Gabung KODING 020223

KODING
ICD X- ICD IX-CM

DEPARTEMEN/SMF BEDAHTORAKS,KARDIAK, DAN VASKULAR
RSUDDR. SOETOMOSURABAYA
2023
CODING
KARDIAK
PEDIATRI
Atrial Septal Defect (Q21.1)
(Termasuk defek sinus koronarius dan PFO)
• Repair of atrial septal defect with prosthesis. open technique (35.51)
• Repair of atrial septal defect with prosthesis. closed technique (35.52)
• Pada 2 tindakan ini terdapat top Up Prosthesis sebesar 48.292.200 (TIPEA) 21.337.800 (TIPE B)
(Harap dipastikan tindakan betul menggunakan prosthesis bukan graft (graft tidak dapat top up)
Kode INA TIPE A TIPE B
Deskripsi INA-CBG
- CBG Kelas 3 Kelas 2 Kelas 1 Kelas 3 Kelas 2 Kelas 1
Prosedur Kardiotorasik
I-1-06-I 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800
lain (Ringan )
I-1-06-II 73.637.100 85.787.200 97.937.400 51.360.200 59.834.700 68.309.100
lain (Sedang)
I-1-06-III 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
lain (Berat)
Comorbid :
Sev II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF (I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2). PAC(I49.1).
sick sinus syndrome (I49.5). SVT(I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/ Hipokalemia (E87.5/E87.6)
Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1), Stenosis of pulmonary artery (Q25.6), Patent
Ductus Arteriosus(Q25.0) , Congenital pulmonary valve stenosis(Q22.1), Atresia of pulmonary artery(Q25.5), Congenital
insufficiency of aortic valve (Q23.1), Pulmonary heart disease, unspecified (I27.9), Other congenital malformations of aorta
(Q25.4), Pulmonary infundibular stenosis (Q24.3), Nonrheumatic tricuspid (valve) insufficiency (I36.1), Tricuspid
insufficiency (I07.1), Partial anomalous pulmonary venous connection (Q26.3), Aortic (valve) insufficiency (I35.1),
Pulmonary valve atresia (Q22.0), Congenital tricuspid stenosis (Q22.4)
Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3). VF (I49. 0).
VT(I47.2)
Atrial Septal Defect (Q21.1)
(Termasuk defek sinus koronarius dan PFO)
• Repair of atrial septal defect with tissue graft (35.61)

• Other and unspecified repair of atrial septal defect 35.71

Deskripsi INA-CBG
I-1-06-I 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800
lain (Ringan )
I-1-06-II 73.637.100 85.787.200 97.937.400 51.360.200 59.834.700 68.309.100
lain (Sedang)
I-1-06-III 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
lain (Berat)
Comorbid :
Sev II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF (I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2). PAC
(I49.1). sick sinus syndrome (I49.5). SVT (I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/ Hipokalemia
(E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1), ), Stenosis of pulmonary artery
(Q25.6), Patent Ductus Arteriosus(Q25.0) , Congenital pulmonary valve stenosis(Q22.1), Atresia of pulmonary
artery(Q25.5), Congenital insufficiency of aortic valve (Q23.1), Pulmonary heart disease, unspecified (I27.9), Other
congenital malformations of aorta (Q25.4), Pulmonary infundibular stenosis (Q24.3), Nonrheumatic tricuspid (valve)
insufficiency (I36.1), Tricuspid insufficiency (I07.1), Partial anomalous pulmonary venous connection (Q26.3), Aortic
(valve) insufficiency (I35.1), Pulmonary valve atresia (Q22.0), Congenital tricuspid stenosis (Q22.4)
Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3). VF (I49.
0). VT(I47.2)
Ventricle Septal Defect (Q21.0)
• Repair of ventricular septal defect with prosthesis. open technique 35.53

• Repair of ventricular septal defect with prosthesis. closed technique 35.55
• Pada 2 tindakan ini terdapat top Up Prosthesis sebesar 48.292.200 (TIPEA) 21.337.800 (TIPE B)
(Harap dipastikan tindakan betul menggunakan prosthesis bukan graft (graft tidak dapat top up))

Deskripsi INA-CBG
-CBG Kelas 3 Kelas 2 Kelas 1 Kelas 3 Kelas 2 Kelas 1
I-1-06-I 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800
lain (Ringan )
I-1-06-II 73.637.100 85.787.200 97.937.400 51.360.200 59.834.700 68.309.100
lain (Sedang)
I-1-06-III 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
lain (Berat)
Comorbid :
Sev II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF (I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2).
PAC (I49.1). sick sinus syndrome (I49.5). SVT (I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/
Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) Patent Ductus
Arteriosus(Q25.0), Stenosis of pulmonary artery (Q25.6), Congenital pulmonary valve stenosis(Q22.1), Atresia of
pulmonary artery(Q25.5), Congenital insufficiency of aortic valve (Q23.1), Pulmonary heart disease, unspecified
(I27.9), Other congenital malformations of aorta (Q25.4), Pulmonary infundibular stenosis (Q24.3), Nonrheumatic
tricuspid (valve) insufficiency (I36.1), Tricuspid insufficiency (I07.1), Partial anomalous pulmonary venous
connection (Q26.3), Aortic (valve) insufficiency (I35.1), Pulmonary valve atresia (Q22.0), Congenital tricuspid
stenosis (Q22.4)
Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3). VF
(I49. 0). VT(I47.2)
Ventricle Septal Defect (Q21.0)
• Repair of ventricular septal defect with tissue graft 35.62
• Other and unspecified repair of ventricular septal defect 35.72

Deskripsi INA-CBG
I-1-06-I 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800
lain (Ringan )
I-1-06-II 73.637.100 85.787.200 97.937.400 51.360.200 59.834.700 68.309.100
lain (Sedang)
I-1-06-III 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
lain (Berat)
Comorbid :
Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) Patent Ductus
Arteriosus(Q25.0), Stenosis of pulmonary artery (Q25.6), Congenital pulmonary valve stenosis(Q22.1), Atresia of
pulmonary artery(Q25.5), Congenital insufficiency of aortic valve (Q23.1), Pulmonary heart disease, unspecified
stenosis (Q22.4)
(I49. 0). VT(I47.2)
Tetralogy Of Fallot (Q21.3)
• Modified Blalock-Taussig (BT) Shunt (39.0)

Deskripsi INA-CBG
PROSEDUR PEMBULUH
I-1-12-I 17.055.400 19.869.500 22.683.700 12.522.500 14.588.700 16.654.900
DARAH TORASIK
KOMPLEKS (RINGAN)
PROSEDUR PEMBULUH
I-1-12-II 27.854.800 32.450.800 37.046.900 19.492.900 22.709.200 25.925.600
DARAH TORASIK
KOMPLEKS (SEDANG)
PROSEDUR PEMBULUH
I-1-12-III 36.647.200 42.694.000 48.740.800 26.563.600 30.946.600 35.329.600
DARAH TORASIK
KOMPLEKS (BERAT)
Comorbid :
Sev II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF(I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2).
PAC(I49.1). sick sinus syndrome (I49.5). SVT(I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/
Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1), ), Stenosis of
pulmonary artery (Q25.6), Patent Ductus Arteriosus(Q25.0),
Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3).
VF(I49. 0). VT(I47.2)
Tetralogy Of Fallot (Q21.3)
• Reparasi TOF(35.81)
Pada tindakan ini terdapat top Up Prosthesis sebesar 16.938.500 (TIPEA) 7.259.700 (TIPE B)
Kode TIPE A TIPE B

INA Deskripsi INA-CBG
- Kelas 3 Kelas 2 Kelas 1 Kelas 3 Kelas 2 Kelas 1
CBG
OPERASI KARDIOTORASIK
I-1-03-I 47.918.300 55.824.800 63.731.300 30.240.000 35.229.600 40.219.200
KOMPLEKS PADA JANTUNG
ANOMALI (RINGAN)
I-1-03-II 66.424.600 77.384.700 88.344.800 46.809.400 54.533.000 62.256.500
ANOMALI (SEDANG)
I-1-03-III 82.896.100 96.573.900 110.251.800 56.673.100 66.024.100 75.375.200
ANOMALI (BERAT)
Comorbid :
Sev II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF(I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2). PAC
(I49.1). sick sinus syndrome (I49.5). SVT(I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/ Hipokalemia
(E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1), Stenosis of pulmonary artery
(Q25.6), Patent DuctusArteriosus(Q25.0),
(I49. 0). VT(I47.2)
AVSD (Q21.2)
• 37.99 (Pulmonary Artery (PA) Banding)

Deskripsi INA-CBG
I-1-06-I 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800
lain (Ringan )
I-1-06-II 73.637.100 85.787.200 97.937.400 51.360.200 59.834.700 68.309.100
lain (Sedang)
I-1-06-III 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
lain (Berat)
Comorbid :
(E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) ), Stenosis of pulmonary artery
(Q25.6) Patent Ductus Arteriosus(Q25.0), Congenital pulmonary valve stenosis(Q22.1), Atresia of pulmonary
artery(Q25.5), Congenital insufficiency of aortic valve (Q23.1), Pulmonary heart disease, unspecified (I27.9), Other
congenital malformations of aorta (Q25.4), Pulmonary infundibular stenosis (Q24.3), Nonrheumatic tricuspid (valve)
insufficiency (I36.1), Tricuspid insufficiency (I07.1), Partial anomalous pulmonary venous connection (Q26.3), Aortic
(valve) insufficiency (I35.1), Pulmonary valve atresia (Q22.0), Congenital tricuspid stenosis (Q22.4)
Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3). VF (I49.
0). VT(I47.2)
AVSD (Q21.2)
• 35.54 (Complete Atrioventricular Septal Defect (CAVSD) Repair)
Kode TIPE A TIPE B

CBG
I-1-03-I 47.918.300 55.824.800 63.731.300 30.240.000 35.229.600 40.219.200
ANOMALI (RINGAN)
I-1-03-II 66.424.600 77.384.700 88.344.800 46.809.400 54.533.000 62.256.500
ANOMALI (SEDANG)
I-1-03-III 82.896.100 96.573.900 110.251.800 56.673.100 66.024.100 75.375.200
ANOMALI (BERAT)
Comorbid :
Sev II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF (I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2). PAC (I49.1).
sick sinus syndrome (I49.5). SVT (I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/ Hipokalemia (E87.5/E87.6)
Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) ), Stenosis of pulmonary artery (Q25.6), Patent
Ductus Arteriosus(Q25.0), Congenital pulmonary valve stenosis(Q22.1), Atresia of pulmonary artery(Q25.5), Congenital
insufficiency of aortic valve (Q23.1), Pulmonary heart disease, unspecified (I27.9), Other congenital malformations of aorta
(Q25.4), Pulmonary infundibular stenosis (Q24.3), Nonrheumatic tricuspid (valve) insufficiency (I36.1), Tricuspid
insufficiency (I07.1), Partial anomalous pulmonary venous connection (Q26.3), Aortic (valve) insufficiency (I35.1),
Pulmonary valve atresia (Q22.0), Congenital tricuspid stenosis (Q22.4)
Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3). VF (I49. 0).
VT(I47.2)
Patent Ductus Arteriosus(Q25.0)
• 38.85(Ligasi PDA)

Deskripsi INA-CBG
PROSEDUR SISTIM
I-1-20-I 21.764.000 25.355.000 28.946.100 15.701.600 18.292.300 20.883.100
PEREDARAN DARAH
LAIN-LAIN (RINGAN)
PROSEDUR SISTIM
I-1-20-II 27.189.200 31.675.400 36.161.700 19.617.500 22.854.400 26.091.300
PEREDARAN DARAH
LAIN-LAIN (SEDANG)
PROSEDUR SISTIM
I-1-20-III 32.022.200 37.305.900 42.589.600 25.778.600 30.032.100 34.285.500
PEREDARAN DARAH
LAIN-LAIN (BERAT)
Comorbid :
(E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1), ), Stenosis of pulmonary artery
(Q25.6), Congenital pulmonary valve stenosis(Q22.1), Atresia of pulmonary artery(Q25.5), Congenital insufficiency of
aortic valve (Q23.1), Pulmonary heart disease, unspecified (I27.9), Other congenital malformations of aorta (Q25.4),
Pulmonary infundibular stenosis (Q24.3), Nonrheumatic tricuspid (valve) insufficiency (I36.1), Tricuspid insufficiency
(I07.1), Partial anomalous pulmonary venous connection (Q26.3), Aortic (valve) insufficiency (I35.1), Pulmonary valve
atresia (Q22.0), Congenital tricuspid stenosis (Q22.4)
Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3). VF(I49.
0). VT(I47.2)
Transposition of Great Arteries (Q25.9)
• Total correction of transposition of great vessels, not elsewhere classified 35.84
• (Fontan Procedure / Total Cavo-Pulmonary Connection (TCPC)) 35.94
Kode TIPE A TIPE B

CBG
I-1-03-I 47.918.300 55.824.800 63.731.300 30.240.000 35.229.600 40.219.200
ANOMALI (RINGAN)
I-1-03-II 66.424.600 77.384.700 88.344.800 46.809.400 54.533.000 62.256.500
ANOMALI (SEDANG)
I-1-03-III 82.896.100 96.573.900 110.251.800 56.673.100 66.024.100 75.375.200
ANOMALI (BERAT)
Comorbid :
Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) ), Stenosis of
pulmonary artery (Q25.6), Patent Ductus Arteriosus(Q25.0), Congenital pulmonary valve stenosis(Q22.1), Atresia
of pulmonary artery(Q25.5), Congenital insufficiency of aortic valve (Q23.1), Pulmonary heart disease, unspecified
stenosis (Q22.4)
(I49. 0). VT(I47.2)
• 39.0 (Modified Blalock-Taussig (BT) Shunt)

Deskripsi INA-CBG
PROSEDUR PEMBULUH
I-1-12-I 17.055.400 19.869.500 22.683.700 12.522.500 14.588.700 16.654.900
DARAH TORASIK
KOMPLEKS (RINGAN)
PROSEDUR PEMBULUH
I-1-12-II 27.854.800 32.450.800 37.046.900 19.492.900 22.709.200 25.925.600
DARAH TORASIK
KOMPLEKS (SEDANG)
PROSEDUR PEMBULUH
I-1-12-III 36.647.200 42.694.000 48.740.800 26.563.600 30.946.600 35.329.600
DARAH TORASIK
KOMPLEKS (BERAT)
Comorbid :
Sev II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF (I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm
(I49.2). PAC (I49.1). sick sinus syndrome (I49.5). SVT (I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/
Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) ), Stenosis
of pulmonary artery (Q25.6), Patent Ductus Arteriosus(Q25.0), Congenital pulmonary valve stenosis(Q22.1),
Atresia of pulmonary artery(Q25.5), Congenital insufficiency of aortic valve (Q23.1), Pulmonary heart disease,
unspecified (I27.9), Other congenital malformations of aorta (Q25.4), Pulmonary infundibular stenosis
(Q24.3), Nonrheumatic tricuspid (valve) insufficiency (I36.1), Tricuspid insufficiency (I07.1), Partial anomalous
pulmonary venous connection (Q26.3), Aortic (valve) insufficiency (I35.1), Pulmonary valve atresia (Q22.0),
Congenital tricuspid stenosis (Q22.4)
Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC
(I49.3). VF(I49. 0). VT(I47.2)
• 39.2 (Bidirectional Cavopulmonary Shunt (BCPS))

Deskripsi INA-CBG
PROSEDUR PEMBULUH
I-1-12-I 17.055.400 19.869.500 22.683.700 12.522.500 14.588.700 16.654.900
DARAH TORASIK
KOMPLEKS (RINGAN)
PROSEDUR PEMBULUH
I-1-12-II 27.854.800 32.450.800 37.046.900 19.492.900 22.709.200 25.925.600
DARAH TORASIK
KOMPLEKS (SEDANG)
PROSEDUR PEMBULUH
I-1-12-III 36.647.200 42.694.000 48.740.800 26.563.600 30.946.600 35.329.600
DARAH TORASIK
KOMPLEKS (BERAT)
Comorbid :
Sev II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF (I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm
(I49.2). PAC (I49.1). sick sinus syndrome (I49.5). SVT (I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/
Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) ), Stenosis
of pulmonary artery (Q25.6), Patent Ductus Arteriosus(Q25.0), Congenital pulmonary valve stenosis(Q22.1),
unspecified (I27.9), Other congenital malformations of aorta (Q25.4), Pulmonary infundibular stenosis
(Q24.3), Nonrheumatic tricuspid (valve) insufficiency (I36.1), Tricuspid insufficiency (I07.1), Partial anomalous
pulmonary venous connection (Q26.3), Aortic (valve) insufficiency (I35.1), Pulmonary valve atresia (Q22.0),
Congenital tricuspid stenosis (Q22.4)
Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC
(I49.3). VF(I49. 0). VT(I47.2)
37.99 (Pulmonary Artery (PA) Banding)

Deskripsi INA-CBG
I-1-06-I 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800
lain (Ringan )
I-1-06-II 73.637.100 85.787.200 97.937.400 51.360.200 59.834.700 68.309.100
lain (Sedang)
I-1-06-III 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
lain (Berat)
Comorbid :
Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) ), Stenosis of
pulmonary artery (Q25.6), Patent Ductus Arteriosus(Q25.0), Congenital pulmonary valve stenosis(Q22.1),
unspecified (I27.9), Other congenital malformations of aorta (Q25.4), Pulmonary infundibular stenosis (Q24.3),
Nonrheumatic tricuspid (valve) insufficiency (I36.1), Tricuspid insufficiency (I07.1), Partial anomalous pulmonary
venous connection (Q26.3), Aortic (valve) insufficiency (I35.1), Pulmonary valve atresia (Q22.0), Congenital
tricuspid stenosis (Q22.4)
Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3).
VF(I49. 0). VT(I47.2)
Wound Dehiscence
• Disruption of operation wound ICD X T81.3
• Nonexcisional debridement of wound, infection, or burn ICD IX 86.28
Kode RS Tipe A RS Tipe B

Deskripsi
INA- Kelas 3 Kelas 2 Kelas 1 Kelas 3 Kelas 2 Kelas 1
CBGs
Komplikasi dari
S-4-13-I Penatalaksanaan Pasien 4.643.200 5.409.300 6.175.400 3.584.300 4.175.700 4.767.100
(ringan)
Komplikasi dari
S-4-13-II Penatalaksanaan Pasien 7.631.500 8.890.700 10.149.900 5.743.000 6.690.600 7.638.200
(sedang)
Komplikasi dari
S-4-13-III Penatalaksanaan Pasien 12.386.700 14.430.500 16.474.400 9.030.700 10.520.800 12.010.900
(berat)
• Comorbid:
o Sev II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF(I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2). PAC
(I49.1). sick sinus syndrome (I49.5). SVT(I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/ Hipokalemia
(E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) Diabetes Mellitus ( E11.8/
E10.8) CKD(N18.-) Stroke ( I63.9)
o Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3). VF
(I49. 0). VT(I47.2)
Tindakan Ventilator > 96 Jam(4x24 Jam)
Tindakan :
• Continuous invasive mechanical ventilation for 96 consecutive hours or more ICD IX96.72
INA- Deskripsi
CBGs Kelas 3 Kelas 2 Kelas 1 Kelas 3 Kelas 2 Kelas 1
J-1- Ventilasi Mekanikal

02-I Long Term Tanpa 62.014.000 72.246.300 82.478.600 40.990.500 47.753.900 54.517.400
Trakeostomi (Ringan)
02-II Long Term Tanpa 78.249.600 91.160.800 104.072.000 52.026.400 60.610.800 69.195.100
Trakeostomi (Sedang)
02-III Long Term Tanpa 91.540.900 106.645.200 121.749.400 67.795.900 78.982.200 90.168.500
Trakeostomi (Berat)
(I47.2) Disruption of operation wound (T81.3)
• Comorbid:
o Sev. II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF (I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2). PAC (I49.1). sick
sinus syndrome (I49.5). SVT(I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/ Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis
(E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) Diabetes Mellitus ( E11.8/ E10.8) CKD(N18.-) Stroke ( I63.9)
o Sev. III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3). VF (I49. 0). VT
Tindakan Ventilator < 96 Jam(4x24 Jam)
Tindakan :
• Continuous invasive mechanical ventilation for less tahn 96 consecutive hours ICD IX 96.71

INAC Deskripsi
BGS Kelas 3 Kelas 2 Kelas 1 Kelas 3 Kelas 2 Kelas 1
J-1- Prosedur Sistem

20-I Pernapasan Non- Kompleks 35.243.900 41.059.100 46.874.400 19.229.600 22.402.500 25.575.400
(Ringan)
J-1- Prosedur Sistem Pernapasan
20-II Non- Kompleks (Sedang) 36.905.100 42.994.400 49.083.800 22.324.000 26.007.500 29.691.000
20-III Non- Kompleks (Berat) 46.515.700 54.190.700 61.865.800 31.562.600 36.770.500 41.978.300
• Comorbid:
sinus syndrome (I49.5). SVT (I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/ Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis
CATATAN
FOKUSINA pada ICD IX, Jika diagnosis berubah tapi tindakan tetap, MAKAPenentu INA di ICD IX
Cardiopulmonary resuscitation, not otherwise specified (99.60)

Atrial cardioversion(99.61)
Other electric countershock of heart(99.62)
Closed chest cardiac massage(99.63)
Carotid sinus stimulation(99.64)
Other conversion of cardiac rhythm(99.69)
Extracorporeal circulation auxiliary to open heart surgery (39.61)
Incision of chest wall (34.01)
Pada koding ICD IX-CM diatas hanya ditambahkan untuk membuktikan adanya tindakan tersebut pada suatu kondisi tapi ke 6
koding tersebut tidak mempengaruhi Nominal INACBGs di kelas dan kasus manapun.
KETENTUAN KODING PEDIATRI
• AV blok(I44.-) : Harap EKG dan pembacaan disertakan
• Supraventricular tachycardia (I47.1) : termasuk pola AV nodal, junctional, atrial
• HF (I50.0) : HF yang congestive / RV failure
• HF (I50.1) : HF dengan tanda-tanda oedema paru / LV Failure
• Bradikardi (R00.1)
• Penyakit jantung tiroid (I43.8 + E05.9)
KETENTUAN KODING UMUM

• CPR (99.60)
• Angkat jahitan sesuai dengan region
• Rehab medic disesuaikan dengan modalitas yang digunakan
• Sepsis dengan tanda-tanda syok R57.2
• Sepsis dengan syok kardiogenik = R57.0
• Hipertensi
o I10 jika hipertensi saja tanpa ada komplikasi lain
o I11 jika ada komplikasi jantung
§ I11.0 Hypertensive heart disease dan HF dengan tanda-tanda edema paru
§ I11.9 Hypertensive heart disease dan HF tanpa tanda-tanda edema paru
o I12 jika ada komplikasi ginjal
o I13 jika ada komplikasi ginjal dan jantung bersamaan
• Cardiac Arrest (I46.9) bisa dikoding jika bukan kasus DOA dan DNR
• Pada koding elektrolit imbalans seperti hiponatremi, hipernatremi dan hipo/hiper kalemi mohon disertakan terapi dan lab
pendukung
CODING
KARDIAK
DEWASA
CABG
Diagnosis:
• Other forms of chronic ischaemic heart disease ICD XI25.8
• Atherosclerotic heart disease ICD XI25.1
• Chronic Ischemic heart disease, unspecified ICD XI25.9
• Presence of aortocoronary bypass ICD XZ95.1
Tindakan :
• Coronary Arthery Bypass Graft (CABG)
o 1 graft ICD IX 36.11
o single mammary ICD IX 36.15
o double mammary ICD IX 36.16
o other bypass anastomosis ICD IX 36.19
• Kateterisasi Jantung ICD IX 88.56
• Other heart revascularization ICD 36.39
• Aortocoronary bypass for heart revascularizaton ICD IX 36.10
• Interview and evaluation, described as comprehensive ICD IX 89.03
INA- Deskripsi
I-1- Pembedahan Bypass Pembuluh 89.014.800 103.702.200 118.389.700 67.359.500 78.473.800 89.588.100
05-I Koroner Dengan Kateterisasi
Jantung (Ringan)
05-II Koroner Dengan Kateterisasi
Jantung (Sedang)
05-III Koroner Dengan Kateterisasi
Jantung (Berat)
• Comorbid :
o Sev. II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF (I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2). PAC (I49.1).
Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) Diabetes Mellitus ( E11.8/ E10.8) CKD (N18.-) Stroke (
I63.9)
o Sev. III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3). VF (I49. 0).
VT(I47.2) Disruption of operation wound (T81.3)
CABG
Diagnosis:
• Other forms of chronic ischaemic heart disease ICD XI25.8
• Atherosclerotic heart disease ICD XI25.1
• Chronic Ischemic heart disease, unspecified ICD XI25.9
• Presence of aortocoronary bypass ICD XZ95.1
Tindakan :
• Coronary Arthery Bypass Graft (CABG)
o single mammary ICD IX 36.15
o double mammary ICD IX 36.16
o other bypass anastomosis ICD IX 36.19
• Other heart revascularization ICD 36.39
• Aortocoronary bypass for heart revascularizaton ICD IX 36.10
Kode
INA- RS Tipe A RS Tipe B
Deskripsi
Kelas 3 Kelas 2 Kelas 1 Kelas 3 Kelas 2 Kelas 1
CBGs
I-1- Prosedur Bypass Koroner

07-I Tanpa Kateterisasi Jantung 79.304.100 92.389.300 105.474.400 55.783.600 64.987.900 74.192.200
(Ringan)
I-1- 07- Prosedur Bypass Koroner
II Tanpa Kateterisasi Jantung 98.905.300 115.224.700 131.544.100 67.737.200 78.913.900 90.090.500
(Sedang)
I-1- Prosedur Bypass Koroner
07-III Tanpa Kateterisasi Jantung 148.357.900 172.837.000 197.316.100 93.060.000 108.414.900 123.769.900
(Berat)
• Comorbid :
Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) Diabetes Mellitus ( E11.8/ E10.8) CKD(N18.-) Stroke (
I63.9)
Mitral Valve Replacement/repair
Diagnosis:
• Rheumatic mitral valve diseases ICD X I05.-
• Mitral stenosis ICD X I05.0
• Mitral stenosis with insufficiency ICD X I05.2
• Mitral (valve) insufficiency ICD X I34.0
• Mitral (valve) prolapse ICD XI34.1
• Nonrheumatic mitral (valve) stenosis ICD X I34.2
• Rheumatic mitral Insuffiency ICD X I05.1
• Rheumatic heart disease unspecified ICD X I09.9
• Nonrheumatic mitral valve disorder ICD X I34.9
Tindakan:
• Open heart valvuloplasty of mitral valve without replacement ICD IX 35.12
• Open and other replacement of mitral valve with tissue graft ICD IX 35.23
• Open and other replacement of mitral valve ICD IX 35.24
• Closed heart valvotomy, mitral valve ICD IX 35.02
• Open and other replacement of unspecified heart valve, elsewehere ICD IX 35.20
• Diagnostic ultrasound of heart ICD IX 88.72
Kode INA-
CBGs RS Tipe A RS Tipe B
Deskripsi
I-1- 04-I Prosedur Katup Jantung

71.944.100 83.814.800 95.685.600
Tanpa Kateterisasi 56.752.600 66.116.700 75.480.900
Jantung (Ringan)
I-1- 04-II Prosedur Katup Jantung
Tanpa Kateterisasi 89.776.200 104.589.300 119.402.300 70.819.300 82.504.500 94.189.700
Jantung (Sedang)
I-1- 04-III Prosedur Katup Jantung

Jantung (Berat)
• Comorbid :
(I47.2) Acute amd subacute endocarditis (I33.-) Disruption of operation wound (T81.3)
Aortic Valve Replacement/repair
Diagnosis:
o Rheumatic aortic valve diseases ICD X I06.-
o Aortic stenosis ICD X I35.0
o Aortic (valve) insufficiency ICD X I35.1
o Aortic (valve) stenosis with insufficiency ICD XI35.2
o Rheumatic Aortic Stenosis with insufficiency ICD XI06.2
o Aortic aneurysm and dissection ICD I71.-
o Aortic aneurysm of unspecified site ICD 71.8
Tindakan :
o Open heart valvuloplasty of aortic valve without replacement ICD IX 35.11
o Open and other replacement of aortic valve with tissue graft ICD IX 35.21
o Open and other replacement of aortic valve ICD IX 35.22
o Diagnostic ultrasound of heart ICDIX 88.72
o Interview and evaluation, described as comprehensive ICD IX 89.0
Kode RSTIpe A RSTipe B
INA- Deskripsi
I-1- 04-I Prosedur Katup

Jantung Tanpa
71.944.100 83.814.800 95.685.600 56.752.600 66.116.700 75.480.900
Kateterisasi Jantung
(Ringan)
I-1- 04-II Prosedur Katup
Jantung Tanpa
89.776.200 104.589.300 119.402.300 70.819.300 82.504.500 94.189.700
(Sedang)
I-1- 04- Prosedur Katup
III Jantung Tanpa
135.487.100 157.842.500 180.197.900 85.283.200 99.354.900 113.426.600
(Berat)
• Comorbid :
o Sev II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF (I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2). PAC (I49.1). sick sinus
syndrome (I49.5). SVT(I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/ Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis
o Sev III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC(I49.3). VF (I49. 0). VT (I47.2)
Acute and subacute endocarditis (I33.-) Disruption of operation wound (T81.3)
Double Valve Replacement
Diagnosis:
• Mitral (valve) Disease • Aortic(valve) Disease
o Rheumatic mitral valve diseases ICD X I05.- o Rheumatic aortic valve diseases ICD X I06.-
o Mitral stenosis ICD X I05.0 o Aortic stenosis ICD X I35.0
o Mitral stenosis with insufficiency ICD X I05.2 o Aortic (valve) insufficiency ICD X I35.1
o Mitral (valve) insufficiency ICD X I34.0 o Aortic (valve) stenosis with insufficiency ICD XI35.2
o Mitral (valve) prolapse ICD XI34.1 o Rheumatic Aortic Stenosis with insufficiency ICD X I06.2
o Nonrheumatic mitral (valve) stenosis ICD X I34.2
o Rheumatic mitral Insuffiency ICD X I05.1
o Rheumatic heart disease unspecified ICD XI09.9
o Nonrheumatic mitral valve disorder ICD X I34.9
Tindakan :
• Mitral (valve) Procedure
o Open and other replacement of mitral valve with tissue graft ICD IX 35.23
o Open and other replacement of mitral valve ICD IX 35.24
o Closed heart valvotomy, mitral valve ICD IX 35.02
o Diagnostic ultrasound of heart ICD IX 88.72
• Aortic(valve) procedure
o Open and other replacement of aortic valve with tissue graft ICD IX 35.21
o Open and other replacement of aortic valve ICD IX 35.22
o Diagnostic ultrasound of heart ICD IX 88.72
INA- Deskripsi
I-1- 04-I Prosedur Katup Jantung

Jantung (Ringan)
I-1- 04-II Prosedur Katup Jantung
Jantung (Sedang)
I-1- 04-III Prosedur Katup Jantung
Jantung (Berat)
• Comorbid :
(I47.2) Acute and subacute endocarditis (I33.-) Disruption of operation wound (T81.3)
LA/RA Myxoma
Diagnosis:
• Benign Neoplasm of the heart ICD XD15.1
Tindakan :
• Incision of heart, not otherwise specified ICD IX 37.10
• Excision or destruction of other lesion or tissue of heart, open ICD IX 37.33
• Diagnostic ultrasound of heart ICD IX 88.72
Kode RSTipe A RSTipe B

INA- Deskripsi
I–1–
06–I
Prosedur Kardiotorasik Lain 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800
(Ringan)
I–1– 06–
II
(Sedang)
I–1– 06–
Prosedur Kardiotorasik Lain
III 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
(Berat)
• Comorbid :
o Sev. II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF (I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2). PAC(I49.1). sick sinus
syndrome (I49.5). SVT(I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/ Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis
o Sev. III : Shock Cardiogenik (R57.0). Cardiac Arrest (I46.0/I46.9) . effusi pleura (J90/J91). pneumonia. PVC (I49.3). VF (I49. 0). VT
Fistula Koroner
Diagnosis:
• Malformation of coronary vessels ICD XQ24.5
Tindakan :
• Other operations on vessels of heart ICD IX 36.99

INA- Deskripsi
I–1–
06–I
(Ringan)
I–1– 06–
II
(Sedang)
I–1– 06–
Prosedur Kardiotorasik Lain
III 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
(Berat)
• Comorbid :
Ruptur SinusValsava
Diagnosis:
• Ventricular septal defect ICD XQ21.0
• Ventricular septal defect as current complication following acute myocardial infarction ICD XI23.2
• Rupture of cardiac wall without haemopericardium ICD XI23.3
Tindakan :
• Repair of ventricular septal defect with prosthesis, open technique ICD IX 35.53
• Repair of ventricular septal defect with prosthesis, closed technique ICD IX 35.55
• Other operations on septa of heart ICD IX 35.98
Top Up : Prosthesis sebesar 48.292.200
INA- Deskripsi
I–1– 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800

Prosedur Kardiotorasik Lain (Ringan)
06–I
I–1– Prosedur Kardiotorasik Lain (Sedang) 73.637.100 85.787.200 97.937.400 51.360.200 59.834.700 68.309.100
06–II
I–1– Prosedur Kardiotorasik Lain (Berat)

06–III 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
• Comorbid:
Ruptur SinusValsava
Diagnosis:
• Ventricular septal defect ICD XQ21.0
• Aortic aneurysm and dissection ICD X I71.-
• Aortic aneurysm of unspecified site ICD X71.8
Tindakan :
• Repair of ventricular septal defect with prosthesis, open technique ICD IX 35.53
• Other Replacement of aortic valve ICD IX 35.22
• Other repair of aneurysm ICD IX 39.52

INA- Deskripsi
I-1- Prosedur Katup Jantung

(Ringan)
04-II Tanpa Kateterisasi Jantung 89.776.200 104.589.300 119.402.300 70.819.300 82.504.500 94.189.700
(Sedang)
(Berat)
• Comorbid:
Acidosis / Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) Diabetes Mellitus ( E11.8/ E10.8) CKD(N18.-) Stroke (
I63.9)
Hyperthropic Obstructive Cardiomyopathy (HOCM)
Diagnosis:
• Cardiomyopathy ICD XI42
• Aneurysm of heart ICD XI25.3
• Intracardiac thrombosis, not elsewhere classified ICD XI51.3
Tindakan :
• Other and unspecified repair of unspecified septal defect of heart ICD IX 35.70
• Other operations on septa of heart ICD IX 35.98

INA- Deskripsi
I–1–
06–I Prosedur Kardiotorasik Lain (Ringan) 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800
I–1–
06–II Prosedur Kardiotorasik Lain (Sedang) 73.637.100 85.787.200 97.937.400 51.360.200 59.834.700 68.309.100
I–1–
06–III Prosedur Kardiotorasik Lain (Berat) 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
• Comorbid:
sinus syndrome (I49.5). SVT (I47.1). Anemia (D64.9) . effusi perikardium(I31.3). Hiper/ Hipokalemia (E87.5/E87.6) Acidosis /
Alkalosis (E87.2 / E87.3). Hiper/ Hiponatremia ( E87.0/ E87.1) Diabetes Mellitus ( E11.8/ E10.8) CKD(N18.-) Stroke ( I63.9)
Penyakit Perikardium
Diagnosis:
• Acute nonspecific idiopathic pericarditis ICD XI30
• Chronic adhesive pericarditis ICD XI31.0
• Pericarditis in bacterial diseases classified elsewhere ICD XI32
• Haemopericardium ICD XI31.2
• Other specified diseases of pericardium ICD XI31.8
• Pericardial effusion (noninflammatory) ICD XI31.1
Tindakan :
• Pericardiocentesis ICD IX 37.0
• Pericardiectomy ICD IX 37.31
• Control of hemorrhage, not otherwise specified ICD IX 39.98
• Pericardiotomy ICD IX 37.12
INA- Deskripsi
I–1–
06–I Prosedur Kardiotorasik Lain (Ringan) 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800
I–1–
06–II Prosedur Kardiotorasik Lain (Sedang) 73.637.100 85.787.200 97.937.400 51.360.200 59.834.700 68.309.100
I–1–
06–III Prosedur Kardiotorasik Lain (Berat) 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
• Comorbid:
Implantasi Pacemaker
Diagnosis:
• Atrioventricular and left bundle-branch block ICD XI44
• Atrioventricular block, complete ICD XI44.2
• Presence of cardiac pacemaker ICD XZ95.0
• Atrial Fibrillation and flutter ICD XI48
Tindakan:
• Insertion of permanent pacemaker, initial or replacement, type of device not specified ICD IX 37.8
• Revision or removal of pacemaker device ICD IX 37.89
• Removal of foreign body, not otherwise specified ICD IX 98.20
INA- Deskripsi
I-1- Penggantian Alat Defibrilator dan

30-I Pacemaker Jantung (Ringan) 26.861.900 31.294.100 35.726.300 15.701.600 18.292.300 20.883.100

30-II Pacemaker Jantung (Sedang) 35.549.300 41.415.000 47.280.600 19.617.500 22.854.400 26.091.300

30-III Pacemaker Jantung (Berat) 53.070.700 61.827.400 70.584.100 25.778.600 30.032.100 34.285.500
• Comorbid:
Tricuspid Valve Replacement/repair
Diagnosis:
• Mitral stenosis ICD X I05
• Rheumatic aortic stenosis ICD X I06
• Rheumatic tricuspid valve diseases ICDX I07
• Tricuspid insufficiency ICD XI07.1
• Disorders of both mitral and aortic valves ICD X I08
• Other rheumatic heart diseases ICD X I09
• Nonrheumatic tricuspid (valve) stenosis ICD XI36
• Tricuspid valve disorders in diseases classified elsewhere ICD XI39.2
Tindakan:
• Open heart valvuloplasty of tricuspid valve without replacement ICD IX 35.14
INA- Deskripsi

(Ringan)
04-II Tanpa Kateterisasi Jantung 89.776.200 104.589.300 119.402.300 70.819.300 82.504.500 94.189.700
(Sedang)
(Berat)
• Comorbid:
o Sev. II : Pulmonary Hypertension (I27.1/ I27.2 ) . HF(I50.9/ I50.1). Atrial Fibrilasi (I48). Junctional rhytm (I49.2). PAC(I49.1). sick
Emboli Arteri Pulmonal
Diagnosis:
• Pulmonary embolism ICD X I26
• Other pulmonary heart diseases ICD X I27
• Other diseases of pulmonary vessels ICD XI28
Tindakan:
• Ligation and stripping of varicose veins, unspecified site ICD IX38.50
• Ligation and stripping of varicose veins, other thoracic vessels ICD IX 38.5

INA- Deskripsi
I-1- Prosedur Pembuluh

12-I Darah Torasik 17.055.400 19.869.500 22.683.700 12.522.500 14.588.700 16.654.900
Kompleks (ringan)
12-II Darah Torasik 27.854.800 32.450.800 37.046.900 19.492.900 22.709.200 25.925.600
Kompleks(sedang)
12-III Darah Torasik 36.647.200 42.694.000 48.740.800 26.563.600 30.988.200 35.329.600
Kompleks (berat)
• Comorbid:
Wound Dehiscence
Diagnosis:
• Disruption of operation wound ICD XT81.3
Tindakan :
• Nonexcisional debridement of wound, infection, or burn ICD IX 86.28

INA- Deskripsi
S-4- Komplikasi dari Penatalaksanaan Pasien

13-I (ringan) 4.643.200 5.409.300 6.175.400 3.584.300 4.175.700 4.767.100

13-II (sedang) 7.631.500 8.890.700 10.149.900 5.743.000 6.690.600 7.638.200
13-III (berat) 12.386.700 14.430.500 16.474.400 9.030.700 10.520.800 12.010.900
• Comorbid:
Tindakan Ventilator > 96 Jam(4x24 Jam)
Tindakan :
• Continuous invasive mechanical ventilation for 96 consecutive hours or more ICD IX96.72
INA- Deskripsi
Ventilasi Mekanikal Long

J-1-
Term Tanpa 62.014.000 72.246.300 82.478.600 40.990.500 47.753.900 54.517.400
02-I
Trakeostomi (Ringan)
J-1-
Term Tanpa 78.249.600 91.160.800 104.072.000 52.026.400 60.610.800 69.195.100
02-II
Trakeostomi (Sedang)
J-1-
Term Tanpa 91.540.900 106.645.200 121.749.400 67.795.900 78.982.200 90.168.500
02-III
Trakeostomi (Berat)
• Comorbid:
Tindakan Ventilator < 96 Jam(4x24 Jam)
Tindakan :
• Continuous invasive mechanical ventilation for less tahn 96 consecutive hours ICD IX 96.71

INA- Deskripsi
CBGS Kelas 3 Kelas 2 Kelas 1 Kelas 3 Kelas 2 Kelas 1

20-I Non- Kompleks (Ringan)
35.243.900 41.059.100 46.874.400 19.229.600 22.402.500 25.575.400

20-II Non- Kompleks (Sedang) 36.905.100 42.994.400 49.083.800 22.324.000 26.007.500 29.691.000
20-III Non- Kompleks (Berat) 46.515.700 54.190.700 61.865.800 31.562.600 36.770.500 41.978.300
• Comorbid:
OTHERS
Diagnosis
• HIV disease resulting in other viral infection ICD XB20.3
• Presence of prostethic heart valve ICD XZ95
• Other specified complications of cardiac and vascular prosthetic devices, implants and grafts ICD X T82.8
Comorbid :
Sev-I
• Hypertensive heart disease without (congestive) heart failure (I11.9) Cardiomegaly ( I51.7) Benign neoplasm: heart
(D15.1)
Prosedur
• Extracorporeal circulation auxiliary to open heart surgery ICD IX

39.61
• Incision of chest wall ICD IX
34.01
• Insertion of intercostal catheter for drainage ICD IX
34.04
• Cardioplegia ICD IX
39.63
KETENTUAN KODINGDEWASA
• AV blok(I44.-) : Harap EKGdan pembacaan disertakan

• Supraventricular tachycardia (I47.1) : termasuk polaAV nodal, junctional, atrial
• HF (I50.0) : HF yang congestive / RV failure
• HF(I50.1) : HFdengan tanda-tanda oedema paru / LVFailure
• Bradikardi (R00.1)
• Penyakit jantung tiroid (I43.8 + E05.9)

• CPR (99.60)
• Hipertensi
pendukung
CODING
THORAKS
HEMOTHORAKSTRAUMATIK
ICD X: ICD IX :
• Traumatic haemothorax S27.1 • Insertion of intercostal catheter for drainage 34.04
• Removal of thoracotomy tube or pleural cavity drain 97.41
RS. TIPE A RS. TIPE B

KODE DESKRIPSI
INA-
KELAS 3 KELAS 2 KELAS 1 KELAS 3 KELAS 2 KELAS 1
CBGS
PLEURAL EFUSI DAN
J-4-20-I 5.640.300 6.570.900 7.501.500 4.743.000 5.525.600 6.308.200
PNEUMOTORAK
(RINGAN)
PLEURAL EFUSI DAN
J-4-20-II
PNEUMOTORAK 7.985.100 9.302.600 10.620.100 6.571.300 7.655.500 8.739.800
(SEDANG)
PLEURAL EFUSI DAN
J-4-20-III
PNEUMOTORAK 8.946.000 10.422.100 11.898.100 7.941.800 9.252.200 10.562.600
(BERAT)
Severity II : Pulmonary Hypertension (I27.1/ I27.2 ) , Heart Failure (I50.9/ I50.1), Atrial Fibrilasi (I48), Junctional rhytm (I49.2),
PAC(I49.1), sick sinus syndrome (I49.5), SVT(I47.1), Anemia (D64.9) , effusi perikardium(I31.3), Hiper/ Hipokalemia
(E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3), Hiper/ Hiponatremia ( E87.0/ E87.1)
Severity III : Shock Cardiogenik (R57.0), Cardiac Arrest (I46.0/I46.9) , effusi pleura (J90/J91), pneumonia (J18.9), PVC(I49.3), VF
(I49. 0), VT(I47.2)
PNEUMOTHORAKSTRAUMATIK
ICD X: ICD IX:
• Traumatic pneumothorax S27.0 • Insertion of intercostal catheter for drainage 34.04

KODE DESKRIPSI
INACB
GS
PLEURAL EFUSI DAN
J-4-20-I 5.640.300 6.570.900 7.501.500 4.743.000 5.525.600 6.308.200
PNEUMOTORAK
(RINGAN)
PLEURAL EFUSI DAN
J-4-20-II
PNEUMOTORAK 7.985.100 9.302.600 10.620.100 6.571.300 7.655.500 8.739.800
(SEDANG)
PLEURAL EFUSI DAN
J-4-20-III
PNEUMOTORAK 8.946.000 10.422.100 11.898.100 7.941.800 9.252.200 10.562.600
(BERAT)
(I49. 0), VT(I47.2)
HEMOPNEUMOTHORAKSTRAUMATIK
ICD X: ICD IX:
• Traumatic haemopneumothorax S27.2 • Insertion of intercostal catheter for drainage 34.04

KODE DESKRIPSI
INACB
GS
PLEURAL EFUSI DAN
J-4-20-I 5.640.300 6.570.900 7.501.500 4.743.000 5.525.600 6.308.200
PNEUMOTORAK
(RINGAN)
PLEURAL EFUSI DAN
J-4-20-II
PNEUMOTORAK 7.985.100 9.302.600 10.620.100 6.571.300 7.655.500 8.739.800
(SEDANG)
PLEURAL EFUSI DAN
J-4-20-III
PNEUMOTORAK 8.946.000 10.422.100 11.898.100 7.941.800 9.252.200 10.562.600
(BERAT)
(I49. 0), VT(I47.2)
TENSION PNEUMOTHORAKS
ICD X: ICD IX:
• Spontaneous tension pneumothorax J93.0
• Thoracentesis 34.91
• Insertion of intercostal catheter for drainage 34.04

KODE
DESKRIPSI
INACB
GS
PLEURAL EFUSI DAN

J-4-20-I 5.640.300 6.570.900 7.501.500 4.743.000 5.525.600 6.308.200
PNEUMOTORAK
(RINGAN)
PLEURAL EFUSI DAN
J-4-20-II
PNEUMOTORAK 7.985.100 9.302.600 10.620.100 6.571.300 7.655.500 8.739.800
(SEDANG)
PLEURAL EFUSI DAN
J-4-20-III
PNEUMOTORAK (BERAT) 8.946.000 10.422.100 11.898.100 7.941.800 9.252.200 10.562.600
PERICARDIAL EFFUSION (NON INFLAMATORIK)
ICD X:
• Pericardial effusion (noninflammatory) I31.3 Primer
• Pleural effusion, not elsewhere classified J90 Sekunder
ICD IX :
• Exploratory thoracotomy 34.02
• Pericardiotomy 37.12
KODE RS. TIPE A RS. TIPE B

DESKRIPSI
INACB
GS
I-1-06-I PROSEDUR KARDIOTORASIK LAIN

(RINGAN)
50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800
I-1-06-II PROSEDUR KARDIOTORASIK LAIN

(SEDANG) 73.637.100 85.787.200 97.937.400 51.360.200 59.834.700 68.309.100
PROSEDUR KARDIOTORASIK LAIN

I-1-06-III 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
(BERAT)
(I49. 0), VT(I47.2)
TRAUMA THORAKSRINGAN
ICD X:
• Contusion of thorax S20.2/ S20.3
• Superficial injury of other and unspecified parts of thorax S20.8
• Open wound of thorax, part unspecified S21.9
ICD IX :
• Suture of skin and subcutaneous tissue of other sites 86.59

KODE DESKRIPSI
INA-
CBGS KELAS 3 KELAS 2 KELAS 1 KELAS 3 KELAS 2 KELAS 1
TRAUMA PADA KULIT, JARINGAN

L-4-13-I BAWAH KULIT DAN PAYUDARA 3.560.200 4.147.600 4.735.100 2.748.300 3.201.700 3.655.200
(RINGAN)
J-4-13-II 4.789.000 5.579.200 6.369.400 3.696.800 4.306.800 4.916.800
BAWAH KULIT DAN PAYUDARA
(SEDANG)
J-4-13-III 8.555.500 9.967.200 11.378.900 4.851.500 5.652.000 6.452.500
BAWAH KULIT DAN PAYUDARA
(BERAT)
Severity II : Pulmonary Hypertension (I27.1/ I27.2 ) , Heart Failure (I50.9/ I50.1), Atrial Fibrilasi (I48), Junctional rhytm (I49.2), PAC (I49.1),
sick sinus syndrome (I49.5), SVT (I47.1), Anemia (D64.9) , effusi perikardium(I31.3), Hiper/ Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis
(E87.2 / E87.3), Hiper/ Hiponatremia ( E87.0/ E87.1)
Severity III : Shock Cardiogenik (R57.0), Cardiac Arrest (I46.0/I46.9) , effusi pleura (J90/J91), pneumonia (J18.9), PVC (I49.3), VF (I49. 0), VT
(I47.2)
FRAKTURCOSTA
ICD X: ICD IX:
• Multiple fractures of ribs, closed S22.40 Internal fixation of bone without fracture reduction on
• Flail chest, open S22.51 scapula, clavicle, and thorax (ribs and sternum) 78.51
• Flail chest, closed S22.50
• Contusion of thorax S20.2
Top up: Exploratory thoracotomy (34.02) Rp. 10,142,700
pada RStipe A(Rp 7,097,900 tipe B)

KODE DESKRIPSI
INACB
GS KELAS 3 KELAS 2 KELAS 1 KELAS 3 KELAS 2 KELAS 1
PROSEDUR SISTEM
J-1-30-I 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
PERNAFASAN KOMPLEKS
(RINGAN)
PROSEDUR SISTEM
J-1-30-II 23.742.000 27.659.500 31.576.900 18.728.700 21.819.000 24.909.200
PERNAFASAN KOMPLEKS
(SEDANG)
PROSEDUR SISTEM 44.660.300 52.029.300 59.398.200 30.580.500 35.626.300 40.672.000
J-1-30-III
PERNAFASAN KOMPLEKS
(BERAT)
Severity III : Shock Cardiogenik (R57.0), Cardiac Arrest (I46.0/I46.9) , effusi pleura (J90/J91), pneumonia (J18.9), PVC(I49.3),
VF(I49. 0), VT(I47.2)
FRAKTURSTERNUM
ICD X: ICD IX:
Fracture of sternum S22.2 Primer Internal fixation of bone without fracture reduction on scapula,
Disruption of operation wound, not elsewhere classified T81.3 clavicle, and thorax (ribs and sternum) 78.51
Sekunder Application of pressure dressing 93.56
Application of external fixation device, scapula, clavicle, and
thorax (ribs and sternum)78.11

DESKRIPSI
INACB
GS
PROSEDUR SISTEM
J-1-30-I PERNAFASAN 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
KOMPLEKS (RINGAN)
PROSEDUR SISTEM
J-1-30-II PERNAFASAN 23.742.000 27.659.500 31.576.900 18.728.700 21.819.000 24.909.200
KOMPLEKS (SEDANG)
PROSEDUR SISTEM
J-1-30-III PERNAFASAN 44.660.300 52.029.300 59.398.200 30.580.500 35.626.300 40.672.000
KOMPLEKS (BERAT)
(I49. 0), VT(I47.2)
INJURYOF TRACHEA
ICD X:
Injury of thoracic trachea, with open wound into thoracic cavity S27.51 Primer
ICD IX :
Suture of laceration of trachea 31.71
Insertion of intercostal catheter for drainage 34.04

KODE
DESKRIPSI
INA-
PROSEDUR SISTEM PERNAPASAN

J-1-20-I 35.243.900 41.059.100 46.874.400 19.229.600 22.402.500 25.575.400
NON-KOMPLEKS (RINGAN)
J-1-20 PROSEDUR SISTEM

- II PERNAPASAN NON-KOMPLEKS 36.905.100 42.994.400 49.083.800 22.324.000 26.007.500 29.691.000
(SEDANG)
J-1-20 PROSEDUR SISTEM
46.515.700 54.190.700 61.865.800 31.562.600 36.770.500 41.978.300
- III PERNAPASAN NON-KOMPLEKS
(BERAT)
(I49. 0), VT(I47.2)
INJURYOF BRONCUS
ICDX: ICDIX:
Injury of bronchus Other repair and plastic operations on bronchus 33.48
S27.4 Insertion of intercostal catheter for drainage 34.04
Interstitial emphysema Other and unspecified ablation of lung lesion or tissue 32.26
J98.2 Exploratory thoracotomy 34.02
Removal of thoracotomy tube or pleural cavity drain 97.41

KODE
INA- DESKRIPSI
PROSEDUR SISTEM
J-1-10-I PERNAFASAN SANGAT 35.651.800 41.534.400 47.416.900 21.170.000 24.663.100 28.156.100
KOMPLEKS (RINGAN)
PROSEDUR SISTEM
J-1-10-II PERNAFASAN SANGAT 39.314.400 45.801.300 52.288.200 27.589.400 32.141.700 36.693.900
KOMPLEKS (SEDANG)
PROSEDUR SISTEM 46.983.600 54.735.800 62.488.100 32.083.600 37.377.400 42.671.200
J-1-10-III PERNAFASAN SANGAT
KOMPLEKS (BERAT)
PAC (I49.1), sick sinus syndrome (I49.5), SVT (I47.1), Anemia (D64.9) , effusi perikardium(I31.3), Hiper/ Hipokalemia
Severity III : Shock Cardiogenik (R57.0), Cardiac Arrest (I46.0/I46.9) , effusi pleura (J90/J91), pneumonia (J18.9), PVC (I49.3), VF
(I49. 0), VT(I47.2)
INJURYOF INTRATHORACICORGAN
ICD X:
• Injury of other specified intrathoracic organs, without open wound into thoracic cavity S27.80
ICD IX :
• Repair of diaphragmatic hernia with thoracic approach, not otherwise specified 53.80

KODE
DESKRIPSI
INA-
PROSEDUR SISTEM
J-1-30-I PERNAFASAN 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
KOMPLEKS (RINGAN)
PROSEDUR SISTEM
J-1-30-II PERNAFASAN 23.742.000 27.659.500 31.576.900 18.728.700 21.819.000 24.909.200
KOMPLEKS (SEDANG)
PROSEDUR SISTEM
J-1-30-III PERNAFASAN 44.660.300 52.029.300 59.398.200 30.580.500 35.626.300 40.672.000
KOMPLEKS (BERAT)
(I49. 0), VT(I47.2)
EMFISEMA INTERSTITIAL
ICD X: ICD IX:
• Emphysema interstitial J98.2 • Other incision with drainage of skin & SCtissue 86.04

KODE DESKRIPSI
INACB
GS
PLEURAL EFUSI DAN
J-4-20-I 5.640.300 6.570.900 7.501.500 4.743.000 5.525.600 6.308.200
PNEUMOTORAK
(RINGAN)
PLEURAL EFUSI DAN
J-4-20-II
PNEUMOTORAK 7.985.100 9.302.600 10.620.100 6.571.300 7.655.500 8.739.800
(SEDANG)
PLEURAL EFUSI DAN
J-4-20-III 8.946.000 10.422.100 11.898.100 7.941.800 9.252.200 10.562.600
PNEUMOTORAK
(BERAT)
(I49. 0), VT(I47.2)
MALIGNANT NEOPLASMA OF BRONCUSAND LUNG (1)
ICDX : ICDIX :
Malignant neoplasm, bronchus or lung, unspecified C34.9 • Insertion of intercostal catheter for drainage 34.04
• Other and unspecified ablation of lung lesion or tissue 32.26
• Other and unspecified segmental resection of lung 32.39
• Thoracoscopic segmental resection of lung 32.30
Top up: Exploratory thoracotomy (34.02) Rp. 10,142,700 pada RS tipe A • Other local excision or destruction of lesion or tissue of lung 32.29
(Rp 7,097,900 tipe B) • Thoracoscopic excision of lesion or tissue of lung 32.20

KODE
DESKRIPSI
INA-
PROSEDUR SISTEM
J-1-30-I 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
PERNAFASAN KOMPLEKS
(RINGAN)
PROSEDUR SISTEM
J-1-30-II 23.742.000 27.659.500 31.576.900 18.728.700 21.819.000 24.909.200
PERNAFASAN KOMPLEKS
(SEDANG)
PROSEDUR SISTEM
J-1-30-III 44.660.300 52.029.300 59.398.200 30.580.500 35.626.300 40.672.000
PERNAFASAN KOMPLEKS
(BERAT)
(I49. 0), VT(I47.2)
ICDX : ICDIX :
Malignant neoplasm, bronchus or lung, unspecified C34.9 • Insertion of intercostal catheter for drainage 34.04
• Thoracoscopic pneumonectomy 32.50
• Other and unspecified pneumonectomy 32.59
• Thoracoscopic lobectomy of lung 32.41
• Other lobectomy of lung 32.49

KODE
DESKRIPSI
INA-
CBGS
PROSEDUR SISTEM
J-1-10-I PERNAFASAN SANGAT 35.651.800 41.534.400 47.416.900 21.170.000 24.663.100 28.156.100
KOMPLEKS (RINGAN)
PROSEDUR SISTEM
KOMPLEKS (SEDANG)
PROSEDUR SISTEM
J-1-10-III PERNAFASAN SANGAT 46.983.600 54.735.800 62.488.100 32.083.600 37.377.400 42.671.200
KOMPLEKS (BERAT)
(I49. 0), VT(I47.2)
ICD X :
Malignant neoplasm, bronchus or lung, unspecified C34.9
ICD IX :

KODE
DESKRIPSI
INA-
CBGS
J-4-14-I TUMOR PARU (RINGAN) 6.447.000 7.510.700 8.574.400 4.511.600 5.256.000 6.000.400
J-4-14-II TUMOR PARU (SEDANG) 10.491.100 12.222.100 13.953.100 7.568.800 8.817.600 10.066.400
J-4-14-III TUMOR PARU (BERAT) 12.412.000 14.460.000 16.507.900 8.954.600 10.432.100 11.909.600
(I49. 0), VT(I47.2)
TUMOR MEDIASTINUM (1)
ICDX : ICDIX :
Neoplasm of uncertain or unknown behaviour of Mediastinum D38.3 • Biopsy of thymus 07.16
• Thymectomy, not otherwise specified 07.80
• Partial excision of thymus 07.81
• Total excision of thymus 07.82
• Other and unspecified thoracoscopic operations on thymus 07.98

KODE
DESKRIPSI
INA-
CBGS
PROSEDUR PADA DARAH DAN ORGAN

D-1-20-I
PEMBENTUK DARAH LAIN-LAIN (RINGAN)
7.541.600 8.786.000 10.030.400 5.277.700 6.148.500 7.019.400

D-1-20-II
PEMBENTUK DARAH LAIN-LAIN (SEDANG) 20.783.600 24.212.900 27.642.200 14.544.400 16.944.200 19.344.100

D-1-20-III
PEMBENTUK DARAH LAIN-LAIN (BERAT) 32.968.800 38.408.600 43.848.500 23.071.700 26.878.600 30.685.400
(I49. 0), VT(I47.2)
TUMOR MEDIASTINUM (2)
ICD X : Neoplasm of uncertain or unknown behaviour of Mediastinum ICDIX :
D38.3 • Mediastinoscopy 34.22
Benign neoplasm, mediastinum D15.2 • Biopsy of chest wall 34.23
• Open mediastinum biopsy 34.26
Top up: Exploratory thoracotomy (34.02) Rp. 10,142,700 pada RStipe • Other diagnostic procedures on mediastinum 34.29
A(Rp 7,097,900 tipe B) • Excision or destruction of lesion or tissue of mediastinum 34.3

KODE
DESKRIPSI
INA-
CBGS
PROSEDURSISTEM PERNAFASANKOMPLEKS
J-1-30-I 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
(RINGAN)
J-1-30-II 23.742.000 27.659.500 31.576.900 18.728.700 21.819.000 24.909.200
(SEDANG)
J-1-30-III PROSEDURSISTEM PERNAFASAN KOMPLEKS(BERAT)

44.660.300 52.029.300 59.398.200 30.580.500 35.626.300 40.672.000
(I49. 0), VT(I47.2)
KARSINOMA ESOFAGUS(1)
ICDX : Malignant neoplasm, thoracic part of oesophagus ICDIX :
C15.1 • Incision of esophageal web 42.01
• Other incision of esophagus 42.09
• Cervical esophagostomy 42.11
• Other external fistulization of esophagus 42.19
• Other esophagoscopy 42.23
• Open biopsy of esophagus 42.25
• Local excision of other lesion or tissue of esophagus 42.32

DESKRIPSI
INACB
GS
PROSEDUR DUODENUM, ESOFAGUS &
K-1-30-I LAMBUNG NON KOMPLEKS (RINGAN) 11.089.400 12.919.100 14.748.900 8.560.300 9.972.800 11.385.200

K-1-30-II
LAMBUNG NON KOMPLEKS (SEDANG) 18.113.500 21.102.200 24.091.000 12.677.200 14.768.900 16.860.600

K-1-30-III
LAMBUNG NON KOMPLEKS (BERAT) 24.924.400 29.036.900 33.149.500 17.981.600 20.948.600 23.915.600
(I49. 0), VT(I47.2)
KARSINOMA ESOFAGUS(2)
ICDX : ICDIX :
Malignant neoplasm, thoracic part of oesophagus C15.1 • Partial esophagectomy 42.41
• Total esophagectomy 42.42
• Intrathoracic esophageal anastomosis with other interposition
42.58
• Other antesternal esophageal anastomosis with interposition
42.68

KODE
DESKRIPSI
INA-
PROSEDUR INTESTINAL
K-1-20-I KOMPLEKS (RINGAN) 17.246.000 20.091.600 22.937.200 12.442.100 14.495.000 16.548.000
PROSEDUR INTESTINAL
K-1-20-II
KOMPLEKS (SEDANG) 24.088.800 28.063.400 32.038.100 17.378.800 20.246.300 23.113.800
PROSEDUR INTESTINAL
K-1-20-III 35.172.200 40.975.600 46.779.000 25.374.900 29.561.700 33.748.600
KOMPLEKS (BERAT)
(I49. 0), VT(I47.2)
MALIGNANT PLEURALEFFUSION (1)
ICD X:
• Secondary malignant neoplasm of pleura C78.2 PRIMER
• Pleural effusion, not elsewhere classified J90
ICD IX :

KODE
DESKRIPSI
INA-
CBGS
J-4-14-I TUMOR PARU (RINGAN) 6.447.000 7.510.700 8.574.400 4.511.600 5.256.000 6.000.400
J-4-14-II TUMOR PARU (SEDANG) 10.491.100 12.222.100 13.953.100 7.568.800 8.817.600 10.066.400
J-4-14-III TUMOR PARU (BERAT) 12.412.000 14.460.000 16.507.900 8.954.600 10.432.100 11.909.600
ICD X: ICD IX:
• Secondary malignant neoplasm of pleura C78.2 à PRIMER • Insertion of intercostal catheter for drainage 34.04
• Pleural effusion, not elsewhere classified J90 • Decortication of lung 34.51
• Scarification of pleura 34.6

KODE
DESKRIPSI
INA-
CBGS
PROSEDUR SISTEM
J-1-10-I PERNAFASAN 35.651.800 41.534.400 47.416.900 21.170.000 24.663.100 28.156.100
SANGAT KOMPLEKS
(RINGAN)
PROSEDUR SISTEM
J-1-10-II PERNAFASAN 39.314.400 45.801.300 52.288.200 27.589.400 32.141.700 36.693.900
SANGAT KOMPLEKS
(SEDANG)
PROSEDUR SISTEM
J-1-10-III PERNAFASAN 46.983.600 54.735.800 62.488.100 32.083.600 37.377.400 42.671.200
SANGAT KOMPLEKS
(BERAT)
ICDX : ICDIX :
• Secondary malignant neoplasm of pleura C78.2 à PRIMER • Insertion of intercostal catheter for drainage 34.04
• Pleural effusion, not elsewhere classified J90 • Thoracoscopic pleural biopsy 34.20
• Transpleural thoracoscopy 34.21
Top up: Exploratory thoracotomy (34.02) Rp. 10,142,700 pada RStipe
A(Rp 7,097,900 tipe B)

KODE
DESKRIPSI
INACB
PROSEDUR SISTEM
J-1-30-I PERNAFASAN 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
KOMPLEKS (RINGAN)
PROSEDUR SISTEM
J-1-30-II PERNAFASAN 23.742.000 27.659.500 31.576.900 18.728.700 21.819.000 24.909.200
KOMPLEKS (SEDANG)
PROSEDUR SISTEM
J-1-30-III PERNAFASAN 44.660.300 52.029.300 59.398.200 30.580.500 35.626.300 40.672.000
KOMPLEKS (BERAT)
MALIGNANT NEOPLASMA OF THYMUS
ICD X: ICD IX:
• Malignant neoplasm of thymus C37 Incision of chest wall 34.01
Thoracoscopic excision of lesion or tissue of lung 32.20


KODE
DESKRIPSI
INACB
PROSEDUR SISTEM
J-1-30-I PERNAFASAN 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
KOMPLEKS (RINGAN)
PROSEDUR SISTEM
J-1-30-II PERNAFASAN 23.742.000 27.659.500 31.576.900 18.728.700 21.819.000 24.909.200
KOMPLEKS (SEDANG)
PROSEDUR SISTEM
J-1-30-III PERNAFASAN 44.660.300 52.029.300 59.398.200 30.580.500 35.626.300 40.672.000
KOMPLEKS (BERAT)
(I49. 0), VT(I47.2)
BENIGN LIPOMATOUSNEOPLASMA
ICD X: ICD IX:
• Benign lipomatous neoplasm, unspecified D17.9 Excision of lesion of other soft tissue 83.39

KODE DESKRIPSI
INACBGS KELAS 3 KELAS 2 KELAS 1 KELAS 3 KELAS 2 KELAS 1
M-1-50-I PROSEDUR JARINGAN LUNAK (RINGAN) 7.552.600 8.798.800 10.044.900 5.448.800 6.347.900 7.246.900
M-1-50-II PROSEDUR JARINGAN LUNAK (SEDANG) 13.786.600 16.061.400 18.336.200 9.946.300 11.587.400 13.228.500
M-1-50-III PROSEDUR JARINGAN LUNAK (BERAT) 22.643.600 26.379.800 30.116.000 16.336.100 19.031.600 21.727.000
Severity III : Shock Cardiogenik (R57.0), Cardiac Arrest (I46.0/I46.9) , effusi pleura (J90/J91), pneumonia (J18.9), PVC(I49.3),
VF(I49. 0), VT(I47.2)
BENIGN NEOPLASMA, LOWER JAWBONE
ICD X:
• Benign neoplasm, lower jaw bone D16.5
ICD IX :
• Excision of bone for graft, scapula, clavicle, and thorax (ribs and sternum) 77.71

KODE
DESKRIPSI
INA-
CBGS
PROSEDUR SISTEM PERNAFASAN

J-1-30-I 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
KOMPLEKS (RINGAN)

J-1-30-II 23.742.000 27.659.500 31.576.900 18.728.700 21.819.000 24.909.200
KOMPLEKS (SEDANG)

J-1-30-III 44.660.300 52.029.300 59.398.200 30.580.500 35.626.300 40.672.000
KOMPLEKS (BERAT)
(I49. 0), VT(I47.2)
FOREIGN BODYIN RESPIRATORYSYSTEM
ICD X: ICD IX :
• Foreign body in bronchus T17.5 • Exploratory thoracotomy 34.02
• Foreign body in other and multiple parts of respiratory • Other operations on bronchus 33.98
tract T17.8 • Insertion of intercostal catheter for drainage 34.04
• Foreign body in respiratory tract, part unspecified • Removal of thoracotomy tube or pleural cavity drain 97.41
T17.9

KODE
DESKRIPSI
INA-
CBGS
PROSEDUR SISTEM
J-1-10-I 35.651.800 41.534.400 47.416.900 21.170.000 24.663.100 28.156.100
PERNAFASAN SANGAT
KOMPLEKS (RINGAN)
PROSEDUR SISTEM
KOMPLEKS (SEDANG)
PROSEDUR SISTEM
J-1-10-III PERNAFASAN SANGAT 46.983.600 54.735.800 62.488.100 32.083.600 37.377.400 42.671.200
KOMPLEKS (BERAT)
(I49. 0), VT(I47.2)
CONGENITALMALFORMATIONSOFLUNG (1)
ICDX : ICDIX :
• Other congenital malformations of lung Q33.8 • Insertion of intercostal catheter for drainage 34.04
• Ectopic tissue in lung Q33.5 • Other and unspecified ablation of lung lesion or tissue 32.26
Top up: Exploratory thoracotomy (34.02) Rp. 10,142,700 pada • Thoracoscopic segmental resection of lung 32.30
RStipe A(Rp 7,097,900 tipe B) • Other local excision or destruction of lesion or tissue of lung 32.29
• Thoracoscopic excision of lesion or tissue of lung 32.20

KODE DESKRIPSI
INA-
PROSEDURSISTEM PERNAFASAN
J-1-30-I
KOMPLEKS(RINGAN) 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
PROSEDURSISTEM PERNAFASAN
J-1-30-II
KOMPLEKS(SEDANG) 23.742.000 27.659.500 31.576.900 18.728.700 21.819.000 24.909.200
J-1-30-III
(BERAT) 44.660.300 52.029.300 59.398.200 30.580.500 35.626.300 40.672.000
(I49. 0), VT(I47.2)
ICDX : ICDIX :
• Other congenital malformations of lung Q33.8 • Insertion of intercostal catheter for drainage 34.04
• Ectopic tissue in lung Q33.5 • Thoracoscopic pneumonectomy 32.50

KODE
DESKRIPSI
INA-
CBGS
J-1-10-I PROSEDUR SISTEM

PERNAFASAN SANGAT 35.651.800 41.534.400 47.416.900 21.170.00024.663.10028.156.100
KOMPLEKS (RINGAN)
J-1-10-II PROSEDUR SISTEM
PERNAFASAN SANGAT 39.314.400 45.801.300 52.288.200 27.589.40032.141.70036.693.900
KOMPLEKS (SEDANG)
J-1-10-III PROSEDUR SISTEM
PERNAFASAN SANGAT 46.983.600 54.735.800 62.488.100 32.083.600 37.377.400 42.671.200
KOMPLEKS (BERAT)
(I49. 0), VT(I47.2)
ICDX : ICDIX :
• Other congenital malformations of lung Q33.8 • Thoracentesis 34.91
• Ectopic tissue in lung Q33.5 • Insertion of intercostal catheter for drainage 34.04

KODE
DESKRIPSI
INA-
CBGS
GEJALA, TANDA DAN DIAGNOSIS SISTEM

J-4-21-I
PERNAFASAN LAIN-LAIN 3.103.700 3.615.800 4.127.900 2.860.100 3.332.000 3.803.900
(RINGAN)
J-4-21-II
(SEDANG)
J-4-21-III
(BERAT)
(I49. 0), VT(I47.2)
KELAINAN DIAFRAGMA (HERNIA DAN EVENTRASIO DIAFRAGMA)
ICDX : ICDIX :
• Diaphragmatic hernia without obstruction or gangrene • Repair of diaphragmatic hernia with thoracic approach, not otherwise
K44.9 à PRIMER specified 53.80
• Disorders of diaphragm • Plication of the diaphragm 53.81
J98.6 • Repair of parasternal hernia 53.82
Top up: Exploratory thoracotomy (34.02) Rp. 10,142,700 pada RS • Laparoscopic repair of diaphragmatic hernia with thoracic approach
tipe A 53.83
• Other and open repair of diaphragmatic hernia, with thoracic approach
53.84

KODE DESKRIPSI
INA-

J-1-30-I 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
KOMPLEKS (RINGAN)
J-1-30-II 23.742.000 27.659.500 31.576.900 18.728.700 21.819.000 24.909.200
(SEDANG)
J-1-30-III PROSEDURSISTEM PERNAFASANKOMPLEKS(BERAT) 44.660.300 52.029.300 59.398.200 30.580.500 35.626.300 40.672.000
(I49. 0), VT(I47.2)
ACHALASIA ESOFAGUS, DIVERTIKULUM ESOFAGUS, STRIKTUR
ESOFAGUS
ICD X : Achalasia of cardia K22.0
ICD IX :
• Esophagomyotomy 42.7
• Local excision of esophageal diverticulum 42.31
• Suture of laceration of esophagus 42.82
• Repair of esophageal fistula, not elsewhere classified 42.84
• Repair of esophageal stricture 42.85

DESKRIPSI
INA-
CBGS
PROSEDUR INTESTINAL 17.246.000 20.091.600 22.937.200
K-1-20-I 12.442.100 14.495.000 16.548.000
KOMPLEKS (RINGAN)

K-1-20-II 17.378.800 20.246.300 23.113.800
KOMPLEKS (SEDANG)

K-1-20-III 25.374.900 29.561.700 33.748.600
KOMPLEKS (BERAT)
(I49. 0), VT(I47.2)
SIMPLEPENUMOTORAKS
ICD X: ICD IX:
• Pneumothorax, unspecified J93.9 • Thoracentesis 34.91

KODE DESKRIPSI
INACB
GS
PLEURAL EFUSI DAN
J-4-20-I 5.640.300 6.570.900 7.501.500 4.743.000 5.525.600 6.308.200
PNEUMOTORAK
(RINGAN)
PLEURAL EFUSI DAN
J-4-20-II
PNEUMOTORAK 7.985.100 9.302.600 10.620.100 6.571.300 7.655.500 8.739.800
(SEDANG)
PLEURAL EFUSI DAN
J-4-20-III
PNEUMOTORAK 8.946.000 10.422.100 11.898.100 7.941.800 9.252.200 10.562.600
(BERAT)
(I49. 0), VT(I47.2)
PERICARDIAL EFFUSION INFLAMATORIK
ICD X:
• Disease of pericardium, unspecified I31.9
ICD IX :
• Pericardiotomy 37.12

DESKRIPSI
INA-
CBGS
I-1-06-I PROSEDUR KARDIOTORASIK LAIN

(RINGAN) 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800
I-1-06-II PROSEDUR KARDIOTORASIK LAIN

(SEDANG) 73.637.100 85.787.200 97.937.400 51.360.200 59.834.700 68.309.100
PROSEDUR KARDIOTORASIK LAIN

I-1-06-III 87.862.700 102.360.000 116.857.400 61.706.800 71.888.400 82.070.000
(BERAT)
(I49. 0), VT(I47.2)
PYOTHORAX (1)
ICD X : Pyothorax without fistula J86.9 / Benign neoplasm, mesothelial tissue of pleura D19.0
ICDIX :
• Other local excision or destruction of lesion or tissue of lung 32.29
Top up: Exploratory thoracotomy (34.02) Rp. 10,142,700 pada RStipe A(Rp 7,097,900 tipe B)
KODE
DESKRIPSI
INACB
KELAS 3 KELAS 2 KELAS 1 KELAS 3 KELAS KELAS 1
GS 2
J-1-30-I 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
(RINGAN)
J-1-30-II 23.742.000 27.659.500 31.576.900 18.728.70021.819.00024.909.200
(SEDANG)
PROSEDURSISTEM PERNAFASAN KOMPLEKS(BERAT)
J-1-30-III 44.660.300 52.029.300 59.398.200 30.580.500 35.626.300 40.672.000
(I49. 0), VT(I47.2)
PYOTHORAX (2)
ICDIX :
• Decortication of lung 34.51
• Thoracoscopic decortication of lung 34.52

KODE
DESKRIPSI
INACB

KOMPLEKS (RINGAN)
KOMPLEKS (SEDANG)
KOMPLEKS (BERAT)
Severity II : Pulmonary Hypertension (I27.1/ I27.2 ) , Heart Failure (I50.9/ I50.1), Atrial Fibrilasi (I48), Junctional rhytm (I49.2), PAC (I49.1), sick sinus
syndrome (I49.5), SVT (I47.1), Anemia (D64.9) , effusi perikardium(I31.3), Hiper/ Hipokalemia (E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3), Hiper/
Hiponatremia ( E87.0/ E87.1)
Severity III : Shock Cardiogenik (R57.0), Cardiac Arrest (I46.0/I46.9) , effusi pleura (J90/J91), pneumonia (J18.9), PVC(I49.3), VF (I49. 0), VT (I47.2)
PYOTHORAX (3)
ICD IX :

KODE
DESKRIPSI
INA-
CBGS
PERADANGAN DAN
J-4-15-I INFEKSI
4.665.100 5.434.800 6.204.600 4.431.900 5.163.100 5.894.400
PERNAPASAN
(RINGAN)
PERADANGAN DAN
J-4-15-II
INFEKSI
7.725.400 9.000.100 10.274.800 5.767.700 6.719.300 7.671.000
PERNAPASAN
(SEDANG)
PERADANGAN DAN
J-4-15-III 14.031.600 16.346.800 18.662.000 7.308.800 8.514.700 9.720.700
INFEKSI
PERNAPASAN (BERAT)
(I49. 0), VT(I47.2)
MEDIASTINITIS
ICD X:
• Diseases of mediastinum, not elsewhere classified J98.5
ICD IX :
• Temporary tracheostomy 31.1
• Mediastinal tracheostomy 31.21
• Other permanent tracheostomy 31.29

KODE
DESKRIPSI
INACB
GS KELAS 3 KELAS 2 KELAS 1 KELAS 3 KELAS KELAS 1
2
J-1-30-I 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
(RINGAN)
J-1-30-II 23.742.000 27.659.500 31.576.900 18.728.70021.819.00024.909.200
KOMPLEKS (SEDANG)
(I49. 0), VT(I47.2)
ABSESPARU (1)
ICD X: Abscess of lung with pneumonia J85.1
ICD IX :
• Other local excision or destruction of lesion or tissue of lung 32.29
DESKRIPSI
INACB
KELAS 3 KELAS 2 KELAS 1 KELAS 3 KELAS KELAS 1
GS 2
J-1-30-I 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100
(RINGAN)
J-1-30-II 23.742.000 27.659.500 31.576.900 18.728.70021.819.00024.909.200
(SEDANG)
(I49. 0), VT(I47.2)
ABSESPARU (2)
ICD IX :

DESKRIPSI
INACB
GS

KOMPLEKS (RINGAN)
KOMPLEKS (SEDANG)
KOMPLEKS (BERAT)
(E87.5/E87.6) Acidosis / Alkalosis (E87.2 / E87.3), Hiper/ Hiponatremia (E87.0/ E87.1)
(I49. 0), VT(I47.2)
ABSESPARU (3)
ICD IX :

KODE DESKRIPSI
INACB
J-1-30-I PROSEDURSISTEM PERNAFASAN 10.676.600 12.438.200 14.199.900 8.255.000 9.617.100 10.979.100

KOMPLEKS(RINGAN)
J-1-30-II PROSEDURSISTEM PERNAFASAN 23.742.000 27.659.500 31.576.900 18.728.700 21.819.000 24.909.200

KOMPLEKS(SEDANG)
(I49. 0), VT(I47.2)
INFEKSI DAERAHOPERASI(IDO)
ICD X:
Infection following a procedure, not elsewhere classified T81.4 Primer
ICD IX :
Excisional debridement of wound, infection, or burn 86.22

KODE
DESKRIPSI
INACB
A-4-11-I INFEKSI SESUDAH OPERASI &

TRAUMA (RINGAN) 4.917.700 5.729.100 6.540.500 3.796.200 4.422.500 5.048.900
A-4-11-II INFEKSI SESUDAH OPERASI &

TRAUMA (SEDANG) 6.465.700 7.532.500 8.599.300 4.991.100 5.814.600 6.638.200
A-4-11- INFEKSI SESUDAH OPERASI &
III TRAUMA (BERAT) 8.841.500 10.300.300 11.759.200 6.631.100 7.725.200 8.819.400
(I49. 0), VT(I47.2)
TINDAKAN VENTILATOR > 96 JAM (4X24 JAM)
ICD IX :
Continuous invasive mechanical ventilation for 96 consecutive hours or more 96.72

KODE
DESKRIPSI
INACB
VENTILASI MEKANIKAL LONG

TERM TANPA TRAKEOSTOMI
J-1-02-I 62.014.000 72.246.300 82.478.600 40.990.500 47.753.900 54.517.400
(RINGAN)

J-1-02
TERM TANPA TRAKEOSTOMI 78.249.600 91.160.800 104.072.000 52.026.400 60.610.800 69.195.100
- II (SEDANG)
J-1-02
TERM TANPA TRAKEOSTOMI 91.540.900 106.645.200 121.749.400 67.795.900 78.982.200 90.168.500
- III (BERAT)
(I49. 0), VT(I47.2)
TINDAKAN VENTILATOR < 96 JAM (4X24 JAM)
ICD IX :
Continuous invasive mechanical ventilation for less tahn 96 consecutive hours 96.71

KODE
DESKRIPSI
INACB
PROSEDUR SISTEM PERNAPASAN

J-1-20-I NON-KOMPLEKS (RINGAN) 35.243.900 41.059.100 46.874.400 19.229.600 22.402.500 25.575.400
J-1-20 PROSEDUR SISTEM PERNAPASAN

- II NON-KOMPLEKS (SEDANG) 36.905.100 42.994.400 49.083.800 22.324.000 26.007.500 29.691.000
J-1-20 PROSEDUR SISTEM PERNAPASAN

- III NON-KOMPLEKS (BERAT) 46.515.700 54.190.700 61.865.800 31.562.600 36.770.500 41.978.300
(I49. 0), VT(I47.2)
KETENTUAN KODING TORAKS
• TB dengan pneumonia bisa dikoding terpisah jika terbukti terinfeksi pada episode yang berbeda
• TB + HIV = B20.0
• Pada TB anak P37.0
• Sepsis dengan Pneumonia = A40.3
• Effusi pleura dengan positif sel kanker dari analisa cairan pleura bisa dikoding C78.2
• Pneumonia dengan prasyarat harus ditemukan tampilan fibroinfiltrat di foto rontgen dada disertai keluhan lain yang mendukung. (J18.9)
• Pneumonia + PPOK = J44.0
• Bronkitis pada dewasa (J40); Pada anak2 < 15 th = J20
• Haemopytisis (R04.2) = batuk darah yang tidak diketahui penyebabnya
• hiper kalemi mohon disertakan terapi dan lab pendukung
Foreign body in bronchus T17.5

Foreign body in other and T17.8
multiple parts of respiratory
tract
Foreign body in respiratory T17.9
tract, part unspecified
Foreign body in trachea T17.4
Foreign body in larynx T17.3
Foreign body in nostril T17.1
Foreign body in pharynx T17.2

Foreign body in nasal sinus T17.0

• CPR (99.60)
• Hipertensi
pendukung
CODING BPJS
VASKULAR
ANEURISMA AORTA
Diagnosis : AAA(I71.4) ; TAA(I71.2 )
Tindakan
• Resection of vessel with replacement, unspecified (38.40)
• Other surgical occlusion of vessels, unspecified site (38.80)
TOPUP:
• EVAR/TEVAR Prosthesis (39.71) à 103,378,500 (RSTipe A); 96,957,300 (RSTipe B)
KodeINA- Deskripsi TIPE A TIPE B
CBG
I-1-20-I Prosedur sistem peredaran
21.764.000 25.355.000 28.946.100 15.701.600 18.292.300 20.883.100
darah lain-lain (ringan)
I-1-20-II Prosedur sistem peredaran
27.189.200 31.675.400 36.161.700 19.617.500 22.854.400 26.091.300
darah lain-lain (sedang)
I-1-20-III Prosedur sistem peredaran
32.022.200 37.305.900 42.589.600 25.778.600 30.032.100 34.285.500
darah lain-lain (berat)
Comorbid
• Severity I : Hipertensi (I10)
• Severity II : DM (E11.8)/ Anemia (D64.9)/ TB Paru (A16)/ Gagal jantung (I50.9)/ CKDst.V (N18)
• Severity III : Pneumonia (J18.9)/Efusi Pleura (J90)/ Sepsis (A41.8), Coagulopathy (D68.9)/ Disruption of operation
wound (T81.3)
ANEURISMA ARTERI PERIFER
Pilihan diagnosis: Aneurysma of… Pilihan Tindakan
• Artery of upper extremity (ICD XI72.1) • Angiography (88.67) -- tambahan
• Artery of lower extremity (ICD XI72.4) • Angioplasty (39.50)
• Carotid artery (ICD XI72.0) • Clipping of aneurysm (39.51)
• Illiac artery (ICD XI172.3) • Repair pseudoaneurisma (39.59)
• Other specified arteries (ICD XI72.8) • Other repair of aneurysm (39.52)
• Renal artery (ICD XI72.2)
• Unspecified site (ICD XI72.9)

CBG
21.764.000 25.355.000 28.946.100 15.701.600 18.292.300 20.883.100
27.189.200 31.675.400 36.161.700 19.617.500 22.854.400 26.091.300
32.022.200 37.305.900 42.589.600 25.778.600 30.032.100 34.285.500
Comorbid
wound (T81.3)
STENOSIS/OKLUSIARTERI PERIFER(1)
Diagnosis Tindakan
• Occlusion and stenosis of extremities artery (I65.2) • Angiography (88.67)
• Atherosclerosis of other arteries (I70.8)
• Generalized and unspecified atherosclerosis (I70.9)

CBG Kelas 3 Kelas 2 Kelas 1 Kelas 3 Kelas 2 Kelas 1
Penyakit pembuluh darah
I-4-15-I
perifer dan lain-lain 4.971.200 5.791.400 6.611.600 4.580.900 5.336.700 6.092.500
(ringan)
I-4-15-II perifer dan lain- 9.374.000 10.920.700 12.467.400 6.231.900 7.260.200 8.288.400
lain (sedang)
Penyakit pembuluh
I-4-15-III
darah perifer dan lain- 11.248.800 13.104.900 14.960.900 7.478.300 8.712.200 9.946.100
lain (berat)
Comorbid
wound (T81.3)
STENOSIS/OKLUSIARTERI PERIFER(2)
Diagnosis Tindakan
• Atherosclerosis of native arteries of the extremities • Angioplasty (39.50)
(I70.2 ) • Endarterectomy, upper limb vessels (ICD IX 38.13)
• Atherosclerosis of other arteries (I70.8)
• Endarterectomy, lower limb vessels (ICD IX 38.18)
• Generalized and unspecified atherosclerosis (I70.9)
• Endarterectomy, unspecified site (ICD IX38.10)

I-1-20-I Prosedur sistem
peredaran darah lain- 21.764.000 25.355.000 28.946.100 15.701.600 18.292.300 20.883.100
lain (ringan)
I-1-20-II Prosedur sistem
lain (sedang)
I-1-20-III Prosedur sistem
lain (berat)
Comorbid
wound (T81.3)
STENOSIS/OKLUSIARTERI CAROTID (1)
Diagnosis Tindakan
• Occlusion and stenosis of carotid artery (I65.2) • Angiography (88.67)

CBG
G-4-15-I Kecederaan Pembuluh
Darah Otak Non-Spesifik &
Penyumbatan Pre-Cerebral
5.982.100 6.969.100 7.956.100 4.186.200 4.876.900 5.567.600
Tanpa Infark (Ringan)
G-4-15-II Kecederaan Pembuluh
7.139.200 8.317.200 9.495.100 4.996.000 5.820.300 6.644.600
Tanpa Infark (Sedang)
G-4-15-III Kecederaan Pembuluh
10.076.400 11.739.000 13.401.500 7.051.500 8.215.000 9.378.400
Tanpa Infark (Berat)
Comorbid
wound (T81.3)
STENOSIS/OKLUSIARTERI CAROTID (2)
Diagnosis Tindakan
• Occlusion and stenosis of carotid artery (I65.2) • Angioplasty (39.50)
• Endarterectomy, upper limb vessels (ICD IX 38.13)
• Endarterectomy, lower limb vessels (ICD IX 38.18)
• Endarterectomy, unspecified site (ICD IX38.10)

lain (ringan)
lain (sedang)
lain (berat)
Comorbid
wound (T81.3)
STENOSIS/OKLUSIAORTATORAKALIS(1)
Diagnosis Tindakan
• Atherosclerosis of Aorta (ICD X: I70.0) • Angiography / phlebography of other specific sites
using contrast material (88.67)

CBG
I-4-15-I
(ringan)
Penyakit pembuluh
I-4-15-II darah perifer dan lain- 9.374.000 10.920.700 12.467.400 6.231.900 7.260.200 8.288.400
lain (sedang)
Penyakit pembuluh
I-4-15-III
lain (berat)
Comorbid
wound (T81.3)
STENOSIS/OKLUSIAORTATORAKALIS(2)
Diagnosis Tindakan
• Atherosclerosis of Aorta (ICD X: I70.0) • Angioplasty (39.50)
• Endarterectomy of other thoracic vessels (38.15)

CBG
Prosedur pembuluh
I-1-12-I
darah torasik kompleks 17.055.400 19.869.500 22.683.700 12.522.500 14.588.700 16.654.900
(ringan)
Prosedur pembuluh
I-1-12-II
(sedang)
Prosedur pembuluh
I-1-12-III
(berat)
Comorbid
wound (T81.3)
STENOSIS/OKLUSIAORTAABDOMINALIS(1)
Diagnosis Tindakan
• Atherosclerosis of Aorta (ICD X: I70.0) • Angiography (88.67)

I-4-15-I
(ringan)
Penyakit pembuluh
I-4-15-II darah perifer dan lain- 9.374.000 10.920.700 12.467.400 6.231.900 7.260.200 8.288.400
lain (sedang)
Penyakit pembuluh
I-4-15-III
lain (berat)
Comorbid
wound (T81.3)
STENOSIS/OKLUSIAORTAABDOMINALIS(2)
Diagnosis Tindakan
• Atherosclerosis of Aorta (ICD X: I70.0) • Angioplasty (39.50)
• Endarterectomy of other Abdominal vessels (38.16)

CBG
Prosedur pembuluh darah
I-1-13-I
abdominal komplek 16.543.400 19.273.100 22.002.800 12.526.000 14.592.800 16.659.600
(ringan)
Prosedur pembuluh
I-1-13-II darah abdominal
22.451.900 26.156.400 29.861.000 17.711.000 20.633.300 23.555.600
komplek
(sedang)
Prosedur pembuluh
I-1-13-III
darah abdominal 27.478.900 32.012.900 36.546.900 21.676.500 25.253.100 28.829.800
komplek (berat)
Comorbid
wound (T81.3)
STENOSIS/OKLUSIARTERI RENAL (1)
Diagnosis Tindakan
• Atherosclerosis of Renal Artery (ICD X: I70.1) • Angiography (88.67)

Penyakit ginjal dan
N-4-16-I
saluran urin lain-lain 5.397.400 6.288.000 7.178.600 3.935.100 4.584.400 5.233.700
(ringan)
Penyakit ginjal dan
N-4-16-II
(sedang)
Penyakit ginjal dan
N-4-16-III
(berat)
Comorbid
wound (T81.3)
STENOSIS/OKLUSIARTERI RENAL (2)
Diagnosis Tindakan
• Atherosclerosis of Renal Artery (ICD X: I70.1) • Angioplasty or atherectomy of other non-coronary
vessel (39.50)

CBG
lain (ringan)
lain (sedang)
lain (berat)
Comorbid
wound (T81.3)
ARTERIAL THROMBOSIS
Diagnosis : Embolism and thrombosis of other arteries (I82.8)
Tindakan :
• Endovaskular trombektomi (39.79)
• Tromboembolektomi (Other surgical occlusion of vessels, unspecified site) (38.80)
• Other (peripheral) vascular shunt or bypass (39.29)
lain (ringan)
lain (sedang)
lain (berat)
Comorbid
wound (T81.3)
DIABETIC WITH VASCULARCOMPLICATION (1)
Diagnosis :
• Non-insulin-dependent diabetes mellitus: With peripheral circulatory complications (E11.5); DM dengan CKD E10-13.2
• Non-insulin-dependent diabetes mellitus: With peripheral circulatory complications (ulcer, gangrene) (E14.5)
• Ulkus decubitus karena DM (L89)
Tindakan :
• Excisional debridement of wound, infection, or burn (86.22)
• Application of other wound dressing (93.57)

CBG
I-4-15-I
(ringan)
I-4-15-II
(sedang)
Penyakit pembuluh
I-4-15-III
lain (berat)
Comorbid
wound (T81.3)
Diagnosis : DM dengan Gangren E10-13.5
Tindakan : Amputation of toe (ICD IX84.11) (Mutilasi)
Kode Deskripsi TIPE A TIPE B

INA-CBG Kelas 3 Kelas 2 Kelas 1 Kelas 3 Kelas 2 Kelas 1
M-1-30-I Prosedur kaki 12.381.000 14.423.900 16.466.800
8.932.300 10.406.100 11.880.000
(ringan)
M-1-30-II Prosedur kaki 20.062.300 23.372.600 26.682.900
14.474.000 16.862.200 19.250.400
(sedang)
M-1-30-III Prosedur kaki (berat) 28.687.300 33.420.700 38.154.200 20.696.400 24.111.300 27.526.200
Comorbid
wound (T81.3)
Diagnosis : DM dengan Gangren (E10-13.5)
Tindakan :
• Lower limb amputation, not otherwise specified (84.10)
• Other amputation below knee (84.15)
• Amputation above knee (84.17)
• Amputation through foot (84.12)
• Amputation of ankle through malleoli of tibia and fibula (84.14)

M-1-02-I Amputasi (ringan) 13.470.100 15.692.600 17.915.200 9.718.000 11.321.400 12.924.900

M-1-02-II Amputasi (sedang) 22.097.000 25.743.000 29.389.100 15.941.900 18.572.300 21.202.700
M-1-02-III Amputasi (berat) 37.542.300 43.736.800 49.931.300 26.272.300 30.607.300 34.942.200
Comorbid
wound (T81.3)
KOMPRESI VENA CAVA (1)
Diagnosis : Compression of vein (ICD XI87.1)
Tindakan : Veno-venous bypass (ICD IX 39.29)

Prosedur pembuluh
I-1-12-I 17.055.400 19.869.500 22.683.700 12.522.500 14.588.700 16.654.900
darah torasik kompleks
(ringan)
Prosedur pembuluh
I-1-12-II 27.854.800 32.450.800 37.046.900 19.492.900 22.709.200 25.925.600
(sedang)
Prosedur pembuluh
I-1-12-III 36.647.200 42.694.000 48.740.800 26.563.600 30.946.600 35.329.600
(berat)
Comorbid
wound (T81.3)
KOMPRESI VENA CAVA (2)
Diagnosis : Compression of vein (I87.1)
Tindakan : Veno cava stent (38.7)

lain (ringan)
lain (sedang)
lain (berat)
Comorbid
wound (T81.3)
DEEPVEIN THROMBOSIS(DVT)
Diagnosis : Embolism and thrombosis of other specified veins (I82.8)
Tindakan
• Venography (ICD IX: 88.67) -- tambahan • Other (peripheral) vascular shunt or bypass (ICD IX :
• Injection of anticoagulant ICD IX : 99.19) -- tambahan 39.29)
• Other endovascular procedures on other vessels (ICD • Pasang Vena Cava Filter (ICD IX: 86.07)
IX : 39.79) • Tromboembolektomi (Other surgical occlusion of
vessels, unspecified site) (38.80)

21.764.000 25.355.000 28.946.100 15.701.600 18.292.300 20.883.100
27.189.200 31.675.400 36.161.700 19.617.500 22.854.400 26.091.300
32.022.200 37.305.900 42.589.600 25.778.600 30.032.100 34.285.500
Comorbid
wound (T81.3)
VARICOSEVEIN (1)
Pilihan diagnosis Pilihan Tindakan
• Varicose veins of lower extremities (ICD X : I83) • Endovenous radiofrequency / laser ablation (ICD IX
• Venous insufficiency (ICD X I87.2) 38.50)
• Varicose veins of lower extremities without ulcer or • Ligation and stripping of varicose veins; lower limb
inflammation (ICD X I83.9) varicose vein (ICD IX 38.59)
• Injection of sclerosing agent into vein (ICD IX 39.92)

I-1-17-I Ligasi dan Stripping Pembuluh
19.308.500 22.494.400 25.680.300 13.930.100 16.228.500 18.527.000
Darah Vena (Ringan)
I-1-17-II Ligasi dan Stripping Pembuluh
24.176.100 28.165.100 32.154.200 17.441.800 20.319.700 23.197.600
Darah Vena (Sedang)
I-1-17-III Ligasi dan Stripping Pembuluh
Darah Vena (Berat) 29.905.400 34.839.800 39.774.200 21.575.200 25.135.100 28.695.000
Comorbid
wound (T81.3)
VARICOSEVEIN (2)
• Varicose veins of lower extremities (ICD X : I83) • Elastic bandage (ICD IX 93.59)
• Venous insufficiency (ICD X I87.2)
• Varicose veins of lower extremities without ulcer or
inflammation (ICD X I83.9)

CBG
I-4-15-I Penyakit Pembuluh Darah Perifer dan
Lain – Lain (Ringan) 4.971.200 5.791.400 6.611.600 4.580.900 5.336.700 6.092.500
I-4-15-II Penyakit Pembuluh Darah Perifer dan
Lain – Lain (Sedang)
9.374.000 10.920.700 12.467.400 6.231.900 7.260.200 8.288.400
I-4-15-III Penyakit Pembuluh Darah Perifer dan
Lain – Lain (Berat) 11.248.800 13.104.900 14.960.900 7.478.300 8.712.200 9.946.100
Comorbid
• Severity III : Pneumonia (J18.9)/Efusi Pleura (J90)/ Sepsis (A41.8), Coagulopathy (D68.9)
PHLEBITIS AND THROMBOPHLEBITIS (1)
Diagnosis Tindakan
• Phlebitis and thrombophlebitis (I80) • Elastic bandage (ICD IX 93.59)
• Other venous embolism and thrombosis (I82) • Application of other wound dressing (93.57),
• Embolism and thrombosis of other specified veins (I82.9) • Application of pressure dressing (93.56)

I-4-15-I perifer dan lain-lain 4.971.200 5.791.400 6.611.600 4.580.900 5.336.700 6.092.500
(ringan)
I-4-15-II perifer dan lain-lain 9.374.000 10.920.700 12.467.400 6.231.900 7.260.200 8.288.400
(sedang)
Penyakit pembuluh
I-4-15-III darah perifer dan lain- 11.248.800 13.104.900 14.960.900 7.478.300 8.712.200 9.946.100
lain (berat)
Comorbid
wound (T81.3)
PHLEBITIS AND THROMBOPHLEBITIS(2)
Diagnosis Tindakan
• Phlebitis and thrombophlebitis (I80) • Other (peripheral) vascular shunt or bypass (39.29)
• Other venous embolism and thrombosis (I82)
• Embolism and thrombosis of other specified veins (I82.9)

21.764.000 25.355.000 28.946.100 15.701.600 18.292.300 20.883.100
27.189.200 31.675.400 36.161.700 19.617.500 22.854.400 26.091.300
32.022.200 37.305.900 42.589.600 25.778.600 30.032.100 34.285.500
Comorbid
wound (T81.3)
THROMBOANGITIS OBLITERANS (1)
Diagnosis : Thromboangiitis obliterans [Buerger] (ICD XI73.1)
Tindakan : Lumbal simpatektomi (ICD IX05.23)

CBG
G-1-20-I Prosedur Saraf Kranial dan 12.204.900 14.218.700 16.232.500
9.002.800 10.488.300 11.973.800
Perifer (Ringan)
G-1-20-II Prosedur Saraf Kranial dan 19.456.300 22.666.600 25.876.900
15.019.100 17.497.300 19.975.400
Perifer (Sedang)
G-1-20-III Prosedur Saraf Kranial dan 31.491.000 36.687.000 41.883.100
22.491.900 26.203.100 29.914.300
Perifer (Berat)
Comorbid
wound (T81.3)
THROMBOANGITIS OBLITERANS(2)
Diagnosis : Thromboangiitis obliterans [Buerger] (ICD XI73.1) dengan atau tanpa gangrene kode sama
Tindakan : Amputation and disarticulation of finger (hand) (ICD IX 84.01)

INA-CBG
M-1-80-I Prosedur anggota
12.284.500 14.311.400 16.338.300 8.862.600 10.324.900 11.787.200
tubuh atas (ringan)
M-1-80-II Prosedur anggota
14.588.900 16.996.100 19.403.200 11.010.400 12.827.100 14.643.800
tubuh atas (sedang)
M-1-80-III Prosedur anggota
29.552.700 34.428.900 39.305.100 22.005.700 25.636.600 29.267.500
tubuh atas (berat)
Comorbid
wound (T81.3)
THROMBOANGITIS OBLITERANS (3)
Diagnosis : Thromboangiitis obliterans [Buerger] (ICD XI73.1) dengan atau tanpa gangrene kode sama
Tindakan : Amputation of toe (ICD IX84.11)

M-1-30-I Prosedur kaki 12.381.000 14.423.900 16.466.800
8.932.300 10.406.100 11.879.900
(ringan)
14.474.000 16.862.200 19.250.300
(sedang)
Comorbid
wound (T81.3)
RAYNAUD’S SYNDROME(tanpa gangrene)
Diagnosis : Raynaud’s Syndrome (I73.00)
Tindakan : Torakal simpatektomi (ICD IX05.29)

CBG
G-1-20-I Prosedur Saraf Kranial dan 12.204.900 14.218.700 16.232.500
9.002.800 10.488.300 11.973.800
Perifer (Ringan)
G-1-20-II Prosedur Saraf Kranial dan 19.456.300 22.666.600 25.876.900
15.019.100 17.497.300 19.975.400
Perifer (Sedang)
G-1-20-III Prosedur Saraf Kranial dan 31.491.000 36.687.000 41.883.100
22.491.900 26.203.100 29.914.300
Perifer (Berat)
Comorbid
wound (T81.3)
RAYNAUD’SSYNDROME(dengan gangrene) (1)
Diagnosis : Raynaud’s Syndrome dengan gangrene (I73.01)
Tindakan : Amputation and disarticulation of finger (hand) (ICD IX 84.01)

INA-CBG
M-1-80-I Prosedur anggota 12.284.500 14.311.400 16.338.300
8.862.600 10.324.900 11.787.200
tubuh atas (ringan)
M-1-80-II Prosedur anggota 14.588.900 16.996.100 19.403.200
11.010.400 12.827.100 14.643.800
tubuh atas (sedang)
M-1-80-III Prosedur anggota 29.552.700 34.428.900 39.305.100
22.005.700 25.636.600 29.267.500
tubuh atas (berat)
Comorbid
wound (T81.3)
RAYNAUD’SSYNDROME(dengan gangrene) (2)
Diagnosis : Raynaud’s Syndrome dengan gangrene (I73.01)
Tindakan : Amputation of toe (ICD IX84.11)

M-1-30-I Prosedur kaki 12.381.000 14.423.900 16.466.800
8.932.300 10.406.100 11.879.900
(ringan)
14.474.000 16.862.200 19.250.300
(sedang)
Comorbid
wound (T81.3)
PLACENTAACCRETA
Diagnosis : Placenta accreta, unspecified trimester (O43.219)
Tindakan
• Other surgical occlusion of vessels, aorta, abdominal (38.84)
• Other intra-abdominal vascular shunt or bypass (39.26)
• Other operations on vessels (39.99)

21.764.000 25.355.000 28.946.100 15.701.600 18.292.300 20.883.100
27.189.200 31.675.400 36.161.700 19.617.500 22.854.400 26.091.300
32.022.200 37.305.900 42.589.600 25.778.600 30.032.100 34.285.500
Comorbid
wound (T81.3)
LIMFOEDEMA
Diagnosis : Lymphoedema, not elsewhere classified (ICD XI89.0)
Tindakan : Excision Of Lymphatic Structure (ICD IX 40.2)

Prosedur pada darah dan
D-1-20-I organ pembentuk darah lain- 7.541.600 8.786.000 10.030.400 5.277.700 6.148.500 7.019.400
lain (ringan)
D-1-20-II organ pembentuk darah lain- 20.783.600 24.212.900 27.642.200 14.544.400 16.944.200 19.344.100
lain (sedang)
D-1-20-III organ pembentuk darah lain-
lain
32.968.800 38.408.600 43.848.500 23.071.700 26.878.600 30.685.400
(berat)
Comorbid
• Severity I : DM (E11.8)/ Hipertensi (I.10)/Anemia (D64.9)
• Severity II : DM+Hipertensi/TB Paru (A16.0)
• Severity III : Pneumonia (J18.9)/Efusi Pleura (J90)/Sepsis (a41.8)/Disruption of operation wound (T81.3)
FASCITISNECROTICAN
Diagnosis : Necrotizing fasciitis (M72.66); Gas Gangren tanpa DM (A48.0)
Tindakan :
• Fasciotomy (83.14)
• Lower limb amputation, not otherwise specified (84.10)
• Other amputation below knee (84.15)
• Other immobilization, pressure, and attention to wound (93.59)
M-I-50-I Prosedur jaringan lunak
(ringan)
7.552.600 8.798.800 10.044.900 5.448.800 6.347.900 7.246.900
M-I-50-II Prosedur jaringan lunak
(sedang)
13.786.600 16.061.400 18.336.200 9.946.300 11.587.400 13.228.500
M-I-50-III Prosedur jaringan lunak (berat) 22.643.600 26.379.800 30.116.000 16.336.100 19.031.600 21.727.000
Comorbid
wound (T81.3)
AKSESVASKULARHAEMODIALISA
Diagnosis : CKDstg V on HD Regular (N18.5)
Tindakan
• Pemasangan CDLnon-tunneling (ICD IX : 38.95)
• Pasang CDLtunneling (ICD IX: 38.95)
• Arteriovenostomy for renal dialysis (ICD IX: 39.27)
• Revisi AV Shunt/ CDL(ICD IX: 39.42)

CBG
N-1-12-I Membuat baru, merevisi, dan
memindahkan alat dialysis 8.495.400 9.897.100 11.298.800 5.766.700 6.718.200 7.669.700
(ringan)
N-1-12-II Membuat baru, merevisi, dan
15.763.300
memindahkan alat dialysis 13.530.700 17.995.800 10.774.800 12.552.600 14.330.400
(sedang)
N-1-12-III Membuat baru, merevisi, dan
memindahkan alat dialysis 27.385.600 31.904.200 36.422.800 19.757.300 23.017.200 26.277.100
(berat)
Comorbid
• Severity II : DM (E11.8)/ Anemia pada CKD(D63.8) : Hb < 8 (Wajib Tranfusi)/TB Paru (A16)/ Gagal jantung (I50.9)
wound (T81.3)
AKSESVASKULARKEMOTERAPI
Diagnosis : Chemotherapy session for neoplasm (Z51.1)
Tindakan
• Pemasangan kemoport (86.07)

L-1-40-I Prosedur pada kulit, jaringan
7.270.600 8.470.200 9.669.800 5.088.000 5.927.500 6.767.000
bawah kulit (ringan)
L-1-40-II Prosedur pada kulit, jaringan
12.533.300 14.601.300 16.669.200 9.042.100 10.534.000 12.025.900
bawah kulit (sedang)
L-1-40-III Prosedur pada kulit, jaringan
20.585.100 23.981.600 27.378.100 14.851.000 17.301.400 19.751.800
bawah kulit (berat)
Comorbid
wound (T81.3)
AKSESVASKULARVENA SENTRAL
Diagnosis : Hipokalemia (E87.6) dll
Tindakan
• Central venous catheter placement with guidance (38.97)

E-4-11-I Hipovolemia & Gangguan
4.315.200 5.027.200 5.739.300 3.422.000 3.986.600 4.551.200
Elektrolit (ringan)
E-4-11-II Hipovolemia & Gangguan
Elektrolit (sedang) 6.578.900 7.664.400 8.750.000 4.604.000 5.363.600 6.123.300
E-4-11-III Hipovolemia & Gangguan
Elektrolit (berat) 8.914.900 10.385.800 11.856.800 6.431.600 7.492.800 8.554.100
Comorbid
wound (T81.3)
HEMANGIOMA
Diagnosis : Haemangioma and lymphangioma, any site (D18)
Tindakan : Other excision of vessels, unspecified site (38.60)

CBG
lain (ringan)
lain (sedang)
lain (berat)
Comorbid
wound (T81.3)
ARTERI-VENOUS MALFORMASI (AVM)
Diagnosis : Arteriovenous malformation (peripheral) (Q27.3)
Tindakan
• Angiografi (ICD IX: 88.67) -- tambahan
• Embolisasi (ICD IX: 38.80)
• Other excision of vessels, unspecified site ( ICD IX : 38.60)
• Other endovascular procedures on other vessels (ICD IX : 39.79)

CBG
21.764.000 25.355.000 28.946.100 15.701.600 18.292.300 20.883.100
27.189.200 31.675.400 36.161.700 19.617.500 22.854.400 26.091.300
32.022.200 37.305.900 42.589.600 25.778.600 30.032.100 34.285.500
Comorbid
wound (T81.3)
RUPTUREOF ARTERY
• Rupture of artery (I77.2) • Suture of artery (39.31)
• Injury of brachial artery (S45.1) • Endovascular procedure (39.79)
• Injury of popliteal artery (S85.0) • Angioplasty of other non-coronary vessel(s) (39.50)
• Injury of blood vessels at hip and thigh level (S75.-) • Other revision of vascular procedure (39.49)
• Injury of (anterior)(posterior) tibial artery (S85.1) • Repair of blood vessel with tissue patch graft (39.56)
• Injury of ulnar artery at forearm level (S55.0) • Control of hemorrhage following vascular surgery (39.41)
• Injury of unspecified blood vessel at neck level (S15.9) • Incision of vessel, lower limb arteries (38.08)
• Injury of unspecified blood vessel at shoulder and upper arm
level (S45.9)

CBG
Kelas 3 Kelas 2 Kelas 1 Kelas 3 Kelas 2Kelas 1
I-1-20-I Prosedur sistem peredaran 21.764.000 25.355.000 28.946.100 15.701.600 18.292.300 20.883.100
I-1-20-II Prosedur sistem peredaran 27.189.200 31.675.400 36.161.700 19.617.500 22.854.400 26.091.300
I-1-20-III Prosedur sistem peredaran 32.022.200 37.305.900 42.589.600 25.778.600 30.032.100 34.285.500
Comorbid
• Severity II : DM (E11.8)/ Anemia (D64.9)/ TBParu (A16)/ Gagal jantung (I50.9)/ CKDst.V (N18)
• Severity III : Pneumonia (J18.9)/Efusi Pleura (J90)/ Sepsis (A41.8), Coagulopathy (D68.9)/ Disruption of operation wound (T81.3)
RUPTURE OF VEIN
• Injury of axillary or brachial vein (ICD XS45.2) • Suture of vein (39.32)
• Injury of inferior vena cava (S35.1)
CBG
I-1-17-I Ligasi dan Stripping Pembuluh 19.308.500 22.494.400 25.680.300
13.930.100 16.228.500 18.527.000
Darah Vena (Ringan)
I-1-17-II Ligasi dan Stripping Pembuluh 24.176.100 28.165.100 32.154.200
17.441.800 20.319.700 23.197.600
Darah Vena (Sedang)
I-1-17-III Ligasi dan Stripping Pembuluh 29.905.400 34.839.800 39.774.200
21.575.200 25.135.100 28.695.000
Darah Vena (Berat)
Comorbid
wound (T81.3)
Diagnosis Vaskular Lainnya
Peripheral Vascular disease, unspesific I73.9
Ischaemic infarction of muscle M62.2
Traumatic ischaemia of muscle T79.6
Cutaneous abscess, furuncle and carbuncle of limb L02.4
Ulcer of lower limb, not elsewhere classified L97
Necrosis of artery I77.5
Other chronic osteomyelitis M86.6
Disruption of operation wound, not elsewhere classified T81.3
Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts T82.7
Q87.2
Congenital malformation syndromes predominantly involving limbs
O87.1
Deep phlebothrombosis in the puerperium
L92.-
Granulomatous disorders of skin and subcutaneous tissue T87.5
Necrosis of amputation stump
Osteonecrosis M87.-
KETENTUAN KODING VASKULAR
• Anemia pada CKD (D63.8) : Hb < 8 (Wajib Tranfusi)
• Koding DM dengan CKD E10-13.2
• Koding DM dengan Gangren E10-13.5
• Ulkus decubitus karena DM (L89)
• Gas Gangren tanpa DM (A48.0)

• CPR (99.60)
• Hipertensi
• Pada koding elektrolit imbalans seperti hiponatremi, hipernatremi dan hipo/hiper kalemi mohon disertakan terapi dan
lab pendukung
• Pneumonia Covid -19 (B34.2)

Gabung KODING 020223

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Gabung KODING 020223

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KODING

ICD X- ICD IX-CM

• Repair of atrial septal defect with tissue graft (35.61)

Kode INA TIPE A TIPE B

• Repair of ventricular septal defect with prosthesis. open technique 35.53

Kode INA TIPE A TIPE B

Kode INA TIPE A TIPE B

Kode INA TIPE A TIPE B

Kode TIPE A TIPE B

Kode INA TIPE A TIPE B

Kode TIPE A TIPE B

Kode INA TIPE A TIPE B

Kode TIPE A TIPE B

Kode INA TIPE A TIPE B

Kode INA TIPE A TIPE B

Kode INA TIPE A TIPE B

Kode RS Tipe A RS Tipe B

J-1- Ventilasi Mekanikal

(I47.2) Disruption of operation wound (T81.3)

Kode RS Tipe A RS Tipe B

J-1- Prosedur Sistem

Cardiopulmonary resuscitation, not otherwise specified (99.60)

KETENTUAN KODING UMUM

I-1- Prosedur Bypass Koroner

I-1- 04-I Prosedur Katup Jantung

I-1- 04-III Prosedur Katup Jantung

I-1- 04-I Prosedur Katup

I-1- 04-I Prosedur Katup Jantung

Kode RSTipe A RSTipe B

Kode RSTipe A RSTipe B

I–1– 50.834.000 59.221.600 67.609.200 33.351.700 38.854.700 44.357.800

I–1– Prosedur Kardiotorasik Lain (Berat)

Kode RSTIpe A RSTipe B

I-1- Prosedur Katup Jantung

Kode RSTipe A RSTipe B

I-1- Penggantian Alat Defibrilator dan

I-1- Penggantian Alat Defibrilator dan

I-1- Penggantian Alat Defibrilator dan

I-1- Prosedur Katup Jantung

Kode RS Tipe A RS Tipe B

I-1- Prosedur Pembuluh

Kode RS Tipe A RS Tipe B

S-4- Komplikasi dari Penatalaksanaan Pasien

S-4- Komplikasi dari Penatalaksanaan Pasien

Ventilasi Mekanikal Long

Kode RS Tipe A RS Tipe B

J-1- Prosedur Sistem Pernapasan

J-1- Prosedur Sistem Pernapasan

• Extracorporeal circulation auxiliary to open heart surgery ICD IX

• AV blok(I44.-) : Harap EKGdan pembacaan disertakan

KETENTUAN KODING UMUM

RS. TIPE A RS. TIPE B

RS. TIPE A RS. TIPE B

RS. TIPE A RS. TIPE B

RS. TIPE A RS. TIPE B

PLEURAL EFUSI DAN

KODE RS. TIPE A RS. TIPE B

I-1-06-I PROSEDUR KARDIOTORASIK LAIN

I-1-06-II PROSEDUR KARDIOTORASIK LAIN

PROSEDUR KARDIOTORASIK LAIN

RS. TIPE A RS. TIPE B

TRAUMA PADA KULIT, JARINGAN

RS. TIPE A RS. TIPE B

KODE RS. TIPE A RS. TIPE B