah ini Trakeostomy 31.1 94,602,200 81,087,600 67,573,000 74,528,100 63,881,200 53,234,400
1. BGA : P02<60/SaO2 <91% Terapi
2. Pulse Oksimetri SpO2<91% 1. O2 nasal, masker dsb
3. BGA P/F ratio <300 2. Vent non ivasif BiPAP, CPAP
4. BGA PCO2 > 50 dg PH <7.35 3. Ventilator
5. Peningkatan pCO2>10

Chronic Respiratory failure Ventilation > 96 hours 96.72 54,597,700 46,798,000 38,998,300
J96.1
Semua kriteria ini :
1. PCO2 >50 mmHg
2. HCO3 > 24 & PH Normal
3. PO2 < 60/SaO2 < 91%

Chronic on Acute resp failure :

1. Klinis memburuk : Kesadaran
menurun/sesak nafas/gasping
2. Pulse Oksimetri SpO2<91%
3. BGA PCO2 > 50 dg PH <7.35
SDH Kronis I62.0 Other craniotomy 01.24 23,641,700 20,264,400 16,887,000 15,238,700 13,061,000 10,884,800

27,835,700 23,859,200 19,882,700 17,942,000 15,378,900 12,815,700

30,669,100 26,287,800 21,906,500 19,768,300 16,944,300 14,120,200

Aneurisma Unrupture aneurisma (I67.1) Other surgical occlusion of
intracranial vessel 38.81 23,090,200 19,791,600 16,493,000 14,866,500 12,742,800 10,619,000

AVM AVM (Q28.2) Other excision of intracranial

vessel 38.61 33,116,900 28,385,900 23,654,900

Bacterial meningitis G00.9

Meningitis TB A17.0
Meningitis unspecified G03.9
IVH-ICH I61.5
ICH Non Trauma I62.9 50,271,900 43,090,200 35,908,500 44,522,500 38,162,100 31,801,800
TRAUMA
Fraktur Impresi Frontal Fracture of unspecified skull Other reconstruction of other 25,803,500 22,117,300 18,431,100 14,488,100 12,418,400 10,348,600
and fascial bone S02.9 fascial bone (76.46)
61,695,300 52,881,700 44,068,100 31,792,400 27,250,600 22,708,800

133,071,100 114,061,000 95,050,800 68,573,200 58,777,000 48,980,800

Fraktur Impresi (selain Fracture of unspecified skull Other craniotomy 01.24 23,641,700 20,264,400 16,887,000 15,238,700 13,061,000 10,884,800
frontal) and fascial bone (S02.9)
27,835,700 23,859,200 19,882,700 17,942,000 15,378,900 12,815,700
Fraktur Impresi Vertex Fracture of unspecified skull
and fascial bone (S02.9) 30,669,100 26,287,800 21,906,500 19,768,300 16,944,300 14,120,200

EDH (S06.4)
Traumatic SDH, ICH (S06.5)
COR S06.0 Lab 90.59
TF 87.44
Head CT 87.03 3,428,400 2,938,600 2,448,800

Cerebral oedema G93.6 (Fraud) Manitol 4,335,500 3,716,200 3,096,800

COS, COB S06.2 Lab 90.59
(Termasuk DAI) TF 87.44
Head CT 87.03 4,136,300 3,545,400 2,954,500

Cerebral oedema G93.6 (Fraud) Manitol 5,167,700 4,429,500 3,691,200

ONKOLOGI
Meningioma Benign neoplasm, brain Excision of lesion or tissue of 23,641,700 20,264,400 16,887,000 15,238,700 13,061,000 10,884,800
D33.2 cerebral meninges 01.51
Tuberculoma 27,835,700 23,859,200 19,882,700 17,942,000 15,378,900 12,815,700
Meningeal tuberculoma
A17.1 30,669,100 26,287,800 21,906,500 19,768,300 16,944,300 14,120,200
Osteoma Hyperostosis of skull (M85.2) Other reconstruction of other 25,803,500 22,117,300 18,431,100 14,488,100 12,418,400 10,348,600
fascial bone (76.46)
Sphenoorbital Benign neoplasm, bones of 61,695,300 52,881,700 44,068,100 31,792,400 27,250,600 22,708,800
Meningioma skull and face D16.4
133,071,100 114,061,000 95,050,800 68,573,200 58,777,000 48,980,800
 CONGENITAL (PEDIATRIC)
Hidrocephalus Hidrocephalus Q03.9 VP Shunt (02.34) 16.064.500 13.769.500 11.474.600 12.655.700 10.847.700 9.039.800
02.43 Aff Shunt
02.42 Revisi Shunt
02.31 Shunt Head and Neck
02.32 VA Shunt
02.39 Other operative establish
drainage

Compression of brain G93.5

Cardiac septal defect, acquired
I51.0
Atrial septal defect Q21,1
Tetralogy of fallot Q21.3
Chronic Respiratory failure 29.369.600 25.173.900 20.978.300 23.137.500 19.832.200 16.526.800
J96.1
ISK N39.0 1. Nyeri saat kencing, Leu
urine>10/LPB
2. Kultur urin (+)
Encephalopaty G93.4
Kern Icterus P57.9 48.726.300 41.765.400 34.804.500 42.659.900 36.565.600 30.471.300
Malnutrisi Berat E44.0
Tetraplegi G82.5 Other physical therapy 93.39
Tetraplegic spastic G82.4 Other physical therapy 93.39
Respiratory arrest R09.2 RR 0, ventilator, venti buatan

Sepsis A41.9 Terapi Sepsis

Minimal 2 kriteria :
1. Tax > 38.5 atau Tax<36
2. Nadi > 90x/m
3. RR >20x/m atau PaCO2 < 32
4. Wajib bukti kultur darah
Cele anterior Encephalocele nasofrontal Repair ensefalocele 02.12 23,641,700 20,264,400 16,887,000 15,238,700 13,061,000 10,884,800
Q01.1
27,835,700 23,859,200 19,882,700 17,942,000 15,378,900 12,815,700

30,669,100 26,287,800 21,906,500 19,768,300 16,944,300 14,120,200

Myelocele Myelocele Q05.9 Repair myelocele 03,52 15,235,200 13,058,800 10,882,300 9.820.100 8.417.300 7.014.400

31,811,600 27,267,100 22,722,600 19.889.600 17.048.200 14.206.900

43,338,300 37,147,100 30,955,900 27.934.500 23.943.800 19.953.200

HIDROSEFALUS
Hidrosefalus Hydrocephalus (meningitis, Meningitis (G00.9) VP Shunt 02.34 16.064.500 13.769.500 11.474.600 12.655.700 10.847.700 9.039.800
stroke) G91.9 Meningitis TB (A17.0)
HC G91.0 Meningitis unspecified G03.9 Aff Shunt 02.43 29.369.600 25.173.900 20.978.300 23.137.500 19.832.200 16.526.800
NPH G91.2 ICH-IVH I61.5 Revisi Shunt 02.42
H post trauma G91.3 48.726.300 41.765.400 34.804.500 42.659.900 36.565.600 30.471.300
ICH Non Trauma I62.9
Other Hidrosefalus G91.8 Shunt Head and Neck 02.31
SAH Aneurisma I60.0-9
VA Shunt 02.32

Other operative establish

drainage 02.39
 REKONSTRUKSI
Skull Defek Frontal T90.2 Sequelae of fracture of skull Other Rekon of other facial 25,803,500 22,117,300 18,431,100 14,488,100 12,418,400 10,348,600
and facial bones T90.2 bone (76.46)
61,695,300 52,881,700 44,068,100 31,792,400 27,250,600 22,708,800

133,071,100 114,061,000 95,050,800 68,573,200 58,777,000 48,980,800

Skull Defek non Frontal Sequelae of fracture of skull Cranioplasty (02.06) 23,641,700 20,264,400 16,887,000 15,238,700 13,061,000 10,884,800
T90.2 and facial bones T90.2
27,835,700 23,859,200 19,882,700 17,942,000 15,378,900 12,815,700

30,669,100 26,287,800 21,906,500 19,768,300 16,944,300 14,120,200

PAIN - FUNGSIONAL
Tic Fasialis HFS G51.3 Trigeminal nerve 23.641.700 20.264.400 16.887.000 15,238,700 13,061,000 10,884,800
(S) decompression (04.41)
Hemifacial Spasme Sequel of injury Cranial 27.835.700 23.859.200 19.882.700 17,942,000 15,378,900 12,815,700
nerve T90.3
30,669,100 26,287,800 21,906,500 19,768,300 16,944,300 14,120,200
CTS Carpal Tunnel Syndrome Release of carpal tunnel 04.43 2,023,400 1,734,400 1,445,300
G56.0
SPINE
HNP Lumbal + HNP + Listesis Lumbal Refusi of lumbal, tehnik 31.642.100 27.121.800 22.601.500 26.816.100 22.985.200 19.154.300
Stabilisasi + (Stabilisasi) posterior (81.38)
Canal Stenosis (M99.43) Anemia post hemoragi (D62)
Flaccid paraplegia G82.0
HNP Cervical (M99.41) Spastic paraplegia G82.1 Fusi of cervical, post (81.33)
Fusi of cervical, ant (81.32) 37.010.000 31.722.900 26.435.700 31.365.200 26.884.500 22.403.700
HNP Cervical (M51.0-9) + Stabilisasi
+ Stabilisasi Tetraplegi (G82.5)
45.806.100 39.262.300 32.718.600 38.819.700 33.274.000 27.728.400
Tetraplegic spastic (G82.4)
HNP Cervical & Lumbal HNP Cervical (–) Stabilisasi Microdisectomy/Laminectomy 15,235,200 13,058,800 10,882,300 9.820.100 8.417.300 7.014.400
M51.2 Anemia post hemoragi (D62) (80.51)
Flaccid paraplegia G82.0 31,811,600 27,267,100 22,722,600 19.889.600 17.048.200 14.206.900
Tumor Spinal Benign Neoplasma Spinal Spastic paraplegia G82.1 Other exploration and
43,338,300 37,147,100 30,955,900 27.934.500 23.943.800 19.953.200
D32.1 decompression spinal canal
(03.09)
Potensi

- Sedekah rombongan
- Small train
Post trephine syndrome -> Nyeri kepala, kesemutan -> citicholin (resume, lap operasi, data pendukung seperti radiologi)

Encephalopthy penurunan kesadaran, kejang, bicara melantur, penurunan kabur, hemiparese

Pemeriksaan fisik pandangan kabur, gcs, -> citicholin

Pasien encelopathy harus lewat igd

Injury -> memberat sejak kapan release

Radiologi tulis diresume bacaan ct scan

Rekonstruksi facial bone di lap operasi. Diagnosa ada skull defek frontal. Tepi rima orbita superior dan frontal, kita lakukan rekonstruksi frontal