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Dokumen - Tips Daftar Diagnosis Dan Tindakan Orthopaedi Ina CBG Baru Dan Plafonb
Dokumen - Tips Daftar Diagnosis Dan Tindakan Orthopaedi Ina CBG Baru Dan Plafonb
Orthopaedi
Januari 2014
Residen wajib mengisi lembar RM 1, Lembar Verifikasi dan laporan operasi sesuai
dengan diagnosis dan tindakan yang tertera secara lengkap, setiap selesai operasi
DAFTAR DIAGNOSIS (ICD 10) DAN TINDAKAN (ICD 9)
Luka terbuka di tangan, crush S67.8 Crushing injury of other and 84.03 amputation through 14.952.975
injury unspecified parts of wrist and hand hand.
S55.1 injury of radial artery at forearm
level
Luka kotor /infeksi di jaringan M65.8 Synovitis and tenosynovitis 82.04 incision and drainage 8.403.235
lunak of palmar at thenar space,
86.66 homograft to skin
Infeksi jaringan L.02.51 Cutaneus abscess of the hand. 82.04 incision and drainage 8.403.235
of palmar at thenar space,
86.66 homograft to skin
ganglion M67.4 ganglion 82.29 Excision of other lesion 12.485.355
of soft tissue of hand
Fracture pada pergelangan S62.8 fracture at wrist and hand level 79.34 open reduction of 12.485.355
tangan dan tangan fracture with internal fixation
, carpals and metacarpals.
Luka berat pada jari, tangan S68 traumatic amputasion of wrist 84.04 amputation and 14.952.971
(perlu amputasi) and hand level disarticulation of hand
S55.1 injury of radial artery at forearm
level
Deformitas/ kelainan pada jari M20.0 Deformity of finger 84.03 amputation and 9099.408
disarticulation of Hand
Jepitan pada syaraf/carpal S64 injury of nerves at wrist and hand 05.9 other operation on 11.164.055
tunnel syndrome level nervous system
Syndactili Q70 Syndactili 86.85 correction of 12.485.355
syndactyly
Dislokasi pada jari S63.1 dislocation and sprain of joints 79.84 open reduction of 12.485.355
and ligaments at wrist and hand level dislocation of hand and
finger
Tumor ganas pada ekstremitas C40.1 malignant neoplasm of short 84.03 amputation of through 14.952.975
atas bones of upper limb hand
S55.1 injury of radial artery at forearm
leve
Infeksi pada sendi M00 Pyogenic infection 81.29 arthhrodesis of other 8.404.231
specified joints
86.66 homograft to skin
Kerusakan sendi krn rematik M05 .38 rheumatoid arthritis with 81.29 arthhrodesis of other 8.403.235
rheumatoid factor specified joints
M65.80 other synovitis and 86.66 homograft to skin
tenosynovitis
Kerusakan sendi bukan karena M06 other rheumatoid arthritis 81.29 arthhrodesis of other 8.403.235
rematik specified joints
86.72 pedicle or flap graft,
not otherwise specified
Deformitas/ kelainan pada jari M20.0 Deformity of finger 82.8 other plastic operation 12.485.355
on hand,
kontracture M24.59 contracture unspecified site 82.3 other excision of soft 12.485.355
tissue of hand;
Raw surface, defek soft tissue, L98.9 other disorders of skin and 82.8 other plastic operation 8.403.235
sural flap, semua tindakan flap subcutaneous tissue, not elsewhere on hand
86.72 pedicle or flap graft,
not otherwise spesified
Traumatic amputasi perlu S68.9 traumatic amputasion of wrist 84.22 finger reattachment 8.403.235
replantasi and hand level 86.72 pedicle or flap graft,
S55.1 injury of radial artery at forearm not otherwise spesified
leve
Trauma (Fracture)
5. Fracture distal tibia S82.2 Fracture of shaft tibia 79.36 ORIF 21.963.542
6. Fracture femur S72.31 fracture shaft femur 79.35 ORIF , femur Klas 1= 8.898.656
Klas 2 = 7.627.420
Klas 3 = 6 .356.183
7. Fracture radius S52.3 fracture shaft radius 79.32 ORIF , radius and ulna 12.485.355
8. Fracture ulna S52.2 fracture shaft ulna 79.32 ORIF , radius and ulna 12.485.355
9. Fr antebrachii S52.7 fracture shaft forearm 79.32 ORIF , radius and ulna 12.485.355
10. Fracture humerus S42.3 fracture shaft humerus 79.31 ORIF humerus 12.485.355
11. Fracture pada tangan, S62 fracture at wrist and hand level 79.34 ORIF phalank of hand 12.485.355
metacarpal, phalang
12. Fracture subtrochanter femur S72.2 subtrochanteric fracture of 79.35 ORIF , femur Klas 1= 8.898.656
perlu ORIF femur Klas 2 = 7.627.420
Klas 3 = 6 .356.183
Hip implant :
6000.000
13. Fracture intercondylar femur, S72 fracture shaft femur 79.35 ORIF , femur Klas 1= 8.898.656
Klas 2 = 7.627.420
Klas 3 = 6 .356.183
Knee implant :
6000.000
14. Fracture intertrochanter femur M81.65 Osteoporosis 79.35 ORIF , femur Klas 1= 8.898.656
S72.14 Intertrochanteric fracture of Klas 2 = 7.627.420
femure Klas 3 = 6 .356.183
Hip implant :
6000.000
15. Fracture galeazi S52.3 fracture shaft radius 79.32 ORIF , radius and ulna ; 12.485.355
16. Fracture montegia S52.2 shaft ulna 79.32 ORIF , radius and ulna 12.485.355
;,
17. Fracture prksimal humerus,neck S42.20 fracture of upper end of 79.31 ORIF humerus 12.485.355
humerus humerus
18. OA Sendi lutut perlu TKR M17.4 other secondary gonarthrosis , 81.54 Total Knee 5.978.592
bilateral Replacement
M19.26 secondary of the joint , lower
leg
19. OA Sendi perlu TKR M17.4 other secondary gonarthrosis , 81.47 other repair of knee Klas 1: 30.748.959
bilateral Klas 2:26.353.251
M19.26 secondary of the joint , lower Klas 3: 21.963.542
leg
Knee replacement
3.000.000
20. OA sendi Hip perlu THR M19.26 secondary of the joint , lower 81.51 Total Hip Replacement 5.978.592
leg
21. OA Sendi perlu THR M19.26 secondary of the joint , lower 81.40 Repair of hip, not Klas 1= 8.898.656
leg elsewhere classified Klas 2 = 7.627.420
Klas 3 = 6 .356.183
Hip implant :
22. Fracture collum femur, M81.65 Osteoporosis 81.40 Repair of hip, not Klas 1= 8.898.656
S72.0 fracture of head and neck of elsewhere classified Klas 2 = 7.627.420
femur Klas 3 = 6 .356.183
Hip implant :
3000.000
23. Fracture plateau tibia S82 Fracture of tibia 79.36 ORIF , tibia and fibula 21.963.542
)
24. Fracture acetabulum S32.4 fracture acetabulum 79.30 ORIF , unspecified site 11.164.055
05.9 other operation on
nervous system Hip implant :
6000.000
25. Fracture S82.90 Fracture of lower leg , 79.37 ORIF tarsal,metatarsal 8.855.736
pedis,metacarpale,ankle including ankle
26. Fracture patella 822.1 fracture of patella,open 81.44 patellar stabilization 21.963.542
27. Infeksi pada sendi, M01 direct infection of joint in 81.9 other operation on joint
infectious and parasitic disease structure
classified elsewhere 86.66 homograft to skin
30. Dislokasi bahu S43.0 Dislocation and sprain of joint 79.71 closed reduction of 1.948.000
and ligament of shoulder dislocation shoulder
31. Dislokasi siku S53.1 Dislocation and sprain of joint 79.72 closed reduction of 1.948.000
and ligament of elbow dislocation , elbow
32. Fracture neglected M84.9 disorder of continuity of 78.4 other repair of plastic
bone,unspesified operation of bone
78.70 osteoclasis,unspecified
site
86.66 homograft to skin
33. Ruptur Tendon Achilles
2 Reposisi dan pasang gip S82.7 fracture of lower leg 79.07 closed reduction of 1.948.000
ekstremitas bawah dengan GA fracture without internal
fixation
3 Rekonstruksi ibu jari kaki , halux M20.1 halux valgus/acquired 82.89 other plastic operation 8.855.731
valgus on hand
77.51 other buninectomy
6 Pemanjangan tulang Q66.3 other congenital varus 78.3 limb lengthening 21.953.542
deformities of feet, procedure
Tumor Tulang
2 Eksisi tumor C40.9 malignant neoplasm of bone 82.29 excision of other 12.485.355
and articular cartilage of limb,. lesion of hand
3 Amputasi tumor di atas C40.9 malignant neoplasm of bone 84.17 amputation above 9.099.400
lutut(above knee) and articular cartilage of limb,. S85.0 knee/transfemoral
injury of popliteal artery
4 Amputasi tumor di bawah lutut C40.9 malignant neoplasm of bone 84.15amputation below knee 9.099.400
(below knee) and articular cartilage of limb,. S85.0
injury of popliteal artery
5 Eksisi luas (wide eksisi) D49.2 neoplasm of unspecified 77.60 local excision of lesion 12.485.355
behavior of bone , soft tissue , skin or tissue of bone unspecified
S85.0 injury of popliteal artery site
86.66 homograft to skin
6 Fraktur dengan tumor tulang C40.9 malignant neoplasm of bone 79.3 ORIF
and articular cartilage of limb,. 86.66 homograft to skin
7. Operasi tumor ganas C40.9 malignant neoplasm of bone 78.4 other repair of plastic 8.403.235
and articular cartilage of limb,. S85.0 operation of bone;
injury of popliteal artery 86.72 pedicle or flap graft,
not otherwise spesified
8 Ganti sendi pada kasus tumor C79.9 secondary malignant neoplasm 81.40 repair of hip 8.403.235
tulang/AMP of unspecified site
2 Bahu kaku/frozen shoulder/ M75.0 adhesive capsulitis of shoulder 80.21 arthroscopy shoulder 7.691.547
adhesive capsulitis M35.4 diffuse fasciitis
3 Mengeluarkan benda asing di M25.68 stiffness of joint 81.47 other repair of knee 21.000.000
lutut/loose bodies M65.26 calcific tendinitis
4
5 Debridement shoulder M25.68 stiffness of joint 80.21 arthroscopy shoulder; Klas 3 = 7.691.547
M65.26 calcific tendinitis M35.4 Klass 2 =9226.000
diffuse fasciitis Klass1: 10.768.160
6
7 Rotator cuff tear M75.1 complete rotator cuff tear or 80.21 arthroscopy shoulder; 9.229.852
rupture not specified as traumatic 80.49 division of joint,
M35.4 diffuse fascitis ligament or cartilage of other
specified site
9 Osteoarthritis lutut derajat S83.2 tear of meniscus,current 81.47 other operation of 21.000.000
ringan (1-2)/ artroscopy M35.8 other specified systemic knee
debridement involvement connective tissue
10
11 Ligament ACL/PCL lutut putus M23.61 other spontaneous disruption 81.47 other operation of Klas 3= 21.963.542
of ligament of knee, ACL /Anterior cruciate ligament Klas 2= 26.356.251
horn medial meniscus Klas 1= 30.748.959
Implant knee :
6000.000
12
13 Ganti sendi lutut/ total knee M17 osteoartritis of knee 81.47 other operation of Klas 1: 30.748.959
arthroplasty/osteoarthritis ) knee Klas 2:26.353.251
derajat berat Klas 3: 21.963.542
Knee replacement
3.000.000
14 Rematik di lutut derajat berat M05.661 rhaumatoid arthritis of left 81.47 other operation of Klas 1: 30.748.959
perlu ganti sendi knee with involvement of other organ knee Klas 2:26.353.251
and system Klas 3: 21.963.542
Knee replacement
3.000.000
15
Spine/ Tulang Belakang
2 Spondilolisthesis, canal stenosis M43.15 spondilolisthesis; M48.05 03.09 other exploration and Klass 3= 25.165.278
spinal stenosis decompression of spinal Klass 2= 30.000.000
M48.54 collapse vertebrae canal Klass 1 = 35.231.390
S25.8 injury of other blood vessel of 84.51 insertion of other
thorax spinal device;
81.62 fusion of 2-3 vertebrae
81.04 Dorsal fusion
3. Tumor tulang belakang C41.2 malignant neoplasm of 03.09 other exploration and Klass 3= 25.165.278
vertebral column ; M48.05 spinal decompression of spinal Klass 2= 30.000.000
stenosis canal Klass 1 = 35.231.390
M48.54 collapse vertebrae 84.51 insertion of other
S25.8 injury of other blood vessel of spinal device;
thorax 81.62 fusion of 2-3 vertebrae
81.04 Dorsal fusion
4 HNP/canal stenosis di cervical M50.1 cervical disc disorder; 03.09 other exploration and Klass 3= 25.165.278
dengan tetraparese dengan M48.05 spinal stenosis decompression of spinal Klass 2= 30.000.000
implan M48.54 collapse vertebrae canal Klass 1 = 35.231.390
G82.4 flaccid tetraplegia 84.51 insertion of other
spinal device;
81.62 fusion of 2-3 vertebrae
81.04 Dorsal fusion
5 HNP/canal stenosis di M51.1 thoraxic , thoracolumbal and 03.09 other exploration and Klass 3= 25.165.278
thorakal/lumbal dengan implan lumbosacral intervertebral disc decompression of spinal Klass 2= 30.000.000
disorder; canal Klass 1 = 35.231.390
M48.05 spinal stenosis 84.51 insertion of other
M48.54 collapse vertebrae spinal device;
S25.8 injury of other blood vessel of 81.62 fusion of 2-3 vertebrae
thorax 81.04 Dorsal fusion
6 HNP/Canal stenosis di cervical M50.1 cervical disc disorder; 03.09 other exploration and 25.165.278
tetraparese tanpa implan M48.02 spinal stenosis decompression of spinal
M48.52 collapse vertebrae canal
G82.4 flaccid tetraplegia 81.62 fusion of 2-3 vertebrae
81.04 Dorsal fusion
7 HNP/canal stenosis di M51.1 thoraxic , thoracolumbal and 03.09 other exploration and 19.950.055
thorakal/lumbal tanpa implant lumbosacral intervertebral disc decompression of spinal
disorder; canal
M48.05 spinal stenosis 81.62 fusion of 2-3 vertebrae
M48.54 collapse vertebrae 81.04 Dorsal fusion
8 Fraktur tulang belakang dengan S32.7 fracture of lumbar spine and 03.09 other exploration and Klass 3= 25.165.278
implan pelvis; decompression of spinal Klass 2= 30.000.000
M48.0 spinal stenosis canal Klass 1 = 35.231.390
M48.54 collapse vertebrae 84.51 insertion of other
S25.8 injury of other blood vessel of spinal device;
thorax 81.62 fusion of 2-3 vertebrae
81.04 Dorsal fusion