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161 0187R0060523V004661 2023-05-30 2023-05-30RJ 00*******126861 MI**** Q-5-44-0
128 0187R0060523V003581 2023-05-24 2023-05-24RJ 00*******126866 NA*** AL*Q-5-44-0
162 0187R0060523V004697 2023-05-31 2023-05-31RJ 00*******126866 NA*** AL*Q-5-44-0
56 0187R0060523V002273 2023-05-15 2023-05-15RJ 00*******126878 YO** AR**Q-5-44-0
148 0187R0060523V003910 2023-05-25 2023-05-25RJ 00*******126899 MU******Q-5-44-0
156 0187R0060523V004585 2023-05-30 2023-05-30RJ 00*******126899 MU******Q-5-44-0
142 0187R0060523V003673 2023-05-24 2023-05-24RJ 00*******127067 LI*** SE**Q-5-44-0
158 0187R0060523V004639 2023-05-30 2023-05-30RJ 00*******127067 LI*** SE**Q-5-44-0

1 0187R0060523V003717 2023-05-23 2023-05-29RI 00*******00127226 BA** NY**P-8-08-II

2 0187R0060523V003121 2023-05-20 2023-05-23RI 00*******001335 RA** MU*I-4-19-II

3 0187R0060523V003116 2023-05-19 2023-05-21RI 00*******127161 WA**** E-4-10-II

4 0187R0060523V003136 2023-05-20 2023-05-24RI 00*******00047065 SU*******J-4-17-II

 5 0187R0060523V003929 2023-05-25 2023-05-28RI 00*******00127291 MO* IK***E-4-10-II

6 0187R0060523V003149 2023-05-21 2023-05-23RI 00*******127190 SU***** L-1-30-I

7 0187R0060423V003204 2023-04-27 2023-05-02RI 00*******126667 SI** SA***I-4-15-III

8 0187R0060523V000001 2023-05-01 2023-05-04RI 00*******076691 TI*** AR* E-4-10-III

9 0187R0060523V000032 2023-05-01 2023-05-05RI 00*******126731 SU****** E-4-10-II

10 0187R0060523V000503 2023-05-03 2023-05-06RI 00*******126780 SU***** E-4-10-II

11 0187R0060523V000529 2023-05-03 2023-05-06RI 00*******00024704 SU****** I-4-15-III

12 0187R0060523V000944 2023-05-05 2023-05-07RI 00*******00042462 WI***** E-4-10-III

13 0187R0060523V004102 2023-05-26 2023-05-29RI 00*******00127315 BA***** M-4-17-II

14 0187R0060423V003460 2023-04-30 2023-05-03RI 00*******018866 SA**** J-4-16-II

15 0187R0060423V003443 2023-04-29 2023-05-03RI 00*******126697 ON* YU***J-4-16-III

16 0187R0060423V003429 2023-04-28 2023-05-02RI 00*******126688 IR***** J-4-16-II

17 0187R0060423V003479 2023-04-30 2023-05-02RI 00*******126354 SA**** ARI-4-15-II

18 0187R0060423V003451 2023-04-29 2023-05-02RI 00*******126698 PO**** E-4-10-II

19 0187R0060523V001646 2023-05-10 2023-05-12RI 00*******125765 DU**** ZUG-4-14-I

20 0187R0060523V002100 2023-05-13 2023-05-17RI 00*******127006 MU** AN*G-4-14-I

21 0187R0060523V002112 2023-05-14 2023-05-17RI 00*******00117956 SU***** G-4-14-II

22 0187R0060523V002336 2023-05-15 2023-05-19RI 00*******127072 MO*** MUG-4-14-I

23 0187R0060523V001220 2023-05-08 2023-05-17RI 00*******125819 YA****** J-1-02-III

24 0187R0060523V001024 2023-05-07 2023-05-11RI 00*******00041651 mu****** J-4-16-II

25 0187R0060523V001877 2023-05-11 2023-05-13RI 00*******126894 MU******J-4-16-II

26 0187R0060523V001208 2023-05-08 2023-05-11RI 00*******00121520 BA** NY**A-4-15-III

27 0187R0060523V002107 2023-05-13 2023-05-16RI 00*******127023 MU******G-4-18-III

28 0187R0060523V001875 2023-05-11 2023-05-17RI 00*******00098259 DI****** J-1-02-III

29 0187R0060523V001417 2023-05-09 2023-05-18RI 00*******00074729 AG** JU**I-4-15-III

30 0187R0060523V002108 2023-05-13 2023-05-14RI 00*******00070173 SU***** J-4-16-III

31 0187R0060523V001002 2023-05-06 2023-05-06RI 00*******123729 MI*** PR*I-4-10-III

32 0187R0060523V003366 2023-05-21 2023-05-21RI 00*******127192 MU******E-4-11-II

33 0187R0060523V003580 2023-05-24 2023-05-26RI 00*******127246 AK**** HI U-4-13-II

34 0187R0060523V003361 2023-05-22 2023-05-24RI 00*******118665 MO** AZ**M-1-70-II

35 0187R0060523V004432 2023-05-28 2023-05-30RI 00*******127357 SI** MA**O-6-13-II

36 0187R0060523V001424 2023-05-09 2023-05-12RI 00*******00031561 AN*** AN*N-4-10-II

37 0187R0060523V001033 2023-05-08 2023-05-11RI 00*******126866 NA*** AL*E-4-11-III

38 0187R0060523V001027 2023-05-07 2023-05-12RI 00*******097728 PU** AS**N-4-10-III

39 0187R0060523V002302 2023-05-15 2023-05-18RI 00*******00053559 SU**** N-4-13-III

40 0187R0060523V001406 2023-05-08 2023-05-11RI 00*******00040492 UN* PR***J-4-16-II

41 0187R0060523V002316 2023-05-15 2023-05-17RI 00*******00072861 NA**** MOE-4-10-II

42 0187R0060423V003208 2023-04-28 2023-05-01RI 00*******00048568 SU***** E-4-11-II

43 0187R0060423V003474 2023-04-30 2023-05-03RI 00*******126717 SU*******E-4-10-II

44 0187R0060523V000024 2023-05-01 2023-05-04RI 00*******126729 SU***** J-4-16-II

45 0187R0060523V002101 2023-05-13 2023-05-18RI 00*******123818 SA*** N-4-10-III

46 0187R0060523V003365 2023-05-22 2023-05-25RI 00*******127215 US***** CO-6-10-II

47 0187R0060523V002062 2023-05-12 2023-05-14RI 00*******00122089 Pa*** J-1-20-III

48 0187R0060523V004153 2023-05-28 2023-05-31RI 00*******090523 KA***** I-4-19-III

49 0187R0060523V003062 2023-05-19 2023-05-21RI 00*******00127146 TU*** S-4-16-III

50 0187R0060523V002594 2023-05-16 2023-05-16RI 00*******121391 HA*** BI* I-4-24-III

NOSURATBBYPENGAJ BYVERIFIKASI
5502/BA/VI186800 0 potensi fragmen Setuju
Px dengan dx berbeda N39.0
5502/BA/VI186800 0 potensi fragmen pro tatalaksana lebih lanjut
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
Px nyeri punggung bawah
memberat pro tatalaksana
5502/BA/VI186800 0 potensi fragmen lebih lanjut
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
Px dengan dx berbeda H81.3
5502/BA/VI186800 0 potensi fragmen pro tatalaksana lebih lanjut
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju

Px dengan dx berbeda M54.5

5502/BA/VI186800 0 potensi fragmen pro tatalaksana lebih lanjut
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
Px dengan dx berbeda CRS
5502/BA/VI186800 0 potensi fragmen pro tatalaksana lebih lanjut
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen Setuju
Px dengan dx berbeda J34.3
5502/BA/VI186800 0 potensi fragmen pro tatalaksana lebih lanjut
5502/BA/VI186800 0 potensi fragmen Setuju
Px dengan dx berbeda J31.2
5502/BA/VI186800 0 potensi fragmen pro tatalaksana lebih lanjut
5502/BA/VI186800 0 potensi fragmen Setuju
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI322200 0 potensi fragmen
5502/BA/VI322200 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI551100 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI423100 0 potensi fragmen
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI393300 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI423100 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI423100 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
 rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI1075500 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
indikasi usg
5502/BA/VI551100 0 berulang
 rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI191400 0 potensi fragmen
5502/BA/VI393300 0 potensi fragmen
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
rawat luka bisa
dilakukan di
5502/BA/VI191400 0 faskes 1
5502/BA/VI186800 0 potensi fragmen
indikasi usg
5502/BA/VI551100 0 berulang
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen
5502/BA/VI186800 0 potensi fragmen

BAYI LAHIR
CUKUP UMUR,
RDS tidak
menggunakan
CPAP, maka
reseleksi diagnosa
P220 menjadi
P229 (P220 untuk
bayi prematur,dg
BBLR dan
membutuhkan
ventilasi, CPAP,
ventilator dll)

5502/BA/VI5738100 0 Setuju Tarif tetap

Ada di resume medis dengan

pemberian propanolol
Bukti pendukung 3x10mg dan penegakan
penatalaksanaan diagnosis sesuai dengan ECG
5502/BA/VI4777000 0 E059 terlampir

Sesuai Resume medis px

masuk dengan DM
Gastropathy maka dikoding
E11.6, sudah tercantum
anamnesis, pemeriksaan dan
tatalaksana dan merupakan
5502/BA/VI4899400 0 DM E119 indikasi px dirawat

Sesuai Resume medis px

masuk dengan DM
Gastropathy maka dikoding
E11.6, sudah tercantum
anamnesis, pemeriksaan dan
tatalaksana dan merupakan
5502/BA/VI3453000 0 DM E119 indikasi px dirawat
 Sesuai Resume medis px
masuk dengan DM
Gastropathy maka dikoding
E11.6, sudah tercantum
anamnesis, pemeriksaan dan
tatalaksana dan merupakan
5502/BA/VI4899400 0 DM E119 indikasi px dirawat
Flap diambil dari skin crease
5502/BA/VI6944700 0 flap diambil dari midpalmar DIP joint
Px dengan DM type 2 with
5502/BA/VI7324100 0 gunakan kode E11,ulcer maka dikoding E11.5

Sesuai Resume medis px

masuk dengan DM
Gastropathy maka dikoding
E11.6, sudah tercantum
anamnesis, pemeriksaan dan
tatalaksana dan merupakan
5502/BA/VI7083800 0 gunakan kode E11,indikasi px dirawat

Sesuai Resume medis px

masuk dengan DM
Gastropathy maka dikoding
E11.6, sudah tercantum
anamnesis, pemeriksaan dan
tatalaksana dan merupakan
5502/BA/VI4899400 0 gunakan kode E11,indikasi px dirawat

Px dengan DM hypoglycemia
GDA: 50 dan ada tatalaksana
D10% 150cc dalam 15 menit
5502/BA/VI4899400 0 gunakan kode E11,maka dikoding E11.6
Px dengan DM type 2 with
diabetic foot maka dikoding
5502/BA/VI9741000 0 gunakan kode E11,E11.5

Sesuai Resume medis px

masuk dengan DM
Gastropathy maka dikoding
E11.6, sudah tercantum
anamnesis, pemeriksaan dan
tatalaksana dan merupakan
5502/BA/VI7083800 0 gunakan kode E11,indikasi px dirawat

J449 tidak
terdapat bukti
pendukung
penegakan
5502/BA/VI4697500 0 diagnosa Setuju 3,358,700
 Untuk diagnosis Dengue
Fever tidak harus dilakukan
pemeriksaan IgM anti
5502/BA/VI4930200 0 konfirmasi pemeri Dengue
konfirmasi
tatalaksana Sudah tercantum di resume
Hypovolaemic medis dengan asering
5502/BA/VI7262000 0 shock 1000cc/1jam UO: 10cc/jam
Sudah tercantum di resume
medis dengan iv furosemide
5502/BA/VI6557100 0 konfirmasi tatalaks40mg-40mg-0
Tatalaksana dengan rawat
luka, kompres NS dan IV
antibiotik sudah tercantum
5502/BA/VI6103400 0 konfirmasi tatalak di triage dan resume medis
Sudah tercantum di triage
yaidu dengan medscab
5502/BA/VI4899400 0 konfirmasi tatalakslotion

Sesuai dengan triage dan

resume merupakan stroke
2nd attack, berarti serangan
kedua yang merupakan
kondisi berbeda, yang
sekarang dalam kondisi akut
maka dikoding I63.9, hal ini
yg merupakan indikasi RI dan
sesuai gambaran CT scan
5502/BA/VI3918600 0 mohon kode sqeul kepala

Sesuai dengan triage dan

resume merupakan stroke
kondisi akut maka dikoding
I63.9, hal ini yg merupakan
indikasi RI dan sesuai
5502/BA/VI3918600 0 mohon kode sqeul gambaran CT scan kepala

Sesuai dengan triage dan

resume merupakan stroke
2nd attack, berarti serangan
kedua yang merupakan
kondisi berbeda, yang
sekarang dalam kondisi akut
maka dikoding I63.9, hal ini
yg merupakan indikasi RI dan
sesuai gambaran CT scan
5502/BA/VI7081400 0 mohon kode sqeul kepala

Sesuai dengan triage dan

resume merupakan stroke
kondisi akut maka dikoding
I63.9, hal ini yg merupakan
indikasi RI dan sesuai
5502/BA/VI3918600 0 mohon kode sqeul gambaran CT scan kepala
 Sesuai dengan triage dan
resume merupakan stroke
kondisi akut maka dikoding
I63.9, hal ini yg merupakan
mohon kode indikasi RI dan sesuai
squel untuk gambaran CT scan kepala.
infark, mohon Penunjang J80 sesuai hasil
penunjang dan BGA, J18.9 sesuai hasil CXR,
penanganan tatalaksana pemasangan
5502/BA/VI51849100 0 khusus J80 J189 ventilator

mohon konfirmasi Tatalaksana sudah

penanganan tercantum di resume medis
khusus untuk dengan iv diazepam dan
5502/BA/VI4930200 0 epilepsi stesolid supp

mohon konfirmasi Diagnosis sesuai anamnesis

penunjang dan dan pemeriksaan fisik,
penanganan tatalaksana dengan pedilax
khusus untuk dan probiokid sudah
5502/BA/VI6557100 0 A083 tercantum di resume medis

mohon konfirmasi Bukti pendukung sudah

penunjang dan terlampir, penatalaksanaan
penanganan dengan ARV, fluconazole,
khusus untuk ampicillin-sulbactam,
5502/BA/VI6496100 0 B207 gentamicin
Emngatasi infeksinya dengan
antibiotik inf levofloxacin
1x750mg, iv citicolin
5502/BA/VI8179800 0 mohon penanganan
3x500mg

I46.9 diagnosis ditegakkan

dengan ecg asistole,
mohon tatalaksana dengan CPR
penunjang dan sudah terlampir, J44.1 sesuai
penanganan bacaan CXR, anamnesis dan
khusus I469 dan pemeriksaan fisik,
5502/BA/VI51849100 0 J441 tatalaksana nebulisasi

Diagnosis dengan TD: 88/55,

N: 109, tatalaksana dengan
mohon loading NS 1000cc
penunjang dan monitoring urin output,
penanganan sudah tercantum dalama
5502/BA/VI7324100 0 khusus R571 triage
mohon
penunjang khusus Penunjang cardiac arrest
untuk cardiac sudah terlampir yaitu ECG
5502/BA/VI6233500 0 arrest asistole
 Dx dengan resource terbesar
adalah I21.0 yang
memperlukan streptokinase
5502/BA/VI14039000 0 mohon reseleksi DU
sehingga tetap menjadi DU

Dx A08.3 ditegakkan dengan

anamnesis dan pemeriksaan
5502/BA/VI3727100 0 pendukung A083? fisik sudah terlampir di triage

Dx A08.3 ditegakkan dengan

anamnesis dan pemeriksaan
5502/BA/VI2640500 0 pendukung A083? fisik sudah terlampir di triage

Px dengan osteomyelitis dan

delay union merupakan dx
remove implant, yang berbeda dan butuh
M84 tidak perlu d tatalaksana berbeda
5502/BA/VI12724800 0 koding sehingga perlu dikoding

reseleksi diagnosa
O14.1 menjadi
O14.0
dikarenakan tidak
terdapat
tatalaksana
5502/BA/VI2699900 0 kejang Setuju Tarif tetap
5502/BA/VI4521200 0 reseleksi DU D649 Px tidak ada dx D64.9
N05.9 menjadi DU karena
merupakan causa utama
5502/BA/VI5559600 0 reseleksi DU G419 timbulnya G41.9 5,514,000
5502/BA/VI5299500 0 reseleksi DU I639 Setuju 5,324,400

DU tetap N13.2 karena DPJP

utama IPD dan sesuai
keluhan utama pasien,
sedamgkam I63.9
didapatkan saat perjalanan
5502/BA/VI7644600 0 reseleksi DU I639 ketika dirawat
J18.9 tetap menjadi DU
karena merupakan kondisi
akut dan memerlukan
5502/BA/VI4930200 0 reseleksi DU J441 resource yg lebih besar
5502/BA/VI6516200 0 reseleksi DU J441 Px tidak ada dx J44.1

E86 tetap menjadi DU

karena membutuhkan
resource yang lebih besar,
sedangkan A90 tidak
membuuhkan tatalaksana
khusus kecuali pada kondisi
5502/BA/VI3727100 0 reseleksi kode A90DHF
 E11.6 membutuhkan
resource yang lebih besar,
sedangkan K56.0 tidak
membutuhkan tatalaksana
khusus karena bukan
reseleksi kode merupakan ileus obstructive
K56.0 sebagai DU yang memerlukan
5502/BA/VI6516200 0 penyebab MRS pembedahan
J18.9 tetap menjadi DU
reseleksi kode karena merupakan kondisi
penyebab MRS akut dan memerlukan
5502/BA/VI4930200 0 sebagai DU A90 resource yg lebih besar
I12.0 merupakan kondisi yg
lebih emergency, pd dgn TD:
201/131 perlu tatalaksana
5502/BA/VI5299500 0 rseleksi J189 seba komprehensif

O64.9 merupakan indikasi

utama diakukan SC
Sebagai kondisi sedangkan PRM bukan
utama dlakukan merupakan indikais mutlak
5502/BA/VI5372400 0 SC O421 (DU) SC kecuali ada penyulit

Data pendukung pneumonia

sudah terlqpir, leukosit:
23.600, bacaan CXR:
pneumonia, pemeriksaan
5502/BA/VI30028700 0 tidak ada data un pulmo: rhonki (+)
Tidak terdapat
bukti pendukung
dan tatalaksana
5502/BA/VI5702900 0 E055 Px tdk diperiksa fT4, TSH tapi tatalaksana ada

Bukti pendukung PVC adalah

ECG sudah terlampir yang
Tidak terdapat menunjukkan gambaran
bukti pendukung multiple pvc, ada
I49.3, mohon tatalaksana: Carvedilol
5502/BA/VI9060200 0 tidak di input 2x1/2tab

Tatalaksana R570 adalah

dengan drip dobutamin dan
tidak terdapat NE sudah tercantum di
tatalaksana R570 resume medis, data
dan tidak pendungkung dx HF
terdapat dilampirkan yaitu
5502/BA/VI6858300 0 pendukung HF echocardiography EF: 22% Lampirkan echo > pinjam status px
 2,455,103 3,060,100

echo > pinjam status px