MJK-BKDK LAMPIRAN 173
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
126 E55.9 VITAMIN D DEFICIENCY, UNSPECIFIED 199 U04 SEVERE ACUTE RESPIRATORY SYNDROME [SARS]
127 E56.0 DEFICIENCY OF VITAMIN E 200 U04.9 SEVERE ACUTE RESPIRATORY SYNDROME [SARS],
UNSPECIFIED
128 E56.1 DEFICIENCY OF VITAMIN K
CONTACT WITH AND EXPOSURE TO INTESTINAL
129 E56.8 DEFICIENCY OF OTHER VITAMINS 201 Z20.0 INFECTIOUS DISEASES
130 E56.9 VITAMIN DEFICIENCY, UNSPECIFIED CONTACT WITH AND EXPOSURE INFECTION WITH A
PREDOMINANTLY SEX MODE TRANSMISSION
131 E58 DIETARY CALCIUM DEFICIENCY 202 Z20.2
132 E59 DIETARY SELENIUM DEFICIENCY 203 Z20.3 CONTACT WITH AND EXPOSURE TO RABIES
133 E60 DIETARY ZINC DEFICIENCY 204 Z20.4 CONTACT WITH AND EXPOSURE TO RUBELLA
134 E61.0 COPPER DEFICIENCY 205 Z20.5 CONTACT WITH AND EXPOSURE TO VIRAL HEPATITIS
135 E61.1 IRON DEFICIENCY 206 Z20.7 CONTACT WITH AND EXPOSURE PEDICULOSIS
ACARIASIS AND OTHER INFESTATIONS
136 E61.2 MAGNESIUM DEFICIENCY
137 E61.3 MANGANESE DEFICIENCY 207 Z20.8 CONTACT WITH AND EXPOSURE TO OTHER
COMMUNICABLE DISEASES
138 E61.4 CHROMIUM DEFICIENCY
139 E61.5 MOLYBDENUM DEFICIENCY 208 Z20.9 CONTACT WITH AND EXPOSURE TO UNSPECIFIED
COMMUNICABLE DISEASE
140 E61.6 VANADIUM DEFICIENCY
209 Z22.0 CARRIER OF TYPHOID
141 E61.7 DEFICIENCY OF MULTIPLE NUTRIENT ELEMENTS
210 Z22.1 CARRIER OF OTHER INTESTINAL INFECTIOUS DISEASES
142 E61.8 DEFICIENCY OF OTHER SPECIFIED NUTRIENT
ELEMENTS 211 Z22.2 CARRIER OF DIPHTHERIA
143 E61.9 DEFICIENCY OF NUTRIENT ELEMENT, UNSPECIFIED 212 Z22.3 CARRIER OF OTHER SPECIFIED BACTERIAL DISEASES
144 E63.0 ESSENTIAL FATTY ACID [EFA] DEFICIENCY 213 Z22.4 CARRIER OF INFECTIONS WITH A PREDOM SEXUAL
MODE OF TRANSMISSION
145 E63.1 IMBALANCE OF CONSTITUENTS OF FOOD INTAKE
214 Z22.5 CARRIER OF VIRAL HEPATITIS
146 E63.8 OTHER SPECIFIED NUTRITIONAL DEFICIENCIES
CARRIER OF HUMAN T-LYMPHOTROPIC VIRUS TYPE-1
147 E63.9 NUTRITIONAL DEFICIENCY, UNSPECIFIED 215 Z22.6 [HTLV-1] INFECTION
148 E64.0 SEQUELAE OF PROTEIN-ENERGY MALNUTRITION 216 Z22.8 CARRIER OF OTHER INFECTIOUS DISEASES
149 E64.1 SEQUELAE OF VITAMIN A DEFICIENCY 217 Z22.9 CARRIER OF INFECTIOUS DISEASE, UNSPECIFIED
150 E64.2 SEQUELAE OF VITAMIN C DEFICIENCY 218 Z23.0 NEED FOR IMMUNIZATION AGAINST CHOLERA ALONE
151 E64.3 SEQUELAE OF RICKETS NEED FOR IMMUNIZ AGAINST TYPHOID-PARATYPHOID
ALONE [TAB]
152 E64.8 SEQUELAE OF OTHER NUTRITIONAL DEFICIENCIES 219 Z23.1
153 E64.9 SEQUELAE OF UNSPECIFIED NUTRITIONAL 220 Z23.2 NEED FOR IMMUNIZATION AGAINST TUBERCULOSIS
DEFICIENCY [BCG]
154 E65 LOCALIZED ADIPOSITY 221 Z23.3 NEED FOR IMMUNIZATION AGAINST PLAGUE
155 E66.0 OBESITY DUE TO EXCESS CALORIES 222 Z23.4 NEED FOR IMMUNIZATION AGAINST TULARAEMIA
156 E66.1 DRUG-INDUCED OBESITY 223 Z23.5 NEED FOR IMMUNIZATION AGAINST TETANUS ALONE
157 E66.2 EXTREME OBESITY WITH ALVEOLAR HYPOVENTILATION 224 Z23.6 NEED FOR IMMUNIZATION AGAINST DIPHTHERIA
ALONE
158 E66.8 OTHER OBESITY
159 E66.9 OBESITY, UNSPECIFIED 225 Z23.7 NEED FOR IMMUNIZATION AGAINST PERTUSSIS ALONE
160 E67.0 HYPERVITAMINOSIS A 226 Z23.8 NEED FOR IMMUNIZATION AGAINST OTHER SINGLE
BACTERIAL DISEASES
161 E67.1 HYPERCAROTENAEMIA
227 Z24.0 NEED FOR IMMUNIZATION AGAINST POLIOMYELITIS
162 E67.2 MEGAVITAMIN-B6 SYNDROME
NEED FOR IMMUNIZATION AGAINST ARTHROPOD-
163 E67.3 HYPERVITAMINOSIS D 228 Z24.1 BORNE VIRAL ENCEPHALITIS
164 E67.8 OTHER SPECIFIED HYPERALIMENTATION 229 Z24.2 NEED FOR IMMUNIZATION AGAINST RABIES
165 E68 SEQUELAE OF HYPERALIMENTATION 230 Z24.3 NEED FOR IMMUNIZATION AGAINST YELLOW FEVER
166 E70.0 CLASSICAL PHENYLKETONURIA 231 Z24.4 NEED FOR IMMUNIZATION AGAINST MEASLES ALONE
167 E70.1 OTHER HYPERPHENYLALANINAEMIAS 232 Z24.5 NEED FOR IMMUNIZATION AGAINST RUBELLA ALONE
168 E70.2 DISORDERS OF TYROSINE METABOLISM 233 Z24.6 NEED FOR IMMUNIZATION AGAINST VIRAL HEPATITIS
169 E70.3 ALBINISM 234 Z25.0 NEED FOR IMMUNIZATION AGAINST MUMPS ALONE
170 E70.8 OTHER DISORDERS OF AROMATIC AMINO-ACID 235 Z25.1 NEED FOR IMMUNIZATION AGAINST INFLUENZA
METABOLISM
NEED FOR IMMUNIZATION AGAINST OTH SPECIFIED
171 E70.9 DISORDER OF AROMATIC AMINO-ACID METABOLISM, 236 Z25.8 SINGLE VIRAL DISEASES
UNSPECIFIED
237 Z26.0 NEED FOR IMMUNIZATION AGAINST LEISHMANIASIS
172 E71.0 MAPLE-SYRUP-URINE DISEASE
NEED FOR IMMUNIZATION AGAINST OTHER SPECIFIED
173 E71.1 OTHER DISORDERS OF BRANCHED-CHAIN AMINO- 238 Z26.8 SINGLE INFECTIOUS DISEASES
ACID METABOLISM
NEED FOR IMMUNIZATION AGAINST UNSPECIFIED
174 E71.2 DISORDER OF BRANCHED-CHAIN AMINO-ACID 239 Z26.9 INFECTIOUS DISEASE
METABOLISM, UNSPEC ACT
NEED FOR IMMUNIZATION AGAINST CHOLERA WITH
175 E71.3 DISORDERS OF FATTY-ACID METABOLISM 240 Z27.0 TYPHOID-PARATYPHOID [CHOLERA + TAB]
176 E72.0 DISORDERS OF AMINO-ACID TRANSPORT NEED FOR IMMUNIZATION AGAINST DIPHTHERIA-
TETANUS-PERTUSSIS COMBINED [DTP]
177 E72.1 DISORDERS OF SULFUR-BEARING AMINO-ACID 241 Z27.1
METABOLISM
NEED FOR IMMUNIZATION AGAINST DIPHTHERIA-
178 E72.2 DISORDERS OF UREA CYCLE METABOLISM 242 Z27.2 TETANUS-PERTUSSIS WITH TYPHOID-PARATYPH
179 E72.3 DISORDERS OF LYSINE AND HYDROXYLYSINE [DTP + TAB]
METABOLISM
NEED FOR IMMUNIZATION AGAINST DIPHTHERIA-
180 E72.4 DISORDERS OF ORNITHINE METABOLISM 243 Z27.3 TETANUS-PERTUSSIS WITH POLIOMYELITIS [DTP +
181 E72.5 DISORDERS OF GLYCINE METABOLISM POLIO]
182 E72.8 OTHER SPECIFIED DISORDERS OF AMINO-ACID 244 Z27.4 NEED FOR IMMUNIZATION AGAINST MEASLES-
METABOLISM MUMPS-RUBELLA [MMR]
183 E72.9 DISORDER OF AMINO-ACID METABOLISM, 245 Z27.8 NEED FOR IMMUNIZATION AGAINST OTHER
UNSPECIFIED COMBINATIONS OF INFECTIOUS DISEASES
184 E73.0 CONGENITAL LACTASE DEFICIENCY 246 Z27.9 NEED FOR IMMUNIZATION AGAINST UNSPEC COMBS
OF INFECTIOUS DISEASES
185 E73.1 SECONDARY LACTASE DEFICIENCY
IMMUNIZATION NOT CARRIED OUT BECAUSE OF
186 E73.8 OTHER LACTOSE INTOLERANCE 247 Z28.0 CONTRAINDICATION
187 E73.9 LACTOSE INTOLERANCE, UNSPECIFIED IMMUNIZATION NOT CARRIED OUT BECAUSE OF
248 Z28.1 PATIENT'S DECISION FOR REASON OF BELIEF OR
188 M02.20 POSTIMMUNIZATION ARTHROPATHY, MULTIPLE SITES
GROUP PRESSURE
189 M02.21 POSTIMMUNIZATION ARTHROPATHY, SHOULDER
REGION IMMUNIZATION NOT CARRIED OUT BECAUSE
249 Z28.2 PATIENT'S DECISION FOR OTHER UNSPECIFIED
190 M02.22 POSTIMMUNIZATION ARTHROPATHY, UPPER ARM
REASONS
191 M02.23 POSTIMMUNIZATION ARTHROPATHY, FOREARM
192 M02.24 POSTIMMUNIZATION ARTHROPATHY, HAND 250 Z28.8 IMMUNIZATION NOT CARRIED OUT FOR OTHER
REASONS
193 M02.25 POSTIMMUNIZATION ARTHROPATHY, PELVIC AND
THIGH 251 Z28.9 IMMUNIZATION NOT CARRIED OUT FOR UNSPECIFIED
REASON
194 M02.26 POSTIMMUNIZATION ARTHROPATHY, LOWER LEG
252 Z29.0 ISOLATION
195 M02.27 POSTIMMUNIZATION ARTHROPATHY, ANKLE AND
FOOT 253 Z29.1 PROPHYLACTIC IMMUNOTHERAPY
196 M02.28 POSTIMMUNIZATION ARTHROPATHY, OTHER SITES 254 Z29.2 OTHER PROPHYLACTIC CHEMOTHERAPY
197 M02.29 POSTIMMUNIZATION ARTHROPATHY, UNSPECIFIED 255 Z29.8 OTHER SPECIFIED PROPHYLACTIC MEASURES
SITE
256 Z29.9 PROPHYLACTIC MEASURE, UNSPECIFIED
INSUFFICIENT INTAKE OF FOOD AND WATER DUE TO
198 R63.6 SELF NEGLECT
174 LAMPIRAN MJK-BKDK
0b : PMS (Penyakit Menular Seksual)
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
GONOCOCCAL INFECTION OF LOWER 15 A56.4 CHLAMYDIAL INFECTION OF PHARYNX
1 A54.0 GENITOURINARY TRACT WITHOUT PERIURETHRAL OR
16 A56.8 SEXUALLY TRANSMITTED CHLAMYDIAL INFECTION OF
ACCESORY GLAND ABSCESS OTHER SITES
GONOCOCCAL OF LOWER GENITOURINARY TRACT 17 A57 CHANCROID
2 A54.1 WITH PERIURETHRAL AND ACCESSORY GLAND
18 A58 GRANULOMA INGUINALE
ABSCESS
19 A59.0 UROGENITAL TRICHOMONIASIS
3 A54.2 GONOCOCCAL PELVIPERITONITIS AND OTHER
GONOCOCCAL GENITOURINARY INFECTIONS 20 A59.8 TRICHOMONIASIS OF OTHER SITES
4 A54.3 GONOCOCCAL INFECTION OF EYE 21 A59.9 TRICHOMONIASIS, UNSPECIFIED
5 A54.4 GONOCOCCAL INFECTION OF MUSCULOSKELETAL 22 A60.0 HERPESVIRAL INFECTION OF GENITALIA AND
SYSTEM UROGENITAL TRACT
6 A54.5 GONOCOCCAL PHARYNGITIS 23 A60.1 HERPESVIRAL INFECTION OF PERIANAL SKIN AND
RECTUM
7 A54.6 GONOCOCCAL INFECTION OF ANUS AND RECTUM
24 A60.9 ANOGENITAL HERPESVIRAL INFECTION, UNSPECIFIED
8 A54.8 OTHER GONOCOCCAL INFECTIONS
25 A63.0 ANOGENITAL (VENEREAL) WARTS
9 A54.9 GONOCOCCAL INFECTION, UNSPECIFIED
OTHER SPECIFIED PREDOMINANTLY SEXUALLY
10 A55 CHLAMYDIAL LYMPHOGRANULOMA (VENEREUM) 26 A63.8 TRANSMITTED DISEASES
11 A56.0 CHLAMYDIAL INFECTION OF LOWER GENITOURINARY 27 A64 UNSPECIFIED SEXUALLY TRANSMITTED DISEASE
TRACT
28 A65 NONVENEREAL SYPHILIS
12 A56.1 CHLAMYDIAL INFECTION OF PELVIPERITONEUM AND
OTHER GENITOURINARY ORGANS 29 A67.0 PRIMARY LESIONS OF PINTA
13 A56.2 CHLAMYDIAL INFECTION OF GENITOURINARY TRACT, 30 A67.1 INTERMEDIATE LESIONS OF PINTA
UNSPECIFIED
31 A67.2 LATE LESIONS OF PINTA
14 A56.3 CHLAMYDIAL INFECTION OF ANUS AND RECTUM 32 A67.3 MIXED LESIONS OF PINTA
33 A67.9 PINTA, UNSPECIFIED
0c : Penyakit kongenital yang tidak mengganggu fungsi
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 Q10.0 CONGENITAL PTOSIS 50 Q66.7 PES CAVUS
2 Q10.1 CONGENITAL ECTROPION 51 Q66.8 OTHER CONGENITAL DEFORMITIES OF FEET
3 Q10.2 CONGENITAL ENTROPION 52 Q66.9 CONGENITAL DEFORMITY OF FEET, UNSPECIFIED
4 Q10.3 OTHER CONGENITAL MALFORMATIONS OF EYELID 53 Q67.0 FACIAL ASYMMETRY
5 Q17.0 ACCESSORY AURICLE 54 Q67.1 COMPRESSION FACIES
6 Q17.1 MACROTIA 55 Q67.2 DOLICHOCEPHALY
7 Q17.2 MICROTIA 56 Q67.3 PLAGIOCEPHALY
8 Q17.3 OTHER MISSHAPEN EAR 57 Q69.0 ACCESSORY FINGER(S)
9 Q17.4 MISPLACED EAR 58 Q69.1 ACCESSORY THUMB(S)
10 Q17.5 PROMINENT EAR 59 Q69.2 ACCESSORY TOE(S)
11 Q17.8 OTHER SPECIFIED CONGENITAL MALFORMATIONS 60 Q69.9 POLYDACTYLY, UNSPECIFIED
OF EAR
61 Q70.0 FUSED FINGERS
12 Q17.9 CONGENITAL MALFORMATION OF EAR, UNSPECIFIED
62 Q70.1 WEBBED FINGERS
13 Q18.3 WEBBING OF NECK
63 Q70.2 FUSED TOES
14 Q18.4 MACROSTOMIA
64 Q70.3 WEBBED TOES
15 Q18.5 MICROSTOMIA
65 Q70.4 POLYSYNDACTYLY
16 Q18.6 MACROCHEILIA
66 Q70.9 SYNDACTYLY, UNSPECIFIED
17 Q18.7 MICROCHEILIA
67 Q82.5 CONGENITAL NON-NEOPLASTIC NAEVUS
18 Q38.2 MACROGLOSSIA
68 Q82.8 OTHER SPECIFIED CONGENITAL MALFORMATIONS
19 Q50.0 CONGENITAL ABSENCE OF OVARY OF SKIN
20 Q51.0 AGENESIS AND APLASIA OF UTERUS 69 Q82.9 CONGENITAL MALFORMATION OF SKIN, UNSPECIFIED
21 Q51.1 DOUBLING OF UTERUS WITH DOUBLING OF CERVIX 70 Q83.0 CONGENITAL ABSENCE OF BREAST WITH ABSENT
AND VAGINA NIPPLE
22 Q51.2 OTHER DOUBLING OF UTERUS 71 Q83.1 ACCESSORY BREAST
23 Q51.3 BICORNATE UTERUS 72 Q83.2 ABSENT NIPPLE
24 Q51.4 UNICORNATE UTERUS 73 Q83.3 ACCESSORY NIPPLE
25 Q52.0 CONGENITAL ABSENCE OF VAGINA 74 Q83.8 OTHER CONGENITAL MALFORMATIONS OF BREAST
26 Q52.1 DOUBLING OF VAGINA 75 Q83.9 CONGENITAL MALFORMATION OF BREAST,
UNSPECIFIED
27 Q52.6 CONGENITAL MALFORMATION OF CLITORIS
76 Q84.0 CONGENITAL ALOPECIA
28 Q52.7 OTHER CONGENITAL MALFORMATIONS OF VULVA
CONGENITAL MORPHOLOGICAL DISTURBANCES OF
29 Q52.8 OTHER SPECIFIED CONGENITAL MALFORMATIONS OF 77 Q84.1 HAIR NEC
FEMALE GENITALIA
78 Q84.2 OTHER CONGENITAL MALFORMATIONS OF HAIR
30 Q52.9 CONGENITAL MALFORMATION OF FEMALE GENITALIA,
UNSPECIFIED 79 Q84.3 ANONYCHIA
31 Q54.1 HYPOSPADIAS, PENILE 80 Q84.4 CONGENITAL LEUKONYCHIA
32 Q55.0 ABSENCE AND APLASIA OF TESTIS 81 Q84.5 ENLARGED AND HYPERTROPHIC NAILS
33 Q55.1 HYPOPLASIA OF TESTIS AND SCROTUM 82 Q84.6 OTHER CONGENITAL MALFORMATIONS OF NAILS
34 Q55.2 OTHER CONGENITAL MALFORMATIONS OF TESTIS 83 Q92.0 WHOLE CHROMOSOME TRISOMY, MEIOTIC
AND SCROTUM NONDISJUNCTION
35 Q55.3 ATRESIA OF VAS DEFERENS 84 Q92.1 WHOLE CHROMOSOME TRISOMY, MOSAICISM
(MITOTIC NONDISJUNCTION)
OTHER CONGENITAL MALFORMATIONS VAS
36 Q55.4 DEFERENS, EPIDIDYMIS SEMINAL VESICLES AND 85 Q92.2 MAJOR PARTIAL TRISOMY
PROSTATE 86 Q92.3 MINOR PARTIAL TRISOMY
37 Q55.5 CONGENITAL ABSENCE AND APLASIA OF PENIS 87 Q92.4 DUPLICATIONS SEEN ONLY AT PROMETAPHASE
38 Q55.6 OTHER CONGENITAL MALFORMATIONS OF PENIS 88 Q92.5 DUPLICATIONS WITH OTHER COMPLEX
REARRANGEMENTS
39 Q55.8 OTHER SPECIFIED CONGEN MALFORMATIONS OF
MALE GENITAL ORGANS 89 Q92.6 EXTRA MARKER CHROMOSOMES
40 Q55.9 CONGENITAL MALFORMATION OF MALE GENITAL 90 Q92.7 TRIPLOIDY AND POLYPLOIDY
ORGAN, UNSPECIFIED
91 Q92.8 OTHER SPECIFIED TRISOMIES AND PARTIAL TRISOMIES
41 Q56.0 HERMAPHRODITISM, NOT ELSEWHERE CLASSIFIED OF AUTOSOMES
42 Q56.1 MALE PSEUDOHERMAPHRODITISM, NOT ELSEWHERE 92 Q92.9 TRISOMY AND PARTIAL TRISOMY OF AUTOSOMES,
CLASSIFIED UNSPECIFIED
43 Q56.2 FEMALE PSEUDOHERMAPHRODITISM, NOT 93 Q93.0 WHOLE CHROMOSOME MONOSOMY, MEIOTIC
ELSEWHERE CLASSIFIED NONDISJUNCTION
44 Q56.3 PSEUDOHERMAPHRODITISM, UNSPECIFIED 94 Q93.1 WHOLE CHROM MONOSOMY MOSAICISM (MITOTIC
NONDISJUNCTION)
45 Q56.4 INDETERMINATE SEX, UNSPECIFIED
46 Q66.2 METATARSUS VARUS 95 Q93.2 CHROMOSOME REPLACED WITH RING OR DICENTRIC
47 Q66.3 OTHER CONGENITAL VARUS DEFORMITIES OF FEET 96 Q93.3 DELETION OF SHORT ARM OF CHROMOSOME 4
48 Q66.5 CONGENITAL PES PLANUS 97 Q93.4 DELETION OF SHORT ARM OF CHROMOSOME 5
49 Q66.6 OTHER CONGENITAL VALGUS DEFORMITIES OF FEET 98 Q93.5 OTHER DELETIONS OF PART OF A CHROMOSOME
MJK-BKDK LAMPIRAN 175
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
99 Q93.6 DELETIONS SEEN ONLY AT PROMETAPHASE 119 Q97.1 FEMALE WITH MORE THAN THREE X CHROMOSOMES
100 Q93.7 DELETIONS WITH OTHER COMPLEX 120 Q97.2 MOSAICISM, LINES WITH VARIOUS NUMBERS OF X
REARRANGEMENTS CHROMOSOMES
101 Q93.8 OTHER DELETIONS FROM THE AUTOSOMES 121 Q97.3 FEMALE WITH 46, XY KARYOTYPE
102 Q93.9 DELETION FROM AUTOSOMES, UNSPECIFIED 122 Q97.8 OTHER SPECIFIED SEX CHROMOSOME
ABNORMALITIES FEMALE PHRENOTYPE
103 Q95.0 BALANCED TRANSLOCATION AND INSERTION IN
NORMAL INDIVIDUAL 123 Q97.9 SEX CHROMOSOME ABNORMALITY, FEMALE
PHENOTYPE, UNSPECIFIED
104 Q95.1 CHROMOSOME INVERSION IN NORMAL INDIVIDUAL
124 Q98.0 KLINEFELTERS SYNDROME KARYOTYPE 47, XXY
105 Q95.2 BALANCED AUTOSOMAL REARRANGEMENT IN
ABNORMAL INDIVIDUAL 125 Q98.1 KLINEFELTERS SYNDROME MALE WITH MORE THAN
TWO X CHROMOSOMES
106 Q95.3 BALANCED SEX/AUTOSOMAL REARRANGEMENT IN
ABNORMAL INDIVIDUAL 126 Q98.2 KLINEFELTERS SYNDROME KARYOTYPE MALE WITH 46,
XX KARYOTYPE
107 Q95.4 INDIVIDUALS WITH MARKER HETEROCHROMATIN
127 Q98.3 OTHER MALE WITH 46 XX KARYOTYPE
108 Q95.5 INDIVIDUALS WITH AUTOSOMAL FRAGILE SITE
128 Q98.4 KLINEFELTER'S SYNDROME, UNSPECIFIED
109 Q95.8 OTHER BALANCED REARRANGEMENTS AND
STRUCTURAL MARKERS 129 Q98.5 KARYOTYPE 47, XYY
110 Q95.9 BALANCED REARRANGEMENT AND STRUCTURAL 130 Q98.6 MALE WITH STRUCTURALLY ABNORMAL SEX
MARKER, UNSPECIFIED CHROMOSOME
111 Q96.0 KARYOTYPE 45X 131 Q98.7 MALE WITH SEX CHROMOSOME MOSAICISM
112 Q96.1 KARYOTYPE 46X ISO (XQ) 132 Q98.8 OTHER SPECIFIED SEX CHROMOSOME
ABNORMALITIES, MALE PHENOTYPE
113 Q96.2 KARYOTYPE 46X WITH ABNORMAL SEX
CHROMOSOME, EXCEPT ISO (XQ) 133 Q98.9 SEX CHROMOSOME ABNORMALITY, MALE PHENOTYPE,
UNSPECIFIED
114 Q96.3 MOSAICISM, 45, X/46, XX OR XY
134 Q99.0 CHIMERA 46, XX/46, XY
115 Q96.4 MOSAICISM 45X/OTH CELL LINE(S) WITH ABNORM SEX
CHROMOSOME 135 Q99.1 46, XX TRUE HEMAPHRODITE
116 Q96.8 OTHER VARIANTS OF TURNER'S SYNDROME 136 Q99.2 FRAGILE X CHROMOSOME
117 Q96.9 TURNER'S SYNDROME, UNSPECIFIED 137 Q99.8 OTHER SPECIFIED CHROMOSOME ABNORMALITIES
118 Q97.0 KAROTYPE 47, XXX 138 Q99.9 CHROMOSOMAL ABNORMALITY, UNSPECIFIED
0d : Kondisi Fertilitas, kondisi estetik, kondisi psikososial *
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 E29.0 TESTICULAR HYPERFUNCTION ... ... ...
2 E29.1 TESTICULAR HYPOFUNCTION 472 Z89.6 ACQUIRED ABSENCE OF LEG ABOVE KNEE
3 E29.8 OTHER TESTICULAR DYSFUNCTION ACQUIRED ABSENCE OF BOTH LOWER LIMBS [ANY
LEVEL, EXCEPT TOES ALONE]
4 E29.9 TESTICULAR DYSFUNCTION, UNSPECIFIED 473 Z89.7
5 E30.0 DELAYED PUBERTY 474 Z89.8 ACQUIRED ABSENCE OF UPPER AND LOWER LIMBS
[ANY LEVEL]
6 E30.1 PRECOCIOUS PUBERTY
7 E30.8 OTHER DISORDERS OF PUBERTY 475 Z89.9 ACQUIRED ABSENCE OF LIMB, UNSPECIFIED
8 E30.9 DISORDER OF PUBERTY, UNSPECIFIED 476 Z90.0 ACQUIRED ABSENCE OF PART OF HEAD AND NECK
9 F10.0 MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF 477 Z90.1 ACQUIRED ABSENCE OF BREAST(S)
ALCOHOL: ACUTE INTOXICATION
478 Z90.2 ACQUIRED ABSENCE OF LUNG [PART OF]
MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF
10 F10.1 ALCOHOL: HARMFUL USE 479 Z90.3 ACQUIRED ABSENCE OF PART OF STOMACH
11 F10.2 MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF 480 Z90.4 ACQUIRED ABSENCE OF OTHER PARTS OF DIGESTIVE
ALCOHOL: DEPENDENCE SYNDROME TRACT
12 F10.3 MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF 481 Z90.5 ACQUIRED ABSENCE OF KIDNEY
ALCOHOL: WITHDRAWAL STATE
482 Z90.6 ACQUIRED ABSENCE OF OTHER ORGANS OF URINARY
MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF TRACT
13 F10.4 ALCOHOL: WITHDRAWL STATE WITH DELIRIUM
483 Z90.7 ACQUIRED ABSENCE OF GENITAL ORGAN(S)
14 F10.5 MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF 484 Z90.8 ACQUIRED ABSENCE OF OTHER ORGANS
ALCOHOL: PSYCHOTIC DISORDER
485 Z91.0 PERSONAL HISTORY OF ALLERGY, OTHER THAN TO
MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF DRUGS AND BIPLOGICAL SUBSTANCES
15 F10.6 ALCOHOL: AMNESIC SYNDROME
486 Z91.1 PERSONAL HIST NONCOMPLIANCE WITH MED
MENTAL & BEHAVIOURAL DISORDER DUE TO USE TREATMENT AND REGIMEN
16 F10.7 OF ALCOHOL: RESIDUAL & LATE-ONSET PSYCHOTIC
487 Z91.2 PERSONAL HISTORY OF POOR PERSONAL HYGIENE
DISORDER
488 Z91.3 PERSONAL HISTORY OF UNHEALTHY SLEEP-WAKE
MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF SCHEDULE
17 F10.8 ALCOHOL: OTHER MENTAL & BEHAVIOURAL DISORDER
489 Z91.4 PERSONAL HISTORY OF PSYCHOLOGICAL TRAUMA
MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF NEC
18 F10.9 ALCOHOL: UNSPECIFIED MENTAL & BEHAVIOURAL
490 Z91.5 PERSONAL HISTORY OF SELF-HARM
DISORDER
491 Z91.6 PERSONAL HISTORY OF OTHER PHYSICAL TRAUMA
MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF
19 F11.0 OPIODS: ACUTE INTOXICATION 492 Z91.8 PERSONAL HISTORY OF OTHER SPECIFIED RISK-
FACTORS NEC
MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF
20 F11.1 OPIODS: HARMFUL USE 493 Z92.0 PERSONAL HISTORY OF CONTRACEPTION
MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF 494 Z94.0 KIDNEY TRANSPLANT STATUS
OPIODS: DEPENDENCE SYNDROME
21 F11.2 495 Z94.1 HEART TRANSPLANT STATUS
22 F11.3 MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF 496 Z94.2 LUNG TRANSPLANT STATUS
OPIODS: WITHDRAWAL STATE
497 Z94.3 HEART AND LUNGS TRANSPLANT STATUS
23 F11.4 MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF 498 Z94.4 LIVER TRANSPLANT STATUS
OPIODS: WITHDRAWL STATE WITH DELIRIUM
499 Z94.5 SKIN TRANSPLANT STATUS
24 F11.5 MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF 500 Z94.6 BONE TRANSPLANT STATUS
OPIODS: PSYCHOTIC DISORDER
501 Z94.7 CORNEAL TRANSPLANT STATUS
MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF
25 F11.6 OPIODS: AMNESIC SYNDROME 502 Z94.8 OTHER TRANSPLANTED ORGAN AND TISSUE STATUS
MENTAL & BEHAVIOURAL DISORDER DUE TO USE 503 Z94.9 TRANSPLANTED ORGAN AND TISSUE STATUS,
26 F11.7 OF OPIODS: RESIDUAL & LATE-ONSET PSYCHOTIC UNSPECIFIED
DISORDER 504 Z97.2 PRESENCE OF DENTAL PROSTHETIC DEVICE
(COMPLETE)(PARTIAL)
MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF
27 F11.8 OPIODS: OTHER MENTAL & BEHAVIOURAL DISORDER 505 Z97.3 PRESENCE OF SPECTACLES AND CONTACT LENSES
MENTAL & BEHAVIOURAL DISORDER DUE TO USE 506 Z97.4 PRESENCE OF EXTERNAL HEARING-AID
28 F11.9 OF OPIODS: UNSPECIFIED MENTAL & BEHAVIOURAL
507 Z97.5 PRESENCE OF (INTRAUTERINE) CONTRACEPTIVE
DISORDER DEVICE
29 F12.0 MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF 508 Z97.8 PRESENCE OF OTHER SPECIFIED DEVICES
CANNABINOIDS: ACUTE INTOXICATION
509 Z98.0 INTESTINAL BYPASS AND ANASTOMOSIS STATUS
30 F12.1 MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF 510 Z98.1 ARTHRODESIS STATUS
CANNABINOIDS: HARMFUL USE
511 Z98.2 PRESENCE OF CEREBROSPINAL FLUID DRAINAGE
MENTAL & BEHAVIOURAL DISORDER DUE TO USE OF DEVICE
31 F12.2 CANNABINOIDS: DEPENDENCE SYNDROME
512 Z98.8 OTHER SPECIFIED POSTSURGICAL STATES
* ditampilkan hanya sampling dari total 512 data
176 LAMPIRAN MJK-BKDK
0e : Tuberkulosis (Paru dan Non Paru)
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 A15.0 TUBERCULOSIS OF LUNG, CONFIRMED BY SPUTUM PRIMARY RESPIRATORY TUBERCULOSIS WITHOUT
MICROSCOPY WITH OR WITHOUT CULTURE 17 A16.7 MENTION OF BACTERIOLOGICAL OR HISTOLOGICAL
2 A15.1 TUBERCULOSIS OF LUNG, CONFIRMED BY CULTURE CONFIRMATION
ONLY
OTHER RESPIRATORY TUBERCULOSIS, WITHOUT
3 A15.2 TUBERCULOSIS OF LUNG, CONFIRMED 18 A16.8 MENTION OF BACTERIOLOGICAL OR HISTOLOGICAL
HISTOLOGICALLY
CONFIRMATION
4 A15.3 TUBERCULOSIS OF LUNG, CONFIRMED BY RESPIRATORY TUBERCULOSIS UNSPECIFIED, WITHOUT
UNSPECIFIED MEANS 19 A16.9 MENTION OF BACTERIOLOGICAL OR HISTOLOGICAL
TUBERCULOSIS OF INTRATHORACIC LYMPH CONFIRMATION.
5 A15.4 NODES, CONFIRMED BACTERIOLOGICALLY AND
20 A17.0 TUBERCULOUS MENINGITIS
HISTOLOGICALLY
21 A17.1 MENINGEAL TUBERCULOMA
TUBERCULOSIS OF LARYNX, TRACHEA AND 22 A17.8 OTHER TUBERCULOSIS OF NERVOUS SYSTEM
6 A15.5 BRONCHUS, CONFIRMED BACTERIOLOGICALLY AND
23 A17.9 TUBERCULOSIS OF NERVOUS SYSTEM, UNSPECIFIED
HISTOLOGICALLY
24 A18.0 TUBERCULOSIS OF BONES AND JOINTS
TUBERCULOUS PLEURISY, CONFIRMED
7 A15.6 BACTERIOLOGICALLY AND HISTOLOGICALLY 25 A18.1 TUBERCULOSIS OF GENITOURINARY SYSTEM
8 A15.7 PRIMARY RESPIRATORY TUBERCULOSIS, CONFIRMED 26 A18.2 TUBERCULOUS PERIPHERAL LYMPHADENOPATHY
BACTERIOLOGICALLY & HISTOLOGICALLY
27 A18.3 TUBERCULOSIS OF INTESTINES, PERITONEUM AND
OTHER RESPIRATORY TUBERCULOSIS, CONFIRMED MESENTERIC GLANDS
9 A15.8 BACTERIOLOGICALLY & HISTOLOGICALLY
28 A18.4 TUBERCULOSIS OF SKIN AND SUBCUTANEOUS TISSUE
10 A15.9 RESPIRATORY TUBERCULOSIS UNSPECIFIED, 29 A18.5 TUBERCULOSIS OF EYE
CONFIRMED BACTERIOLOGICALLY & HISTOLOGICALLY
30 A18.6 TUBERCULOSIS OF EAR
11 A16.0 TUBERCULOSIS OF LUNG, BACTERIOLOGICALLY AND 31 A18.7 TUBERCULOSIS OF ADRENAL GLANDS
HISTOLOGICALLY NEGATIVE
32 A18.8 TUBERCULOSIS OF OTHER SPECIFIED ORGANS
12 A16.1 TUBERCULOSIS OF LUNG, BACTERIOLOGICAL AND 33 A19.0 ACUTE MILIARY TUBERCULOSIS OF A SINGLE
HISTOLOGICAL EXAMINATION NOT DONE SPECIFIED SITE
TUBERCULOSIS OF LUNG, WITHOUT MENTION 34 A19.1 ACUTE MILIARY TUBERCULOSIS OF MULTIPLE SITES
13 A16.2 OF BACTERIOLOGICAL OR HISTOLOGICAL
35 A19.2 ACUTE MILIARY TUBERCULOSIS, UNSPECIFIED
CONFIRMATION
36 A19.8 OTHER MILIARY TUBERCULOSIS
TUBERCULOSIS OF INTRATHORACIC LYMPH NODES,
14 A16.3 WITHOUT MENTION OF BACTERIOLOGICAL OR 37 A19.9 MILIARY TUBERCULOSIS, UNSPECIFIED
HISTOLOGICAL CONFIRMATION 38 B90.0 SEQUELAE OF CENTRAL NERVOUS SYSTEM
TUBERCULOSIS
TUBERCULOSIS OF LARYNX, TRACHEA
AND BRONCHUS, WITHOUT MENTION OF 39 B90.1 SEQUELAE OF GENITOURINARY TUBERCULOSIS
15 A16.4 BACTERIOLOGICAL OR HISTOLOGICAL
40 B90.2 SEQUELAE OF TUBERCULOSIS OF BONES AND JOINTS
CONFIRMATION 41 B90.8 SEQUELAE OF TUBERCULOSIS OF OTHER ORGANS
TUBERCULOUS PLEURISY, WITHOUT MENTION 42 B90.9 SEQUELAE OF RESPIRATORY AND UNSPECIFIED
16 A16.5 OF BACTERIOLOGICAL OR HISTOLOGICAL TUBERCULOSIS
CONFIRMATION. 43 Z20.1 CONTACT WITH AND EXPOSURE TO TUBERCULOSIS
0f : HIV
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 B20.0 HIV DISEASE RESULTING IN MYCOBACTERIAL 16 B21.8 HIV DISEASE RESULTING IN OTHER MALIGNANT
INFECTION NEOPLASMS
2 B20.1 HIV DISEASE RESULTING IN OTHER BACTERIAL 17 B21.9 HIV DISEASE RESULTING IN UNSPECIFIED MALIGNANT
INFECTIONS NEOPLASM
3 B20.2 HIV DISEASE RESULTING IN CYTOMEGALOVIRAL 18 B22.0 HIV DISEASE RESULTING IN ENCEPHALOPATHY
DISEASE
19 B22.1 HIV DISEASE RESULTING IN LYMPHOID INTERSTITIAL
4 B20.3 HIV DISEASE RESULTING IN OTHER VIRAL INFECTIONS PNEUMONITIS
5 B20.4 HIV DISEASE RESULTING IN CANDIDIASIS 20 B22.2 HIV DISEASE RESULTING IN WASTING SYNDROME
6 B20.5 HIV DISEASE RESULTING IN OTHER MYCOSES HIV DISEASE RESULTING IN MULTIPLE DISEASES
CLASSIFIED ELSEWHERE
7 B20.6 HIV DISEASE RESULTING IN PNEUMOCYSTIS CARINII 21 B22.7
PNEUMONIA
22 B23.0 ACUTE HIV INFECTION SYNDROME
8 B20.7 HIV DISEASE RESULTING IN MULTIPLE INFECTIONS
HIV DISEASE RESULTING IN (PERSISTENT)
9 B20.8 HIV DISEASE RESULTING IN OTHER INFECTIOUS AND 23 B23.1 GENERALIZED LYMPHADENOPATHY
PARASITIC DISEASE
HIV DISEASE RESULTING IN HAEMATOLOGICAL AND
10 B20.9 HIV DISEASE RESULTING IN UNSPECIFIED INFECTIOUS 24 B23.2 IMMUNOLOGICAL ABNORMALITIES, NOT ELSEWHERE
OR PARASITIC DISEASE
CLASSIFIED
11 B21.0 HIV DISEASE RESULTING IN KAPOSI'S SARCOMA
HIV DISEASE RESULTING IN OTHER SPECIFIED
12 B21.1 HIV DISEASE RESULTING IN BURKITT'S LYMPHOMA 25 B23.8 CONDITIONS
13 B21.2 HIV DISEASE RESULTING IN OTHER TYPES OF NON- 26 B24 UNSPECIFIED HUMAN IMMUNODEFICIENCY VIRUS
HODGKIN'S LYMPHOMA [HIV] DISEASE
HIV DISEASE RESULTING IN OTHER MALIGNANT 27 Z20.6 CONTACT WITH AND EXPOSURE TO HUMAN
14 B21.3 NEOPLASMA OF LYMPHOID, HAEMATOPOIETIC AND IMMUNODEFIC VIRUS [HIV]
RELATED TISSUE
15 B21.7 HIV DISEASE RESULTING IN MULTIPLE MALIGNANT 28 Z21 ASYMPTOMATIC HUMAN IMMUNODEFIC VIRUS [HIV]
NEOPLASMS INFECT STATUS
0g : Penyakit Akibat Kerja
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 J60 COALWORKER'S PNEUMOCONIOSIS 11 J63.8 PNEUMOCONIOSIS DUE TO OTHER SPECIFIED
INORGANIC DUSTS
2 J61 PNEUMOCONIOSIS DUE TO ASBESTOS AND OTHER
MINERAL FIBRES 12 J67.0 FARMER'S LUNG
3 J62.0 PNEUMOCONIOSIS DUE TO TALC DUST 13 J67.1 BAGASSOSIS
4 J62.8 PNEUMOCONIOSIS DUE TO OTHER DUST CONTAINING 14 J67.2 BIRD FANCIER'S LUNG
SILICA
15 J67.3 SUBEROSIS
5 J63.0 ALUMINOSIS (OF LUNG)
16 J67.4 MALTWORKER'S LUNG
6 J63.1 BAUXITE FIBROSIS (OF LUNG)
17 J67.5 MUSHROOM-WORKER'S LUNG
7 J63.2 BERYLLIOSIS
18 J67.6 MAPLE-BARK-STRIPPER'S LUNG
8 J63.3 GRAPHITE FIBROSIS (OF LUNG)
19 J67.7 AIR-CONDITIONER AND HUMIDIFIER LUNG
9 J63.4 SIDEROSIS
20 J67.8 HYPERSENSITIVITY PNEUMONITIS DUE TO OTHER
10 J63.5 STANNOSIS ORGANIC DUSTS
MJK-BKDK LAMPIRAN 177
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
21 J67.9 HYPERSENSITIVITY PNEUMONITIS DUE TO 31 J70.0 ACUTE PULMONARY MANIFESTATIONS DUE TO
UNSPECIFIED ORGANIC DUST RADIATION
22 J68.0 BRONCHITIS & PNEUMONITIS DUE CHEMICALS, GASES 32 J70.1 CHRONIC AND OTHER PULMONARY MANIFESTATIONS
FUMES & VAPOURS DUE TO RADIATION
23 J68.1 ACUTE PULMON'Y OEDEMA DUE CHEMICALS, GASES 33 Z57.0 OCCUPATIONAL EXPOSURE TO NOISE
FUMES & VAPOURS
34 Z57.1 OCCUPATIONAL EXPOSURE TO RADIATION
UPPER RESPIRATORY INFLAMMATION DUE TO
24 J68.2 CHEMICALS GASES, FUMES AND VAPOUR NOT 35 Z57.2 OCCUPATIONAL EXPOSURE TO DUST
ELSEWHERE CLASSIFIED 36 Z57.3 OCCUPATIONAL EXPOSURE TO OTHER AIR
CONTAMINANTS
OTHER ACUTE AND SUBACUTE RESPIRATORY
25 J68.3 CONDITIONS DUE TO CHEMICALS, GASES, FUMES & 37 Z57.4 OCCUPATIONAL EXPOSURE TO TOXIC AGENTS IN
AGRICULTURE
VAPOURS
26 J68.4 CHRONIC RESPIRATORY CONDITIONS DUE 38 Z57.5 OCCUPATIONAL EXPOSURE TO TOXIC AGENTS IN
CHEMICALS, GASES, FUMES AND VAPOURS OTHER INDUSTRIES
27 J68.8 OTHER RESPIRATORY CONDITIONS DUE CHEMICALS, 39 Z57.6 OCCUPATIONAL EXPOSURE TO EXTREME
GASES FUMES & VAPOURS TEMPERATURE
28 J68.9 UNSPECIFIED RESPIRATORY CONDITIONS DUE 40 Z57.7 OCCUPATIONAL EXPOSURE TO VIBRATION
CHEMICALS, GASES FUMES & VAPOURS
41 Z57.8 OCCUPATIONAL EXPOSURE TO OTHER RISK-FACTORS
29 J69.1 PNEUMONITIS DUE TO OILS AND ESSENCES 42 Z57.9 OCCUPATIONAL EXPOSURE TO UNSPECIFIED RISK-
FACTOR
30 J69.8 PNEUMONITIS DUE TO OTHER SOLIDS AND LIQUIDS
0h : Bayi baru lahir
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 P00.0 FETUS AND NEWBORN AFECTED BY MATERNAL 27 P02.6 FETUS AND NEWBORN AFFECT OTH UNSPEC CONDS
HYPERTENSIVE DISORD OF UMBILICAL CORD
2 P00.1 FET AND NEWBORN AFECTED BY MAT RENAL AND 28 P02.7 FETUS AND NEWBORN AFFECTED BY
URINARY TRACT DIS CHORIOAMNIONITIS
3 P00.2 FETUS AND NEWBORN AFFECTED BY MAT INFECT 29 P02.8 FETUS AND NEWBORN AFFECT BY OTH
AND PARASITIC DIS ABNORMALITIES OF MEMBR
4 P00.3 FETUS AND NEWBORN AFFECTED OTH MAT 30 P02.9 FETUS AND NEWBORN AFFECTED BY ABNORM OF
CIRCULATORY AND RESP DIS MEMBRANES UNSP
5 P00.4 FETUS AND NEWBORN AFFECTED BY MATERNAL 31 P03.0 FETUS AND NEWBORN AFFECTED BY BREECH
NUTRITIONAL DISORDERS DELIVERY AND EXTRACTION
6 P00.5 FETUS AND NEWBORN AFFECTED BY MATERNAL 32 P03.1 FET NEWBORN AFFECT OTH MALPRESENT MALPOS
INJURY DISPROP LAB DELIV
7 P00.6 FETUS AND NEWBORN AFFECTED BY SURGICAL 33 P03.2 FETUS AND NEWBORN AFFECTED BY FORCEPS
PROCEDURE ON MOTHER DELIVERY
8 P00.7 FETUS AND NEWBORN AFFECTED OTHER MEDIC 34 P03.3 FET AND NEWBORN AFFECTED DELIV VACUUM
PROCS ON MOTHER NEC EXTRACTOR VENTOUSE
9 P00.8 FETUS AND NEWBORN AFFECTED BY OTHER 35 P03.4 FETUS AND NEWBORN AFFECTED BY CAESAREAN
MATERNAL CONDITIONS DELIVERY
10 P00.9 FETUS AND NEWBORN AFFECTED BY UNSPECIFIED 36 P03.5 FETUS AND NEWBORN AFFECTED BY PRECIPITATE
MATERNAL CONDITION DELIVERY
11 P01.0 FETUS AND NEWBORN AFFECTED BY INCOMPETENT 37 P03.6 FETUS AND NEWBORN AFFECTED BY ABNORMAL
CERVIX UTERINE CONTRACTIONS
12 P01.1 FETUS AND NEWBORN AFFECTED BY PREMATURE 38 P03.8 FETUS AND NEWBORN AFFECTED OTHER SPEC
RUPTURE OF MEMBRANES COMPS OF LABOUR DELIV
13 P01.2 FETUS AND NEWBORN AFFECTED BY 39 P03.9 FETUS AND NEWBORN AFFECTED BY COMP OF LAB
OLIGOHYDRAMNIOS AND DELIV UNSP
14 P01.3 FETUS AND NEWBORN AFFECTED BY 40 P04.0 FET NEWBORN AFFECT MAT ANAESTH AND ANALGES
POLYHYDRAMNIOS PREG LAB DEL
15 P01.4 FETUS AND NEWBORN AFFECTED BY ECTOPIC 41 P04.1 FETUS AND NEWBORN AFFECTED BY OTHER
PREGNANCY MATERNAL MEDICATION
16 P01.5 FETUS AND NEWBORN AFFECTED BY MULTIPLE 42 P04.2 FETUS AND NEWBORN AFFECTED BY MATERNAL USE
PREGNANCY OF TOBACCO
17 P01.6 FETUS AND NEWBORN AFFECTED BY MATERNAL 43 P04.3 FETUS AND NEWBORN AFFECTED BY MATERNAL USE
DEATH OF ALCOHOL
18 P01.7 FETUS AND NEWBORN AFFECTED BY 44 P04.4 FETUS AND NEWBORN AFFECTED BY MAT USE OF
MALPRESENTATION BEFORE LABOUR DRUGS OF ADDICTION
19 P01.8 FETUS AND NEWBORN AFFECTED OTHER MATERNAL 45 P04.5 FETUS AND NEWBORN AFECT BY MAT USE OF
COMPS OF PREG NUTRITIONAL CHEM SUBS
20 P01.9 FETUS AND NEWBORN AFFECT BY MATERNAL COMP FET NEWBORN AFFECT MAT EXPOSURE TO
OF PREG UNSPEC ACT ENVIRONML CHEM SUBS
46 P04.6
FETUS AND NEWBORN AFFECTED BY PLACENTA
21 P02.0 PRAEVIA FETUS AND NEWBORN AFFECTED BY OTHER MAT
NOXIOUS INFLUENCES
FETUS AND NEWBORN AFFECT OTH FORMS PLACENT 47 P04.8
SEPN HAEMORRH
22 P02.1 FETUS AND NEWBORN AFFECTED BY MAT NOXIOUS
INFLUENCE UNSPEC ACT
FETUS NEWBORN AFFECT OTHER UNSP MORPH 48 P04.9
FUNCT ABNORM PLACENT
23 P02.2 49 P05.0 LIGHT FOR GESTATIONAL AGE
24 P02.3 FET AND NEWBORN AFFECTED BY PLACENTAL 50 P05.1 SMALL FOR GESTATIONAL AGE
TRANSFUSION SYNDR
FET MALNUTRIT WITHOUT MENTION LIGHT OR SMALL
25 P02.4 FETUS AND NEWBORN AFFECTED BY PROLAPSED 51 P05.2 FOR GESTAT AGE
CORD
52 P05.9 SLOW FETAL GROWTH, UNSPECIFIED
26 P02.5 FETUS AND NEWBORN AFFECTED OTHER
COMPRESSION UMB CORD 53 P95 FETAL DEATH OF UNSPECIFIED CAUSE
0i : Kasus meninggal mendadak
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 R95 SUDDEN INFANT DEATH SYNDROME 4 R98 UNATTENDED DEATH
2 R96.0 INSTANTANEOUS DEATH OTHER ILL-DEFINED AND UNSPECIFIED CAUSE OF
MORTALITY
3 R96.1 DEATH OCCURRING LESS THAN 24 HR FROM ONSET 5 R99
SYMPTOMS NOT OTHERWISE EXPLAINED
178 LAMPIRAN MJK-BKDK
0j : Kehamilan, persalinan dan nifas beserta seluruh gangguannya SKENARIO
1
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 O80.0 SPONTANEOUS VERTEX DELIVERY 32 Z35.7 SUPERVISION OF HIGH-RISK PREGNANCY DUE TO
SOCIAL PROBLEMS
2 O80.1 SPONTANEOUS BREECH DELIVERY
33 Z35.8 SUPERVISION OF OTHER HIGH-RISK PREGNANCIES
3 O80.8 OTHER SINGLE SPONTANEOUS DELIVERY
SUPERVISION OF HIGH-RISK PREGNANCY,
4 O80.9 SINGLE SPONTANEOUS DELIVERY, UNSPECIFIED 34 Z35.9 UNSPECIFIED
5 O81.0 LOW FORCEPS DELIVERY ANTENATAL SCREENING FOR CHROMOSOMAL
ANOMALIES
6 O81.1 MID-CAVITY FORCEPS DELIVERY 35 Z36.0
7 O81.2 MID-CAVITY FORCEPS WITH ROTATION 36 Z36.1 ANTENATAL SCREENING FOR RAISED
ALPHAFETOPROTEIN LEVEL
8 O81.3 OTHER AND UNSPECIFIED FORCEPS DELIVERY
9 O81.4 VACUUM EXTRACTOR DELIVERY 37 Z36.2 OTHER ANTENATAL SCREENING BASED ON
AMNIOCENTESIS
10 O81.5 DELIVERY BY COMBINATION OF FORCEPS AND
VACUUM EXTRACTOR ANTENATAL SCREENING MALFORMATION USING
38 Z36.3 ULTRASOUND AND OTHER PHYSICAL METHODS
11 Z30.0 GENERAL COUNSELLING AND ADVICE ON
CONTRACEPTION ANTENATAL SCREENING FETAL GROWTH
39 Z36.4 RETARDATION USING ULTRASOUND OTH PHYSICAL
12 Z30.1 INSERTION OF (INTRAUTERINE) CONTRACEPTIVE
DEVICE METHODS
13 Z30.2 STERILIZATION 40 Z36.5 ANTENATAL SCREENING FOR ISOIMMUNIZATION
14 Z30.3 MENSTRUAL EXTRACTION 41 Z36.8 OTHER ANTENATAL SCREENING
15 Z30.4 SURVEILLANCE OF CONTRACEPTIVE DRUGS 42 Z36.9 ANTENATAL SCREENING, UNSPECIFIED
16 Z30.5 SURVEILLANCE OF (INTRAUTERINE) CONTRACEPTIVE 43 Z37.0 SINGLE LIVE BIRTH
DEVICE
44 Z37.1 SINGLE STILLBIRTH
17 Z30.8 OTHER CONTRACEPTIVE MANAGEMENT
45 Z37.2 TWINS, BOTH LIVEBORN
18 Z30.9 CONTRACEPTIVE MANAGEMENT, UNSPECIFIED
46 Z37.3 TWINS, ONE LIVEBORN AND ONE STILLBORN
19 Z32.0 PREGNANCY, NOT (YET) CONFIRMED
47 Z37.4 TWINS, BOTH STILLBORN
20 Z32.1 PREGNANCY CONFIRMED
48 Z37.5 OTHER MULTIPLE BIRTHS, ALL LIVEBORN
21 Z33 PREGNANT STATE, INCIDENTAL
49 Z37.6 OTHER MULTIPLE BIRTHS, SOME LIVEBORN
22 Z34.0 SUPERVISION OF NORMAL FIRST PREGNANCY
50 Z37.7 OTHER MULTIPLE BIRTHS, ALL STILLBORN
23 Z34.8 SUPERVISION OF OTHER NORMAL PREGNANCY
51 Z37.9 OUTCOME OF DELIVERY, UNSPECIFIED
24 Z34.9 SUPERVISION OF NORMAL PREGNANCY, UNSPECIFIED
52 Z38.0 SINGLETON, BORN IN HOSPITAL
SUPERVISION OF PREGNANCY WITH HISTORY OF
25 Z35.0 INFERTILITY 53 Z38.1 SINGLETON, BORN OUTSIDE HOSPITAL
26 Z35.1 SUPERVISION OF PREGNANCY WITH HISTORY OF 54 Z38.2 SINGLETON, UNSPECIFIED AS TO PLACE OF BIRTH
ABORTIVE OUTCOME
55 Z38.3 TWIN, BORN IN HOSPITAL
27 Z35.2 SUPERVISION OF PREGNANCY WITH OTHER POOR 56 Z38.4 TWIN, BORN OUTSIDE HOSPITAL
REPRODUCTIVE OR OBSTETRIC HISTORY
57 Z38.5 TWIN, UNSPECIFIED AS TO PLACE OF BIRTH
28 Z35.3 SUPERVISION OF PREGNANCY WITH HISTORY 58 Z38.6 OTHER MULTIPLE, BORN IN HOSPITAL
INSUFFICIENT ANTENATAL CARE
59 Z38.7 OTHER MULTIPLE, BORN OUTSIDE HOSPITAL
29 Z35.4 SUPERVISION OF PREGNANCY WITH GRAND 60 Z38.8 OTHER MULTIPLE, UNSPECIFIED AS TO PLACE OF BIRTH
MULTIPARITY
61 Z39.0 CARE AND EXAMINATION IMMEDIATELY AFTER DELIVERY
30 Z35.5 SUPERVISION OF ELDERLY PRIMIGRAVIDA
62 Z39.1 CARE AND EXAMINATION OF LACTATING MOTHER
31 Z35.6 SUPERVISION OF VERY YOUNG PRIMIGRAVIDA
63 Z39.2 ROUTINE POSTPARTUM FOLLOW-UP
0j : Kehamilan, persalinan dan nifas beserta seluruh gangguannya * SKENARIO
2
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 O00.0 ABDOMINAL PREGNANCY 23 O04.0 MEDICAL ABORTION, INCOMPLETE, COMPLICATED BY
GENITAL TRACT AND PELVIC INFECTION
2 O00.1 TUBAL PREGNANCY
MEDICAL ABORTION, INCOMPLETE, COMPLICATED BY
3 O00.2 OVARIAN PREGNANCY 24 O04.1 DELAYED OR EXCESSIVE HAEMORRHAGE
4 O00.8 OTHER ECTOPIC PREGNANCY MEDICAL ABORTION, INCOMPLETE, COMPLICATED
BY EMBOLISM
5 O00.9 ECTOPIC PREGNANCY, UNSPECIFIED 25 O04.2
6 O01.0 CLASSICAL HYDATIDIFORM MOLE 26 O04.3 MEDICAL ABORTION, INCOMPLETE, WITH OTHER AND
UNSPECIFIED COMPLICATIONS
7 O01.1 INCOMPLETE AND PARTIAL HYDATIDIFORM MOLE
8 O01.9 HYDATIDIFORM MOLE, UNSPECIFIED 27 O04.4 MEDICAL ABORTION, INCOMPLETE, WITHOUT
COMPLICATION
9 O02.0 BLIGHTED OVUM AND NONHYDATIDIFORM MOLE
MEDICAL ABORTION, COMPLETE OR UNSPECIFIED,
10 O02.1 MISSED ABORTION 28 O04.5 COMPLICATED BY GENITAL TRACT AND PELVIC
11 O02.8 OTHER SPECIFIED ABNORMAL PRODUCTS OF INFECTION
CONCEPTION
MEDICAL ABORTION, COMPLETE OR UNSPECIFIED,
12 O02.9 ABNORMAL PRODUCT OF CONCEPTION, UNSPECIFIED 29 O04.6 COMPLICATED BY DELAYED OR EXCESSIVE
SPONTANEOUS ABORTION, INCOMPLETE ABORTION HAEMORRHAGE
13 O03.0 COMPLICATED BY GENITAL TRACT AND PELVIC
30 O04.7 MEDICAL ABORTION, COMPLETE OR UNSPECIFIED,
INFECTION COMPLICATED BY EMBOLISM
SPONTANEOUS ABORTION, INCOMPLETE ABORTION 31 O04.8 MEDICAL ABORTION, COMPLETE OR UNSPECIFIED,
14 O03.1 COMPLICATED BY DELAYED OR EXCESSIVE WITH OTHER AND UNSPECIFIED COMPLICATIONS
HAEMORRHAGE 32 O04.9 MEDICAL ABORTION, COMPLETE OR UNSPECIFIED,
WITHOUT COMPLICATION
15 O03.2 SPONTANEOUS ABORTION, INCOMPLETE,
COMPLICATED BY EMBOLISM OTHER ABORTION, INCOMPLETE, COMPLICATED BY
33 O05.0 GENITAL TRACT AND PELVIC INFECTION
16 O03.3 SPONTANEOUS ABORTION, INCOMPLETE, WITH
OTHER AND UNSPECIFIED COMPLICATIONS OTHER ABORTION, INCOMPLETE, COMPLICATED BY
34 O05.1 DELAYED OR EXCESSIVE HAEMORRHAGE
17 O03.4 SPONTANEOUS ABORTION, INCOMPLETE, WITHOUT
COMPLICATION OTHER ABORTION, INCOMPLETE, COMPLICATED BY
35 O05.2 EMBOLISM
SPONTANEOUS ABORTION, COMPLETE OR
18 O03.5 UNSPECIFIED, COMPLICATED BY GENITAL TRACT AND 36 O05.3 OTHER ABORTION, INCOMPLETE, WITH OTHER AND
UNSPECIFIED COMPLICATIONS
PELVIC INFECTION
SPONTANEOUS ABORTION, COMPLETE OR 37 O05.4 OTHER ABORTION, INCOMPLETE, WITHOUT
19 O03.6 UNSPECIFIED, COMPLICATED BY DELAYED OR COMPLICATION
EXCESSIVE HAEMORRHAGE OTHER ABORTION, COMPLETE OR UNSPECIFIED,
38 O05.5 COMPLICATED BY GENITAL TRACT AND PELVIC
20 O03.7 SPONTANEOUS ABORTION, COMPLETE OR
UNSPECIFIED, COMPLICATED BY EMBOLISM INFECTION
SPONTANEOUS ABORTION, COMPLETE OR OTHER ABORTION, COMPLETE OR UNSPECIFIED,
21 O03.8 UNSPECIFIED, WITH OTHER AND UNSPECIFIED 39 O05.6 COMPLICATED BY DELAYED OR EXCESSIVE
COMPLICATIONS HAEMORRHAGE
22 O03.9 SPONTANEOUS ABORTION, COMPLETE OR 40 O05.7 OTHER ABORTION, COMPLETE OR UNSPECIFIED,
UNSPECIFIED, WITHOUT COMPLICATION COMPLICATED BY EMBOLISM
MJK-BKDK LAMPIRAN 179
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
41 O05.8 OTHER ABORTION, COMPLETE OR UNSPECIFIED, WITH ... ... ...
OTHER AND UNSPECIFIED COMPLICATIONS
446 Z34.0 SUPERVISION OF NORMAL FIRST PREGNANCY
42 O05.9 OTHER ABORTION, COMPLETE OR UNSPECIFIED,
WITHOUT COMPLICATION 447 Z34.8 SUPERVISION OF OTHER NORMAL PREGNANCY
43 O06.0 UNSPECIFIED ABORTION, INCOMPLETE, COMPLICATED 448 Z34.9 SUPERVISION OF NORMAL PREGNANCY, UNSPECIFIED
BY GENITAL TRACT AND PELVIC INFECTION
449 Z35.0 SUPERVISION OF PREGNANCY WITH HISTORY OF
44 O06.1 UNSPECIFIED ABORTION, INCOMPLETE, COMPLICATED INFERTILITY
BY DELAYED OR EXCESSIVE HAEMORRHAGE
450 Z35.1 SUPERVISION OF PREGNANCY WITH HISTORY OF
45 O06.2 UNSPECIFIED ABORTION, INCOMPLETE, COMPLICATED ABORTIVE OUTCOME
BY EMBOLISM
451 Z35.2 SUPERVISION OF PREGNANCY WITH OTHER POOR
46 O06.3 UNSPECIFIED ABORTION, INCOMPLETE, WITH OTHER REPRODUCTIVE OR OBSTETRIC HISTORY
AND UNSPECIFIED COMPLICATIONS
452 Z35.3 SUPERVISION OF PREGNANCY WITH HISTORY
47 O06.4 UNSPECIFIED ABORTION, INCOMPLETE, WITHOUT INSUFFICIENT ANTENATAL CARE
COMPLICATION
453 Z35.4 SUPERVISION OF PREGNANCY WITH GRAND
UNSPECIFIED ABORTION, COMPLETE OR MULTIPARITY
48 O06.5 UNSPECIFIED, COMPLICATED BY GENITAL TRACT AND
454 Z35.5 SUPERVISION OF ELDERLY PRIMIGRAVIDA
PELVIC INFECTION
455 Z35.6 SUPERVISION OF VERY YOUNG PRIMIGRAVIDA
UNSPECIFIED ABORTION, COMPLETE OR
49 O06.6 UNSPECIFIED, COMPLICATED BY DELAYED OR 456 Z35.7 SUPERVISION OF HIGH-RISK PREGNANCY DUE TO
SOCIAL PROBLEMS
EXCESSIVE HAEMORRHAGE
457 Z35.8 SUPERVISION OF OTHER HIGH-RISK PREGNANCIES
50 O06.7 UNSPECIFIED ABORTION, COMPLETE OR
UNSPECIFIED, COMPLICATED BY EMBOLISM 458 Z35.9 SUPERVISION OF HIGH-RISK PREGNANCY,
UNSPECIFIED
UNSPECIFIED ABORTION, COMPLETE OR
51 O06.8 UNSPECIFIED, WITH OTHER AND UNSPECIFIED 459 Z36.0 ANTENATAL SCREENING FOR CHROMOSOMAL
ANOMALIES
COMPLICATIONS
ANTENATAL SCREENING FOR RAISED
52 O06.9 UNSPECIFIED ABORTION, COMPLETE OR 460 Z36.1 ALPHAFETOPROTEIN LEVEL
UNSPECIFIED, WITHOUT COMPLICATION
OTHER ANTENATAL SCREENING BASED ON
53 O07.0 FAILED MEDICAL ABORTION, COMPLICATED BY 461 Z36.2 AMNIOCENTESIS
GENITAL TRACT AND PELVIC INFECTION
ANTENATAL SCREENING MALFORMATION USING
54 O07.1 FAILED MEDICAL ABORTION COMPLICATED BY 462 Z36.3 ULTRASOUND AND OTHER PHYSICAL METHODS
DELAYED OR EXCESSIVE HAEMORRHAGE
ANTENATAL SCREENING FETAL GROWTH
55 O07.2 FAILED MEDICAL ABORTION, COMPLICATED BY 463 Z36.4 RETARDATION USING ULTRASOUND OTH PHYSICAL
EMBOLISM
METHODS
56 O07.3 FAILED MEDICAL ABORTION, WITH OTHER AND
UNSPECIFIED COMPLICATIONS 464 Z36.5 ANTENATAL SCREENING FOR ISOIMMUNIZATION
57 O07.4 FAILED MEDICAL ABORTION, WITHOUT 465 Z36.8 OTHER ANTENATAL SCREENING
COMPLICATION
466 Z36.9 ANTENATAL SCREENING, UNSPECIFIED
OTHER AND UNSPECIFIED FAILED ATTEMPTED 467 Z37.0 SINGLE LIVE BIRTH
58 O07.5 ABORTION, COMPLICATED BY GENITAL TRACT AND
468 Z37.1 SINGLE STILLBIRTH
PELVIC INFECTION
469 Z37.2 TWINS, BOTH LIVEBORN
OTHER AND UNSPECIFIED FAILED ATTEMPTED
59 O07.6 ABORTION, COMPLICATED BY DELAYED OR EXCESSIVE 470 Z37.3 TWINS, ONE LIVEBORN AND ONE STILLBORN
HAEMORRHAGE 471 Z37.4 TWINS, BOTH STILLBORN
60 O07.7 OTHER AND UNSPECIFIED FAILED ATTEMPTED 472 Z37.5 OTHER MULTIPLE BIRTHS, ALL LIVEBORN
ABORTION, COMPLICATED BY EMBOLISM
473 Z37.6 OTHER MULTIPLE BIRTHS, SOME LIVEBORN
OTHER AND UNSPECIFIED FAILED ATTEMPTED 474 Z37.7 OTHER MULTIPLE BIRTHS, ALL STILLBORN
61 O07.8 ABORTION, WITH OTHER AND UNSPECIFIED
475 Z37.9 OUTCOME OF DELIVERY, UNSPECIFIED
COMPLICATIONS
476 Z38.0 SINGLETON, BORN IN HOSPITAL
OTHER AND UNSPECIFIED FAILED ATTEMPTED
62 O07.9 ABORTION, WITHOUT COMPLICATION 477 Z38.1 SINGLETON, BORN OUTSIDE HOSPITAL
GENITAL TRACT AND PELVIC INFECTION FOLLOWING 478 Z38.2 SINGLETON, UNSPECIFIED AS TO PLACE OF BIRTH
ABORTION AND ECTOPIC AND MOLAR PREGNANCY
63 O08.0 479 Z38.3 TWIN, BORN IN HOSPITAL
DELAYED OR EXCESSIVE HAEMORRHAGE FOLLOWING 480 Z38.4 TWIN, BORN OUTSIDE HOSPITAL
ABORTION AND ECTOPIC AND MOLAR PREGNANCY
64 O08.1 481 Z38.5 TWIN, UNSPECIFIED AS TO PLACE OF BIRTH
65 O08.2 EMBOLISM FOLLOWING ABORTION AND ECTOPIC 482 Z38.6 OTHER MULTIPLE, BORN IN HOSPITAL
AND MOLAR PREGNANCY
483 Z38.7 OTHER MULTIPLE, BORN OUTSIDE HOSPITAL
66 O08.3 SHOCK FOLLOWING ABORTION AND ECTOPIC AND 484 Z38.8 OTHER MULTIPLE, UNSPECIFIED AS TO PLACE OF
MOLAR PREGNANCY BIRTH
67 O08.4 RENAL FAILURE FOLLOWING ABORTION AND ECTOPIC 485 Z39.0 CARE AND EXAMINATION IMMEDIATELY AFTER
AND MOLAR PREGNANCY DELIVERY
68 O08.5 METABOLIC DISORDERS FOLLOWING ABORTION AND 486 Z39.1 CARE AND EXAMINATION OF LACTATING MOTHER
ECTOPIC AND MOLAR PREGNANCY
487 Z39.2 ROUTINE POSTPARTUM FOLLOW-UP
* ditampilkan hanya sampling dari total 487 data
0j : Kehamilan, persalinan dan nifas beserta seluruh gangguannya SKENARIO
berdasarkan grup 2
Grup Deskripsi Grup Jumlah
O00-O08 PREGNANCY WITH ABORTIVE OUTCOME 72
O10-O16 OEDEMA, PROTEINURIA AND HYPERTENSIVE DISORDERS IN PREGNANCY, CHILDBIRTH AND THE PUERPERIUM 20
O20-O29 OTHER MATERNAL DISORDERS PREDOMINANTLY RELATED TO PREGNANCY 57
O30-O48 MATERIAL CARE RELATED TO THE FETUS AND AMNIOTIC CAVITY AND POSSIBLE DELIVERY PROBLEMS 84
O60-O75 COMPLICATIONS OF LABOUR AND DELIVERY 101
O80-O84 DELIVERY 27
O85-O92 COMPLICATIONS PREDOMINANTLY RELATED TO THE PUERPERIUM 46
O94-O99 OTHER OBSTETRIC CONDITIONS, NOT ELSEWHERE CLASSIFIED 27
Z30-Z39 PERSONS ENCOUNTERING HEALTH SERVICES IN CIRCUMSTANCES RELATED TO REPRODUCTION 53
Total 487
0l : PAE (Preventable Adverse Event)
No ICD-10 ICD-10 DESCRIPTION
CODE
1 Z50.3 DRUG REHABILITATION
180 LAMPIRAN MJK-BKDK
Lampiran 17.
ICD 10 - Negative List pada Dx Sekunder*
(* = Kelompok ICD 10 yang bisa dikoding sebagai Dx Sekunder KLBB)
0b : PMS (Penyakit Menular Seksual)
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 N74.2 FEMALE SYPHILITIC PELVIC INFLAMMATORY DISEASE 3 N74.4 FEMALE CHLAMYDIAL PELVIC INFLAMMATORY
2 N74.3 FEMALE GONOCOCCAL PELVIC INFLAMMATORY DISEASE DISEASE
0g : Penyakit Akibat Kerja
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 V09.12 Pedestrian injured in unspecified nontraffic accident: ... ... ...
while work for income 1417 Y31.82
Falling, lying or running before or into moving object,
2 V09.13 Pedestrian injured in unspecified nontraffic accident: 1418 Y31.92 undetermined intent: at other spec places: while work
in oth type work for income
1419 Y33.02 Falling, lying or running before or into moving object,
3 W05.52 Fall involving wheelchair: at trade & service area: while 1420 Y33.12 undetermined intent: at unspec place: while work
work for income 1421 Y33.22 for income
1422 Y33.32 Other specified events, undetermined intent: at home:
4 W05.62 Fall involving wheelchair: at industr & const area: while 1423 Y33.42 while work for income
work for income 1424 Y33.52 Other specified events, undetermined intent: at
1425 Y33.60 residentl institutn: while work for income
5 W05.72 Fall involving wheelchair: at farm: while work for 1426 Y33.61 Other specified events, undetermined intent: at
income 1427 Y33.62 school, other..area: while work for income
Other specified events, undetermined intent: at sport
6 W05.82 Fall involving wheelchair: at other spec places: while 1428 Y33.64 & athlet area: while work for income
work for income Other specified events, undetermined intent: at street
1429 Y33.68 & highway: while work for income
7 W05.92 Fall involving wheelchair: at unspec place: while work 1430 Y33.69 Other specified events, undetermined intent: at trade
for income 1431 Y33.72 & service area: while work for income
1432 Y33.82 Other specified events, undetermined intent: at
8 W06.02 Fall involving bed: at home: while work for income 1433 Y33.92 industr & const area: in sport activity
1434 Y34.02 Other specified events, undetermined intent: at
9 W06.12 Fall involving bed: at residentl institutn: while work 1435 Y34.12 industr & const area: in leisure activity
for income 1436 Y34.22 Other specified events, undetermined intent: at
1437 Y34.32 industr & const area: while work for income
10 W06.22 Fall involving bed: at school, other..area: while work 1438 Y34.42 Other specified events, undetermined intent: at
for income 1439 Y34.52 industr & const area: while resting, sleeping, eating or
1440 Y34.60 engaging in other vital activities
11 W06.32 Fall involving bed: at sport & athlet area: while work 1441 Y34.61 Other specified events, undetermined intent: at
for income 1442 Y34.62 industr & const area: in oth spec activity
Other specified events, undetermined intent: at
12 W06.42 Fall involving bed: at street & highway: while work 1443 Y34.64 industr & const area: during unspec activity
for income Other specified events, undetermined intent: at farm:
1444 Y34.68 while work for income
13 W06.52 Fall involving bed: at trade & service area: while work 1445 Y34.69 Other specified events, undetermined intent: at other
for income 1446 Y34.72 spec places: while work for income
1447 Y34.82 Other specified events, undetermined intent: at
14 W06.62 Fall involving bed: at industr & const area: while work 1448 Y34.92 unspec place: while work for income
for income Unspecified event, undetermined intent: at home:
while work for income
15 W06.72 Fall involving bed: at farm: while work for income Unspecified event, undetermined intent: at residentl
institutn: while work for income
16 W06.82 Fall involving bed: at other spec places: while work Unspecified event, undetermined intent: at school,
for income other..area: while work for income
Unspecified event, undetermined intent: at sport &
17 W06.92 Fall involving bed: at unspec place: while work for athlet area: while work for income
income Unspecified event, undetermined intent: at street &
highway: while work for income
18 W07.02 Fall involving chair: at home: while work for income Unspecified event, undetermined intent: at trade &
service area: while work for income
19 W07.12 Fall involving chair: at residentl institutn: while work Unspecified event, undetermined intent: at industr &
for income const area: in sport activity
Unspecified event, undetermined intent: at industr &
20 W07.22 Fall involving chair: at school, other..area: while work const area: in leisure activity
for income Unspecified event, undetermined intent: at industr &
const area: while work for income
21 W07.32 Fall involving chair: at sport & athlet area: while work Unspecified event, undetermined intent: at industr &
for income const area: while resting, sleeping, eating or engaging
in other vital activities
22 W07.42 Fall involving chair: at street & highway: while work Unspecified event, undetermined intent: at industr &
for income const area: in oth spec activity
Unspecified event, undetermined intent: at industr &
23 W07.52 Fall involving chair: at trade & service area: while work const area: during unspec activity
for income Unspecified event, undetermined intent: at farm: while
work for income
24 W07.62 Fall involving chair: at industr & const area: while work Unspecified event, undetermined intent: at other spec
for income places: while work for income
Unspecified event, undetermined intent: at unspec
25 W07.72 Fall involving chair: at farm: while work for income place: while work for income
26 W07.82 Fall involving chair: at other spec places: while work
for income
27 W07.92 Fall involving chair: at unspec place: while work for
income
28 W08.02 Fall involving other furniture: at home: while work
for income
29 W08.12 Fall involving other furniture: at residentl institutn:
while work for income
30 W08.22 Fall involving other furniture: at school, other..area:
while work for income
31 W08.32 Fall involving other furniture: at sport & athlet area:
while work for income
32 W08.42 Fall involving other furniture: at street & highway:
while work for income
33 W08.52 Fall involving other furniture: at trade & service area:
while work for income
34 W08.62 Fall involving other furniture: at industr & const area:
while work for income
35 W08.72 Fall involving other furniture: at farm: while work
for income
36 W08.82 Fall involving other furniture: at other spec places:
while work for income
* ditampilkan hanya sampling dari total 1448 data
MJK-BKDK LAMPIRAN 181
0g/0l : PAK pada atlet; PAE pada non atlet
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
Diving or jumping into water causing injury other 39 W26.90 Contact with knife, sword or dagger: at unspec place:
1 W16.40 than drowning or submersion: at street & highway: in sport activity
in sport activity 40 W32.00 Handgun discharge: at home: in sport activity
Diving or jumping into water causing injury other 41 W32.10 Handgun discharge: at residentl institutn: in sport
2 W16.50 than drowning or submersion: at trade & service activity
area: in sport activity Handgun discharge: at school, other..area: in sport
activity
Diving or jumping into water causing injury other 42 W32.20
3 W16.60 than drowning or submersion: at industr & const
43 W32.30 Handgun discharge: at sport & athlet area: in sport
area: in sport activity activity
Diving or jumping into water causing injury other 44 W32.40 Handgun discharge: at street & highway: in sport
4 W16.80 than drowning or submersion: at other spec places: activity
in sport activity
Diving or jumping into water causing injury other 45 W32.50 Handgun discharge: at trade & service area: in sport
5 W16.90 than drowning or submersion: at unspec place: in activity
sport activity 46 W32.60 Handgun discharge: at industr & const area: in sport
activity
6 W17.00 Other fall from one level to another: at home: in
sport activity 47 W32.70 Handgun discharge: at farm: in sport activity
7 W17.10 Other fall from one level to another: at residentl 48 W32.80 Handgun discharge: at other spec places: in sport
institutn: in sport activity activity
8 W17.20 Other fall from one level to another: at school, other.. 49 W32.90 Handgun discharge: at unspec place: in sport activity
area: in sport activity
Rifle, shotgun and larger firearm discharge: at home:
9 W17.30 Other fall from one level to another: at sport & athlet 50 W33.00 in sport activity
area: in sport activity
Rifle, shotgun and larger firearm discharge: at
10 W17.40 Other fall from one level to another: at street & 51 W33.10 residentl institutn: in sport activity
highway: in sport activity
Rifle, shotgun and larger firearm discharge: at school,
11 W17.50 Other fall from one level to another: at trade & 52 W33.20 other..area: in sport activity
service area: in sport activity
Rifle, shotgun and larger firearm discharge: at sport
12 W17.60 Other fall from one level to another: at industr & 53 W33.30 & athlet area: in sport activity
const area: in sport activity
Rifle, shotgun and larger firearm discharge: at street
13 W17.70 Other fall from one level to another: at farm: in 54 W33.40 & highway: in sport activity
sport activity
Rifle, shotgun and larger firearm discharge: at trade
14 W17.80 Other fall from one level to another: at other spec 55 W33.50 & service area: in sport activity
places: in sport activity
Rifle, shotgun and larger firearm discharge: at industr
15 W17.90 Other fall from one level to another: at unspec place: 56 W33.60 & const area: in sport activity
in sport activity
Rifle, shotgun and larger firearm discharge: at farm:
16 W18.40 Other fall on same level: at street & highway: in 57 W33.70 in sport activity
sport activity
Rifle, shotgun and larger firearm discharge: at other
17 W18.60 Other fall on same level: at industr & const area: in 58 W33.80 spec places: in sport activity
sport activity
Rifle, shotgun and larger firearm discharge: at
18 W19.40 Unspecified fall: at street & highway: in sport activity 59 W33.90 unspec place: in sport activity
19 W19.60 Unspecified fall: at industr & const area: in sport 60 W34.00 Discharge from other and unspecified firearms: at
activity home: in sport activity
20 W24.00 Contact with lifting and transmission devices, not 61 W34.10 Discharge from other and unspecified firearms: at
elsewhere classified: at home: in sport activity residentl institutn: in sport activity
Contact with lifting and transmission devices, not 62 W34.20 Discharge from other and unspecified firearms: at
21 W24.10 elsewhere classified: at residentl institutn: in sport school, other..area: in sport activity
activity Discharge from other and unspecified firearms: at
sport & athlet area: in sport activity
Contact with lifting and transmission devices, not 63 W34.30
22 W24.20 elsewhere classified: at school, other..area: in sport
64 W34.40 Discharge from other and unspecified firearms: at
activity street & highway: in sport activity
Contact with lifting and transmission devices, not 65 W34.50 Discharge from other and unspecified firearms: at
23 W24.30 elsewhere classified: at sport & athlet area: in sport trade & service area: in sport activity
activity
Contact with lifting and transmission devices, not 66 W34.60 Discharge from other and unspecified firearms: at
24 W24.40 elsewhere classified: at street & highway: in sport industr & const area: in sport activity
activity 67 W34.70 Discharge from other and unspecified firearms: at
farm: in sport activity
Contact with lifting and transmission devices, not
25 W24.50 elsewhere classified: at trade & service area: in 68 W34.80 Discharge from other and unspecified firearms: at
other spec places: in sport activity
sport activity
Contact with lifting and transmission devices, not 69 W34.90 Discharge from other and unspecified firearms: at
26 W24.60 elsewhere classified: at industr & const area: in unspec place: in sport activity
sport activity 70 W39.00 Discharge of firework: at home: in sport activity
27 W24.70 Contact with lifting and transmission devices, not 71 W39.10 Discharge of firework: at residentl institutn: in sport
elsewhere classified: at farm: in sport activity activity
Contact with lifting and transmission devices, not 72 W39.20 Discharge of firework: at school, other..area: in sport
28 W24.80 elsewhere classified: at other spec places: in sport activity
activity Discharge of firework: at sport & athlet area: in
sport activity
Contact with lifting and transmission devices, not 73 W39.30
29 W24.90 elsewhere classified: at unspec place: in sport
74 W39.40 Discharge of firework: at street & highway: in sport
activity activity
30 W26.00 Contact with knife, sword or dagger: at home: in 75 W39.50 Discharge of firework: at trade & service area: in
sport activity sport activity
31 W26.10 Contact with knife, sword or dagger: at residentl 76 W39.60 Discharge of firework: at industr & const area: in
institutn: in sport activity sport activity
32 W26.20 Contact with knife, sword or dagger: at school, other.. 77 W39.70 Discharge of firework: at farm: in sport activity
area: in sport activity
33 W26.30 Contact with knife, sword or dagger: at sport & athlet 78 W39.80 Discharge of firework: at other spec places: in sport
area: in sport activity activity
34 W26.40 Contact with knife, sword or dagger: at street & 79 W39.90 Discharge of firework: at unspec place: in sport
highway: in sport activity activity
35 W26.50 Contact with knife, sword or dagger: at trade & 80 W50.00 Hit, struck, kicked, twisted, bitten or scratched by
service area: in sport activity another person: at home: in sport activity
36 W26.60 Contact with knife, sword or dagger: at industr & Hit, struck, kicked, twisted, bitten or scratched
const area: in sport activity 81 W50.10 by another person: at residentl institutn: in sport
37 W26.70 Contact with knife, sword or dagger: at farm: in activity
sport activity
Hit, struck, kicked, twisted, bitten or scratched by
38 W26.80 Contact with knife, sword or dagger: at other spec 82 W50.20 another person: at school, other..area: in sport
places: in sport activity
activity
182 LAMPIRAN MJK-BKDK
0k1 : Kasus hukum (penganiayaan, korban kekerasan); tidak dalam sedang bekerja (non KK) *
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
Hit, struck, kicked, twisted, bitten or scratched by ... ... ...
1 W50.21 another person: at school, other..area: in leisure 1776 Y09.39
1777 Y09.40 Assault by unspecified means: at sport & athlet area:
activity 1778 Y09.41 during unspec activity
1779 Y09.42 Assault by unspecified means: at street & highway: in
Hit, struck, kicked, twisted, bitten or scratched by 1780 Y09.43 sport activity
2 W50.24 another person: at school, other..area: while resting, Assault by unspecified means: at street & highway: in
1781 Y09.44 leisure activity
sleeping, eating or engaging in other vital activities Assault by unspecified means: at street & highway:
1782 Y09.48 while work for income
Hit, struck, kicked, twisted, bitten or scratched by 1783 Y09.49 Assault by unspecified means: at street & highway: in
3 W50.28 another person: at school, other..area: in oth spec 1784 Y09.50 oth type work
1785 Y09.51 Assault by unspecified means: at street & highway:
activity 1786 Y09.52 while resting, sleeping, eating or engaging in other
1787 Y09.53 vital activities
Hit, struck, kicked, twisted, bitten or scratched by Assault by unspecified means: at street & highway: in
4 W50.29 another person: at school, other..area: during unspec 1788 Y09.54 oth spec activity
Assault by unspecified means: at street & highway:
activity 1789 Y09.58 during unspec activity
1790 Y09.59 Assault by unspecified means: at trade & service area:
5 W50.30 Hit, struck, kicked, twisted, bitten or scratched by 1791 Y09.60 in sport activity
another person: at sport & athlet area: in sport activity 1792 Y09.61 Assault by unspecified means: at trade & service area:
1793 Y09.62 in leisure activity
Hit, struck, kicked, twisted, bitten or scratched by 1794 Y09.63 Assault by unspecified means: at trade & service area:
6 W50.31 another person: at sport & athlet area: in leisure while work for income
1795 Y09.64 Assault by unspecified means: at trade & service area:
activity in oth type work
1796 Y09.68 Assault by unspecified means: at trade & service area:
Hit, struck, kicked, twisted, bitten or scratched by 1797 Y09.69 while resting, sleeping, eating or engaging in other
7 W50.32 another person: at sport & athlet area: while work 1798 Y09.70 vital activities
1799 Y09.71 Assault by unspecified means: at trade & service area:
for income 1800 Y09.72 in oth spec activity
1801 Y09.73 Assault by unspecified means: at trade & service area:
Hit, struck, kicked, twisted, bitten or scratched by 1802 Y09.74 during unspec activity
8 W50.33 another person: at sport & athlet area: in oth type 1803 Y09.78 Assault by unspecified means: at industr & const area:
1804 Y09.79 in sport activity
work 1805 Y09.80 Assault by unspecified means: at industr & const area:
1806 Y09.81 in leisure activity
Hit, struck, kicked, twisted, bitten or scratched by 1807 Y09.82 Assault by unspecified means: at industr & const area:
9 W50.34 another person: at sport & athlet area: while resting, 1808 Y09.83 while work for income
Assault by unspecified means: at industr & const area:
sleeping, eating or engaging in other vital activities 1809 Y09.84 in oth type work
Assault by unspecified means: at industr & const area:
Hit, struck, kicked, twisted, bitten or scratched by 1810 Y09.88 while resting, sleeping, eating or engaging in other
10 W50.38 another person: at sport & athlet area: in oth spec 1811 Y09.89 vital activities
1812 Y09.90 Assault by unspecified means: at industr & const area:
activity 1813 Y09.91 in oth spec activity
1814 Y09.92 Assault by unspecified means: at industr & const area:
Hit, struck, kicked, twisted, bitten or scratched by 1815 Y09.93 during unspec activity
11 W50.39 another person: at sport & athlet area: during unspec Assault by unspecified means: at farm: in sport activity
1816 Y09.94 Assault by unspecified means: at farm: in leisure
activity activity
1817 Y09.98 Assault by unspecified means: at farm: while work
12 W50.40 Hit, struck, kicked, twisted, bitten or scratched by 1818 Y09.99 for income
another person: at street & highway: in sport activity Assault by unspecified means: at farm: in oth type
work
13 W50.41 Hit, struck, kicked, twisted, bitten or scratched by Assault by unspecified means: at farm: while resting,
another person: at street & highway: in leisure activity sleeping, eating or engaging in other vital activities
Assault by unspecified means: at farm: in oth spec
Hit, struck, kicked, twisted, bitten or scratched by activity
14 W50.44 another person: at street & highway: while resting, Assault by unspecified means: at farm: during unspec
activity
sleeping, eating or engaging in other vital activities Assault by unspecified means: at other spec places:
in sport activity
Hit, struck, kicked, twisted, bitten or scratched by Assault by unspecified means: at other spec places:
15 W50.48 another person: at street & highway: in oth spec in leisure activity
Assault by unspecified means: at other spec places:
activity while work for income
Assault by unspecified means: at other spec places:
Hit, struck, kicked, twisted, bitten or scratched by in oth type work
16 W50.49 another person: at street & highway: during unspec Assault by unspecified means: at other spec places:
while resting, sleeping, eating or engaging in other
activity vital activities
Assault by unspecified means: at other spec places: in
Hit, struck, kicked, twisted, bitten or scratched by oth spec activity
17 W50.50 another person: at trade & service area: in sport Assault by unspecified means: at other spec places:
during unspec activity
activity Assault by unspecified means: at unspec place: in
sport activity
Hit, struck, kicked, twisted, bitten or scratched by Assault by unspecified means: at unspec place: in
18 W50.51 another person: at trade & service area: in leisure leisure activity
Assault by unspecified means: at unspec place: while
activity work for income
Assault by unspecified means: at unspec place: in
Hit, struck, kicked, twisted, bitten or scratched by oth type work
19 W50.53 another person: at trade & service area: in oth type Assault by unspecified means: at unspec place: while
resting, sleeping, eating or engaging in other vital
work activities
Assault by unspecified means: at unspec place: in oth
Hit, struck, kicked, twisted, bitten or scratched by spec activity
20 W50.54 another person: at trade & service area: while resting, Assault by unspecified means: at unspec place: during
unspec activity
sleeping, eating or engaging in other vital activities
Hit, struck, kicked, twisted, bitten or scratched by
21 W50.58 another person: at trade & service area: in oth spec
activity
Hit, struck, kicked, twisted, bitten or scratched by
22 W50.59 another person: at trade & service area: during
unspec activity
Hit, struck, kicked, twisted, bitten or scratched by
23 W50.61 another person: at industr & const area: in leisure
activity
Hit, struck, kicked, twisted, bitten or scratched by
24 W50.63 another person: at industr & const area: in oth type
work
Hit, struck, kicked, twisted, bitten or scratched by
25 W50.64 another person: at industr & const area: while resting,
sleeping, eating or engaging in other vital activities
Hit, struck, kicked, twisted, bitten or scratched by
26 W50.68 another person: at industr & const area: in oth spec
activity
Hit, struck, kicked, twisted, bitten or scratched by
27 W50.69 another person: at industr & const area: during
unspec activity
28 W50.70 Hit, struck, kicked, twisted, bitten or scratched by
another person: at farm: in sport activity
29 W50.71 Hit, struck, kicked, twisted, bitten or scratched by
another person: at farm: in leisure activity
30 W50.73 Hit, struck, kicked, twisted, bitten or scratched by
another person: at farm: in oth type work
Hit, struck, kicked, twisted, bitten or scratched by
31 W50.74 another person: at farm: while resting, sleeping,
eating or engaging in other vital activities
32 W50.78 Hit, struck, kicked, twisted, bitten or scratched by
another person: at farm: in oth spec activity
33 W50.79 Hit, struck, kicked, twisted, bitten or scratched by
another person: at farm: during unspec activity
Hit, struck, kicked, twisted, bitten or scratched by
34 W50.80 another person: at other spec places: in sport
activity
* ditampilkan hanya sampling dari total 1818 data
MJK-BKDK LAMPIRAN 183
0k2 : Kasus hukum (penganiayaan, korban kekerasan); dalam kondisi sedang bekerja (KK)
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
Hit, struck, kicked, twisted, bitten or scratched by 15 W51.42 Striking against or bumped into by another person: at
1 W50.22 another person: at school, other..area: while work street & highway: while work for income
for income 16 W51.52 Striking against or bumped into by another person: at
trade & service area: while work for income
Hit, struck, kicked, twisted, bitten or scratched by
2 W50.23 another person: at school, other..area: in oth type 17 W51.62 Striking against or bumped into by another person: at
industr & const area: while work for income
work
Hit, struck, kicked, twisted, bitten or scratched by 18 W51.72 Striking against or bumped into by another person: at
3 W50.42 another person: at street & highway: while work for farm: while work for income
income Striking against or bumped into by another person: at
other spec places: while work for income
4 W50.43 Hit, struck, kicked, twisted, bitten or scratched by 19 W51.82
another person: at street & highway: in oth type work
Striking against or bumped into by another person: at
Hit, struck, kicked, twisted, bitten or scratched by 20 W51.92 unspec place: while work for income
5 W50.52 another person: at trade & service area: while work
21 W52.12 Crushed, pushed or stepped on by crowd or human
for income stampede: at residentl institutn: while work for income
Hit, struck, kicked, twisted, bitten or scratched by Crushed, pushed or stepped on by crowd or human
6 W50.60 another person: at industr & const area: in sport 22 W52.22 stampede: at school, other..area: while work for
activity income
Hit, struck, kicked, twisted, bitten or scratched by Crushed, pushed or stepped on by crowd or human
7 W50.62 another person: at industr & const area: while work 23 W52.32 stampede: at sport & athlet area: while work for
for income income
8 W50.72 Hit, struck, kicked, twisted, bitten or scratched by Crushed, pushed or stepped on by crowd or human
another person: at farm: while work for income stampede: at street & highway: while work for income
24 W52.42
Hit, struck, kicked, twisted, bitten or scratched by
9 W50.82 another person: at other spec places: while work Crushed, pushed or stepped on by crowd or human
25 W52.52 stampede: at trade & service area: while work for
for income
income
Hit, struck, kicked, twisted, bitten or scratched by
10 W50.92 another person: at unspec place: while work for Crushed, pushed or stepped on by crowd or human
26 W52.62 stampede: at industr & const area: while work for
income
income
11 W51.02 Striking against or bumped into by another person: at
home: while work for income
Crushed, pushed or stepped on by crowd or human
12 W51.12 Striking against or bumped into by another person: at 27 W52.72 stampede: at farm: while work for income
residentl institutn: while work for income
Crushed, pushed or stepped on by crowd or human
13 W51.22 Striking against or bumped into by another person: at 28 W52.82 stampede: at other spec places: while work for income
school, other..area: while work for income
Crushed, pushed or stepped on by crowd or human
14 W51.32 Striking against or bumped into by another person: at 29 W52.92 stampede: at unspec place: while work for income
sport & athlet area: while work for income
0l : Preventable Adverse Event (kelalaian, aktifitas ekstrim, sengaja melukai diri sendiri, dan kondisi sejenis)
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 V01.00 Pedestrian injured in collision with pedal cycle, Pedestrian injured in collision with two- or three-
nontraffic accident: in sport activity 22 V02.00 wheeled motor vehicle, nontraffic accident: in sport
2 V01.01 Pedestrian injured in collision with pedal cycle, activity
nontraffic accident: in leisure activity
Pedestrian injured in collision with two- or three-
3 V01.02 Pedestrian injured in collision with pedal cycle, 23 V02.01 wheeled motor vehicle, nontraffic accident: in leisure
nontraffic accident: while work for income
activity
4 V01.03 Pedestrian injured in collision with pedal cycle, Pedestrian injured in collision with two- or three-
nontraffic accident: in oth type work 24 V02.02 wheeled motor vehicle, nontraffic accident: while
Pedestrian injured in collision with pedal cycle, work for income
5 V01.04 nontraffic accident: while resting, sleeping, eating or
Pedestrian injured in collision with two- or three-
engaging in other vital activities 25 V02.03 wheeled motor vehicle, nontraffic accident: in oth
6 V01.08 Pedestrian injured in collision with pedal cycle, type work
nontraffic accident: in oth spec activity
Pedestrian injured in collision with two- or three-
wheeled motor vehicle, nontraffic accident: while
7 V01.09 Pedestrian injured in collision with pedal cycle, 26 V02.04 resting, sleeping, eating or engaging in other vital
nontraffic accident: during unspec activity
activities
8 V01.10 Pedestrian injured in collision with pedal cycle, traffic
accident: in sport activity Pedestrian injured in collision with two- or three-
27 V02.08 wheeled motor vehicle, nontraffic accident: in oth
9 V01.11 Pedestrian injured in collision with pedal cycle, traffic
accident: in leisure activity spec activity
10 V01.12 Pedestrian injured in collision with pedal cycle, traffic Pedestrian injured in collision with two- or three-
accident: while work for income 28 V02.09 wheeled motor vehicle, nontraffic accident: during
Pedestrian injured in collision with pedal cycle, traffic unspec activity
accident: in oth type work
11 V01.13 Pedestrian injured in collision with two- or three-
29 V02.10 wheeled motor vehicle, traffic accident: in sport
Pedestrian injured in collision with pedal cycle, traffic
12 V01.14 accident: while resting, sleeping, eating or engaging in activity
other vital activities Pedestrian injured in collision with two- or three-
30 V02.11 wheeled motor vehicle, traffic accident: in leisure
13 V01.18 Pedestrian injured in collision with pedal cycle, traffic
accident: in oth spec activity activity
14 V01.19 Pedestrian injured in collision with pedal cycle, traffic Pedestrian injured in collision with two- or three-
accident: during unspec activity 31 V02.12 wheeled motor vehicle, traffic accident: while work
Pedestrian injured in collision with pedal cycle, for income
15 V01.90 unspecified whether traffic or nontraffic accident: in
Pedestrian injured in collision with two- or three-
sport activity 32 V02.13 wheeled motor vehicle, traffic accident: in oth type
Pedestrian injured in collision with pedal cycle, work
16 V01.91 unspecified whether traffic or nontraffic accident: in
Pedestrian injured in collision with two- or three-
leisure activity 33 V02.14 wheeled motor vehicle, traffic accident: while resting,
Pedestrian injured in collision with pedal cycle, sleeping, eating or engaging in other vital activities
17 V01.92 unspecified whether traffic or nontraffic accident:
Pedestrian injured in collision with two- or three-
while work for income 34 V02.18 wheeled motor vehicle, traffic accident: in oth spec
Pedestrian injured in collision with pedal cycle, activity
18 V01.93 unspecified whether traffic or nontraffic accident: in
Pedestrian injured in collision with two- or three-
oth type work 35 V02.19 wheeled motor vehicle, traffic accident: during unspec
Pedestrian injured in collision with pedal cycle, activity
19 V01.94 unspecified whether traffic or nontraffic accident: Pedestrian injured in collision with two- or three-
while resting, sleeping, eating or engaging in other 36 V02.90 wheeled motor vehicle, unspecified whether traffic or
vital activities
nontraffic accident: in sport activity
Pedestrian injured in collision with pedal cycle, Pedestrian injured in collision with two- or three-
20 V01.98 unspecified whether traffic or nontraffic accident: in 37 V02.91 wheeled motor vehicle, unspecified whether traffic or
oth spec activity nontraffic accident: in leisure activity
Pedestrian injured in collision with pedal cycle, Pedestrian injured in collision with two- or three-
21 V01.99 unspecified whether traffic or nontraffic accident: 38 V02.92 wheeled motor vehicle, unspecified whether traffic or
during unspec activity nontraffic accident: while work for income
184 LAMPIRAN MJK-BKDK
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE 7532 CODE
7533 Y32.78 Crashing of motor vehicle, undetermined intent: at
... ... ... 7534 Y32.79 farm: in oth spec activity
7517 Y32.54 7535 Y32.80 Crashing of motor vehicle, undetermined intent: at
Crashing of motor vehicle, undetermined intent: at 7536 Y32.81 farm: during unspec activity
7518 Y32.58 trade & service area: while resting, sleeping, eating or 7537 Y32.82 Crashing of motor vehicle, undetermined intent: at
7519 Y32.59 engaging in other vital activities Y32.83 other spec places: in sport activity
7520 Y32.60 Crashing of motor vehicle, undetermined intent: at 7538 Crashing of motor vehicle, undetermined intent: at
7521 Y32.61 trade & service area: in oth spec activity Y32.84 other spec places: in leisure activity
7522 Y32.62 Crashing of motor vehicle, undetermined intent: at 7539 Crashing of motor vehicle, undetermined intent: at
7523 Y32.63 trade & service area: during unspec activity 7540 Y32.88 other spec places: while work for income
Crashing of motor vehicle, undetermined intent: at 7541 Y32.89 Crashing of motor vehicle, undetermined intent: at
7524 Y32.64 industr & const area: in sport activity 7542 Y32.90 other spec places: in oth type work
Crashing of motor vehicle, undetermined intent: at 7543 Y32.91 Crashing of motor vehicle, undetermined intent: at
7525 Y32.68 industr & const area: in leisure activity 7544 Y32.92 other spec places: while resting, sleeping, eating or
7526 Y32.69 Crashing of motor vehicle, undetermined intent: at Y32.93 engaging in other vital activities
7527 Y32.70 industr & const area: while work for income 7545 Crashing of motor vehicle, undetermined intent: at
7528 Y32.71 Crashing of motor vehicle, undetermined intent: at Y32.94 other spec places: in oth spec activity
7529 Y32.72 industr & const area: in oth type work 7546 Crashing of motor vehicle, undetermined intent: at
7530 Y32.73 Crashing of motor vehicle, undetermined intent: at 7547 Y32.98 other spec places: during unspec activity
industr & const area: while resting, sleeping, eating or Y32.99 Crashing of motor vehicle, undetermined intent: at
7531 Y32.74 engaging in other vital activities unspec place: in sport activity
Crashing of motor vehicle, undetermined intent: at Crashing of motor vehicle, undetermined intent: at
industr & const area: in oth spec activity unspec place: in leisure activity
Crashing of motor vehicle, undetermined intent: at Crashing of motor vehicle, undetermined intent: at
industr & const area: during unspec activity unspec place: while work for income
Crashing of motor vehicle, undetermined intent: at Crashing of motor vehicle, undetermined intent: at
farm: in sport activity unspec place: in oth type work
Crashing of motor vehicle, undetermined intent: at Crashing of motor vehicle, undetermined intent:
farm: in leisure activity at unspec place: while resting, sleeping, eating or
Crashing of motor vehicle, undetermined intent: at engaging in other vital activities
farm: while work for income Crashing of motor vehicle, undetermined intent: at
Crashing of motor vehicle, undetermined intent: at unspec place: in oth spec activity
farm: in oth type work Crashing of motor vehicle, undetermined intent: at
Crashing of motor vehicle, undetermined intent: at unspec place: during unspec activity
farm: while resting, sleeping, eating or engaging in
other vital activities
* ditampilkan hanya sampling dari total 7547 data
0m : Bencana alam yang diagnosanya sudah spesifik
No ICD-10 ICD-10 DESCRIPTION No ICD-10 ICD-10 DESCRIPTION
CODE CODE
1 X34.00 Victim of earthquake: at home: in sport activity ... ... ...
2 X34.01 Victim of earthquake: at home: in leisure activity 334 X38.74 Victim of flood: at farm: while resting, sleeping, eating
or engaging in other vital activities
3 X34.02 Victim of earthquake: at home: while work for income
4 X34.03 Victim of earthquake: at home: in oth type work 335 X38.78 Victim of flood: at farm: in oth spec activity
5 X34.04 Victim of earthquake: at home: while resting, sleeping, 336 X38.79 Victim of flood: at farm: during unspec activity
eating or engaging in other vital activities
337 X38.80 Victim of flood: at other spec places: in sport activity
6 X34.08 Victim of earthquake: at home: in oth spec activity
338 X38.81 Victim of flood: at other spec places: in leisure activity
7 X34.09 Victim of earthquake: at home: during unspec activity
339 X38.82 Victim of flood: at other spec places: while work for
8 X34.10 Victim of earthquake: at residentl institutn: in sport income
activity
340 X38.83 Victim of flood: at other spec places: in oth type work
Victim of earthquake: at residentl institutn: in leisure
9 X34.11 activity 341 X38.84 Victim of flood: at other spec places: while resting,
sleeping, eating or engaging in other vital activities
Victim of earthquake: at residentl institutn: while work
10 X34.12 for income 342 X38.88 Victim of flood: at other spec places: in oth spec
activity
Victim of earthquake: at residentl institutn: in oth
11 X34.13 type work 343 X38.89 Victim of flood: at other spec places: during unspec
activity
Victim of earthquake: at residentl institutn: while
12 X34.14 resting, sleeping, eating or engaging in other vital 344 X38.90 Victim of flood: at unspec place: in sport activity
activities 345 X38.91 Victim of flood: at unspec place: in leisure activity
13 X34.18 Victim of earthquake: at residentl institutn: in oth 346 X38.92 Victim of flood: at unspec place: while work for
spec activity income
14 X34.19 Victim of earthquake: at residentl institutn: during 347 X38.93 Victim of flood: at unspec place: in oth type work
unspec activity
348 X38.94 Victim of flood: at unspec place: while resting,
Victim of earthquake: at school, other..area: in sport sleeping, eating or engaging in other vital activities
15 X34.20 activity
349 X38.98 Victim of flood: at unspec place: in oth spec activity
16 X34.21 Victim of earthquake: at school, other..area: in leisure 350 X38.99 Victim of flood: at unspec place: during unspec activity
activity
351 X39.03 Exposure to other and unspecified forces of nature: at
Victim of earthquake: at school, other..area: while home: in oth type work
17 X34.22 work for income
352 X39.10 Exposure to other and unspecified forces of nature: at
Victim of earthquake: at school, other..area: in oth residentl institutn: in sport activity
18 X34.23 type work
Accidental poisoning by and exposure to nonopioid
Victim of earthquake: at school, other..area: while 353 X40.03 analgesics, antipyretics and antir: at home: in oth
19 X34.24 resting, sleeping, eating or engaging in other vital
type work
activities
Accidental poisoning by and exposure to antiepileptic,
20 X34.28 Victim of earthquake: at school, other..area: in oth 354 X41.03 sedative-hypnotic, antiparkin and psychotropic drugs,
spec activity
NEC: at home: in oth type work
21 X34.29 Victim of earthquake: at school, other..area: during Accidental poisoning by and exposure to narcotics
unspec activity 355 X42.03 and psychodysleptics [hallucinogens], NEC: at home:
22 X34.30 Victim of earthquake: at sport & athlet area: in sport in oth type work
activity
Accidental poisoning by and exposure to other drugs
23 X34.31 Victim of earthquake: at sport & athlet area: in leisure 356 X43.03 acting on the autonomic nervous system: at home: in
activity
oth type work
24 X34.32 Victim of earthquake: at sport & athlet area: while Accidental poisoning by and exposure to other and
work for income 357 X44.03 unspecified drugs, medicaments and biological
Victim of earthquake: at sport & athlet area: in oth substances: at home: in oth type work
type work
25 X34.33 358 X45.03 Accidental poisoning by and exposure to alcohol: at
home: in oth type work
Victim of earthquake: at sport & athlet area: while
26 X34.34 resting, sleeping, eating or engaging in other vital Accidental poisoning by and exposure to organic
359 X46.03 solvents and halogenated hydrocarbons and their
activities
vapours: at home: in oth type work
* ditampilkan hanya sampling dari total 359 data
MJK-BKDK LAMPIRAN 185
Lampiran 18.
ICD 9 CM
LIST BENEFIT berdasarkan ICD-9-CM
Status Penjaminan Jumlah ICD-9-CM
NEGATIVE LIST PADA PROSEDUR 422
2.358
POSITIVE LIST 1.845
POSITIVE LIST DENGAN RESTRIKSI
4.625
Grand Total
NEGATIVE LIST PADA PROSEDUR NEGATIVE LIST PADA PROSEDUR
Kode Restriksi Jumlah Kode Restriksi Kode Restriksi Jumlah Kode Restriksi
0d 137 2a,2b,2c,2d 454
0n 105 2b,2c,2d 313
0j 87 3 309
0a 32 1b,2b,2c,2d 127
1a 95
0o 28 1a,1b,3 90
0l 17 5a 90
0c 13 2b,2c,2d,2e 72
0h 2 1a,1b 64
0k1 1 4 57
1b 36
2b,2c,2d,2e,3 24
NEGATIVE LIST PADA PROSEDUR 2d 23
Kode Restriksi Jumlah Kode Restriksi 1a,3 22
9 2358 2f 21
1a,4 12
2b 8
1a,2b 7
3,1b 4
3,4 4
3,5b 3
2b,2c 3
1a,2b,2c 2
1b,2f 2
2b,2c,3 1
5b 1
3,5a 1
186 LAMPIRAN MJK-BKDK
Lampiran 19.
ICD 9 CM - Negative List pada ICD 9 CM*
(* = Kelompok ICD 9CM KLBC)
0a : Program kemkes (gizi, antrax,dsb), wabah/KLB spesifik; tidak termasuk kode O
No KODE NAMA DIAGNOSA No KODE NAMA DIAGNOSA
1 69.7 Insertion of intrauterine contraceptive device 17 99.44 Vaccination against rabies
2 69.91 Insertion of therapeutic device into uterus 18 99.45 Vaccination against measles
3 99.3 Prophylactic vaccination and inoculation against 19 99.46 Vaccination against mumps
certain bacterial diseases
20 99.47 Vaccination against rubella
4 99.31 Vaccination against cholera
21 99.48 Administration of measles-mumps-rubella vaccine
5 99.32 Vaccination against typhoid and paratyphoid fever
22 99.5 Other vaccination and inoculation
6 99.33 Vaccination against tuberculosis
23 99.51 Prophylactic vaccination against the common cold
7 99.34 Vaccination against plague
24 99.52 Prophylactic vaccination against influenza
8 99.35 Vaccination against tularemia
25 99.53 Prophylactic vaccination against arthropod-borne
9 99.36 Administration of diphtheria toxoid viral encephalitis
10 99.37 Vaccination against pertussis 26 99.54 Prophylactic vaccination against other arthropod-
borne viral diseases
11 99.38 Administration of tetanus toxoid
Prophylactic administration of vaccine against other
12 99.39 Administration of diphtheria-tetanus-pertussis, 27 99.55 diseases
combined
28 99.56 Administration of tetanus antitoxin
13 99.4 Prophylactic vaccination and inoculation against
certain viral disease 29 99.57 Administration of botulism antitoxin
14 99.41 Administration of poliomyelitis vaccine 30 99.58 Administration of other antitoxins
15 99.42 Vaccination against smallpox 31 99.59 Other vaccination and inoculation
16 99.43 Vaccination against yellow fever 32 99.84 Isolation
0c : Kongenital (yang tidak mengganggu fungsi)
No KODE NAMA DIAGNOSA No KODE NAMA DIAGNOSA
1 82.81 Transfer of finger, except thumb 7 93.72 Dysphasia training
8 93.73 Esophageal speech training
2 82.82 Repair of cleft hand 9 93.74 Speech defect training
10 93.75 Other speech training and therapy
3 82.83 Repair of macrodactyly 11 93.76 Training in use of lead dog for the blind
12 93.77 Training in braille or Moon
4 82.84 Repair of mallet finger 13 93.78 Other rehabilitation for the blind
5 93.7 Speech and reading rehabilitation and rehabilitation
of the blind
6 93.71 Dyslexia training
0d : Fertilitas, estetik, psikososial
No KODE NAMA DIAGNOSA No KODE NAMA DIAGNOSA
1 11.91 Tattooing of cornea 34 69.92 Artificial insemination
2 60.7 Operations on seminal vesicles 35 70.6 Vaginal construction and reconstruction
3 60.71 Percutaneous aspiration of seminal vesicle 36 70.61 Vaginal construction
4 60.72 Incision of seminal vesicle 37 70.62 Vaginal reconstruction
5 60.73 Excision of seminal vesicle 38 70.63 Vaginal construction with graft or prosthesis
6 60.79 Other operations on seminal vesicles 39 70.64 Vaginal reconstruction with graft or prosthesis
7 60.8 Incision or excision of periprostatic tissue 40 70.76 Hymenorrhaphy
8 60.81 Incision of periprostatic tissue 41 70.77 Vaginal suspension and fixation
9 60.82 Excision of periprostatic tissue 42 70.78 Vaginal suspension and fixation with graft or
prosthesis
10 62.7 Insertion of testicular prosthesis
43 70.79 Other repair of vagina
11 63.0 Diagnostic procedures on spermatic cord, epididymis,
and vas deferens 44 70.8 Obliteration of vaginal vault
12 63.01 Biopsy of spermatic cord, epididymis, or vas deferens 45 85.3 Reduction mammoplasty and subcutaneous
mammectomy
13 63.09 Other diagnostic procedures on spermatic cord,
epididymis, and vas deferens 46 85.31 Unilateral reduction mammoplasty
14 63.53 Transplantation of spermatic cord 47 85.32 Bilateral reduction mammoplasty
15 63.59 Other repair of spermatic cord and epididymis 48 85.33 Unilateral subcutaneous mammectomy with
synchronous implant
16 63.6 Vasotomy
49 85.34 Other unilateral subcutaneous mammectomy
17 63.7 Male sterilization procedure, not otherwise specified
Bilateral subcutaneous mammectomy with
18 63.70 Vasectomy and ligation of vas deferens 50 85.35 synchronous implant
19 63.71 Ligation of vas deferens 51 85.36 Other bilateral subcutaneous mammectomy
20 63.72 Ligation of spermatic cord 52 85.5 Augmentation mammoplasty
21 63.73 Vasectomy 53 85.50 Augmentation mammoplasty, not otherwise specified
22 64.5 Operations for sex transformation, not elsewhere 54 85.51 Unilateral injection into breast for augmentation
classified
55 85.52 Bilateral injection into breast for augmentation
23 64.94 Fitting of external prosthesis of penis
56 85.53 Unilateral breast implant
24 64.95 Insertion or replacement of non-inflatable penile
prosthesis 57 85.54 Bilateral breast implant
25 64.96 Removal of internal prosthesis of penis 58 85.55 Fat graft to breast
26 64.97 Insertion or replacement of inflatable penile 59 85.6 Mastopexy
prosthesis
60 85.7 Total reconstruction of breast
27 65.72 Other reimplantation of ovary
61 85.70 Total reconstruction of breast, not otherwise specified
28 65.73 Other salpingo-oophoroplasty
62 85.86 Transposition of nipple
29 65.75 Laparoscopic reimplantation of ovary
63 85.87 Other repair or reconstruction of nipple
30 65.92 Transplantation of ovary
64 85.89 Other mammoplasty
Implantation or replacement of prosthesis of fallopian
31 66.93 tube 65 85.9 Other operation on the breast
32 66.94 Removal of prosthesis of fallopian tube 66 85.91 Aspiration of breast
33 66.95 Insufflation of therapeutic agent into fallopian tubes 67 85.92 Injection of therapeutic agent into breast
68 85.93 Revision of implant of breast
MJK-BKDK LAMPIRAN 187
No KODE NAMA DIAGNOSA No KODE NAMA DIAGNOSA
69 85.94 Removal of implant of breast 102 94.13 Psychiatric commitment evaluation
103 94.19 Other psychiatric interview and evaluation
70 85.95 Insertion of breast tissue expander 104 94.3 Individual psychotherapy
105 94.31 Psychoanalysis
71 85.96 Removal of breast tissue expander 106 94.32 Hypnotherapy
107 94.33 Behavior therapy
72 85.99 Other, other operations on the breast 108 94.34 Individual therapy for psychosexual dysfunction
109 94.35 Crisis intervention
73 86. Operations on skin and subcutaneous tissue 110 94.36 Play psychotherapy
111 94.37 Exploratory verbal psychotherapy
74 86.0 Incision of skin and subcutaneous tissue 112 94.38 Supportive verbal psychotherapy
113 94.39 Other individual psychotherapy
75 86.01 Aspiration of skin and subcutaneous tissue 114 94.4 Other psychotherapy and counselling
115 94.41 Group therapy for psychosexual dysfunction
76 86.02 Injection or tattooing of skin lesion or defect 116 94.42 Family therapy
117 94.43 Psychodrama
77 86.24 Chemosurgery of skin (Chemical peel of skin) 118 94.44 Other group therapy
119 94.45 Drug addiction counselling
78 86.25 Dermabrasion 120 94.46 Alcoholism counselling
121 94.49 Other counselling
79 86.51 Replantation of scalp 122 94.5 Referral for psychologic rehabilitation
123 94.51 Referral for psychotherapy
80 86.64 Hair transplant 124 94.52 Referral for psychiatric aftercare
125 94.53 Referral for alcoholism rehabilitation
81 86.67 Dermal regenerative graft 126 94.54 Referral for drug addiction rehabilitation
127 94.55 Referral for vocational rehabilitation
82 86.8 Other repair and reconstruction of skin and 128 94.59 Referral for other psychologic rehabilitation
subcutaneous tissue 129 96.17 Insertion of vaginal diaphragm
130 96.54 Dental scaling, polishing, and debridemen
83 86.81 Repair for facial weakness 131 97.24 Replacement and refitting of vaginal diaphragm
132 97.73 Removal of vaginal diaphragm
84 86.82 Facial rhytidectomy 133 99.93 Rectal massage (for levator spasm)
134 99.94 Prostatic massage
85 86.83 Size reduction plastic operation 135 99.95 Stretching of foreskin
136 99.96 Collection of sperm for artificial insemination
86 86.85 Correction of syndactyly 137 99.98 Extraction of milk from lactating breast
87 86.86 Onychoplasty
88 86.87 Fat graft of skin and subcutaneous tissue
89 86.89 Other repair and reconstruction of skin and
subcutaneous tissue
90 86.90 Extraction of fat for graft or banking
91 86.92 Electrolysis and other epilation of skin
92 93.81 Recreation therapy
93 94.0 Psychologic evaluation and testing
94 94.01 Administration of intelligence test
95 94.02 Administration of psychologic test
96 94.03 Character analysis
97 94.08 Other psychologic evaluation and testing
98 94.09 Psychologic mental status determination, not
otherwise specified
99 94.1 Psychiatric interviews, consultations, and evaluations
100 94.11 Psychiatric mental status determination
101 94.12 Routine psychiatric visit, not otherwise specified
0j : Seluruh kehamilan, persalinan dan nifas beserta seluruh gangguannya (kode O, kode Z terkait)
No KODE NAMA DIAGNOSA No KODE NAMA DIAGNOSA
1 69.5 Aspiration curettage of uterus 45 73.93 Incision of cervix to assist delivery
2 69.51 Aspiration curettage of uterus for termination of 46 73.94 Pubiotomy to assist delivery
pregnancy
47 73.99 Other operations to assist delivery
3 69.52 Aspiration curettage following delivery or abortion
48 74. Cesarean section and removal of fetus
4 69.59 Other aspiration curettage of uterus
49 74.0 Classical cesarean section
5 69.6 Menstrual extraction or regulation
50 74.1 Low cervical cesarean section
6 72. Forceps, vacuum, and breech delivery
51 74.2 Extraperitoneal cesarean section
7 72.0 Low forceps operation
52 74.3 Removal of extratubal ectopic pregnancy
8 72.1 Low forceps operation with episiotomy
53 74.4 Cesarean section of other specified type
9 72.2 Mid forceps operation
54 74.9 Cesarean section of unspecified type
10 72.21 Mid forceps operation with episiotomy
55 74.91 Hysterotomy to terminate pregnancy
11 72.29 Other mid forceps operation
56 74.99 Other cesarean section of unspecified type
12 72.3 High forceps operation
57 75. Other obstetric operations
13 72.31 High forceps operation with episiotomy
58 75.0 Intra-amniotic injection for abortion
14 72.39 Other high forceps operation
59 75.1 Diagnostic amniocentesis
15 72.4 Forceps rotation of fetal head
60 75.2 Intrauterine transfusion
16 72.5 Breech extraction
61 75.3 Other intrauterine operations on fetus and amnion
Partial breech extraction with forceps to aftercoming
17 72.51 head 62 75.31 Amnioscopy
18 72.52 Other partial breech extraction 63 75.32 Fetal EKG (scalp)
Total breech extraction with forceps to aftercoming 64 75.33 Fetal blood sampling and biopsy
head
19 72.53 65 75.34 Other fetal monitoring
20 72.54 Other total breech extraction 66 75.35 Other diagnostic procedures on fetus and amnion
21 72.6 Forceps application to aftercoming head 67 75.36 Correction of fetal defect
22 72.7 Vacuum extraction 68 75.37 Amnioinfusion
23 72.71 Vacuum extraction with episiotomy 69 75.38 Fetal pulse oximetry
24 72.79 Other vacuum extraction 70 75.4 Manual removal of retained placenta
25 72.8 Other specified instrumental delivery 71 75.5 Repair of current obstetric laceration of uterus
26 72.9 Unspecified instrumental delivery 72 75.50 Repair of current obstetric laceration of uterus, not
otherwise specified
27 73. Other procedures inducing or assisting delivery
73 75.51 Repair of current obstetric laceration of cervix
28 73.0 Artificial rupture of membranes
74 75.52 Repair of current obstetric laceration of corpus uteri
29 73.01 Induction of labor by artificial rupture of membranes
75 75.6 Repair of other current obstetric laceration
30 73.09 Other artificial rupture of membranes
76 75.61 Repair of current obstetric laceration of bladder
31 73.1 Other surgical induction of labor and urethra
32 73.2 Internal and combined version and extraction 77 75.62 Repair of current obstetric laceration of rectum and
sphincter ani
33 73.21 Internal and combined version without extraction
34 73.22 Internal and combined version with extraction 78 75.69 Repair of other current obstetric laceration
35 73.3 Failed forceps 79 75.7 Manual exploration of uterine cavity, postpartum
36 73.4 Medical induction of labor 80 75.8 Obstetric tamponade of uterus or vagina
37 73.5 Manually assisted delivery 81 75.9 Other obstetric operations
38 73.51 Manual rotation of fetal head 82 75.91 Evacuation of obstetrical incisional hematoma of
perineum
39 73.59 Other manually assisted delivery
83 75.92 Evacuation of other hematoma of vulva or vagina
40 73.6 Episiotomy
84 75.93 Surgical correction of inverted uterus
41 73.8 Operations on fetus to facilitate delivery
Immediate postpartum manual replacement of
42 73.9 Other operations assisting delivery 85 75.94 inverted uterus
43 73.91 External version to assist delivery 86 75.99 Other obstetric operations
44 73.92 Replacement of prolapsed umbilical cord 87 93.37 Prenatal training
188 LAMPIRAN MJK-BKDK
0h : Bayi sehat
No KODE NAMA DIAGNOSA No KODE NAMA DIAGNOSA
1 99.12 Immunization for allergy 2 99.13 Immunization for autoimmune disease
0k1 : Kasus hukum (penganiayaan, korban kekerasan); tidak dalam sedang bekerja (non KK)
No KODE NAMA DIAGNOSA
1 89.8 Autopsy
0l : PAE/Preventable Adverse Event (kelalaian, aktifitas ekstrim, sengaja melukai diri sendiri, dan sejenisnya)
No KODE NAMA DIAGNOSA No KODE NAMA DIAGNOSA
1 44.31 High gastric bypass 9 44.99 Other operations on stomach
10 46.86 Endoscopic insertion of colonic stent(s)
2 44.68 Laparoscopic gastroplasty 11 46.87 Other insertion of colonic stent(s)
12 46.97 Transplant of intestine
3 44.93 Insertion of gastric bubble (balloon) 13 49.44 Destruction of hemorrhoids by cryotherapy
14 49.75 Implantation or revision of artificial anal sphincter
4 44.94 Removal of gastric bubble (balloon) 15 49.76 Removal of artificial anal sphincter
16 49.92 Insertion of subcutaneous electrical anal stimulator
5 44.95 Laparoscopic gastric restrictive procedure 17 49.93 Incision of anal septum
6 44.96 Laparoscopic revision of gastric restrictive procedure
7 44.97 Laparoscopic removal of gastric restrictive device(s)
8 44.98 (Laparoscopic) adjustment of size of adjustable gastric
restrictive device
0n : Pelayanan kesehatan berbiaya tinggi; butuh HTA
No KODE NAMA DIAGNOSA No KODE NAMA DIAGNOSA
1 00.91 Transplant from live related donor 54 52.8 Transplant of pancreas
2 00.92 Transplant from live non-related donor 55 52.80 Pancreatic transplant, not otherwise specified
3 00.93 Transplant from cadaver 56 52.81 Reimplantation of pancreatic tissue
Implantation or replacement of intracranial neurostimulator 57 52.82 Homotransplant of pancreas
4 02.93 lead(s) 58 52.83 Heterotransplant of pancreas
5 07.94 Transplantation of thymus 59 52.84 Autotransplantation of cells of Islets of Langerhans
6 11.6 Corneal transplant
7 11.60 Corneal transplant, not otherwise specified 60 52.85 Allotransplantation of cells of Islets of Langerhans
Transplantation of cells of Islets of Langerhans, not otherwise
8 11.69 Other corneal transplant 61 52.86 specified
9 17.4 Robotic assisted procedures Computer assisted robotic 62 55.53 Removal of transplanted or rejected kidney
surgery Computer- enhanced robotic surgery 63 55.54 Removal of transplanted or rejected kidney
10 17.41 Open robotic assisted procedure
11 17.42 Laparoscopic robotic assisted procedure 64 55.6 Transplant of kidney
65 55.61 Renal autotransplantation
12 17.43 Percutaneous robotic assisted procedure 66 55.69 Other kidney transplantation
13 17.44 Endoscopic robotic assisted procedure
14 17.45 Thoracoscopic robotic assisted procedure 67 55.7 Nephropexy
68 55.98 Removal of mechanical kidney
15 17.49 Other and unspecified robotic assisted procedure 69 83.92 Insertion or replacement of skeletal muscle stimulator
16 17.5 Additional cardiovascular procedures
Implantation of rechargeable cardiac contractility 70 83.93 Removal of skeletal muscle stimulator
modulation [CCM], total system 71 86.93 Insertion of tissue expander
17 17.51 Insertion or replacement of single array neurostimulator
pulse generator
18 17.52 Implantation or replacement of cardiac contractility 72 86.94
modulation [CCM] rechargeable pulse generator only
19 37.5 Heart transplantation procedure 73 86.95 Insertion or replacement of dual array neurostimulator
pulse generator
20 37.51 Heart transplantation Insertion or replacement of other neurostimulator pulse
21 37.52 Implantation of total replacement heart system 74 86.96 generator
22 37.53 Replacement or repair of thoracic unit of total replacement 75 86.97 Insertion or replacement of singer array rechargeable
heart system neurostimulator pulse generator
Replacement or repair of other implantable component of Insertion or replacement of dual array rechargeable
23 37.54 total replacement heart system 76 86.98 neurostimulator pulse generator
24 37.55 Removal of internal biventricular heart replacement system 77 92.3 Stereotactic radiosurgery
25 39.65 Extracorporeal membrane oxygenation [ECMO] 78 92.30 Stereotactic radiosurgery, not otherwise specified
Implantation or replacement of carotid sinus stimulation 79 93.32 Whirlpool treatment
26 39.81 device, total system "Other immobilization, pressure, and attention to wound
27 39.82 Implantation or replacement of carotid sinus stimulation 80 93.59 Elastic stockings; Electronic gaiter Intermittent pressure
lead(s) only device; Oxygenation of wound (hyperbaric); Stereotactic
Implantation or replacement of carotid sinus stimulation head frame; application Velpeau dressing "
28 39.83 pulse generator only 81 93.6 Osteopathic manipulative treatment
29 39.84 Revision of carotid sinus stimulation lead(s) only 82 93.61 Osteopathic manipulative treatment for general
30 39.85 Revision of carotid sinus stimulation pulse generator mobilization
Osteopathic manipulative treatment using high-velocity,
31 39.86 Removal of carotid sinus stimulation device, total system 83 93.62 low-amplitude forces
32 39.87 Removal of carotid sinus stimulation lead(s) only
33 39.88 Removal of carotid sinus stimulation pulse generator only Osteopathic manipulative treatment using low- velocity,
Other operations on carotid body, carotid sinus and other 84 93.63 high-amplitude forces
vascular bodies
34 39.89 85 93.64 Osteopathic manipulative treatment using isotonic, isometric
forces
35 39.96 Total body perfusion 86 93.65 Osteopathic manipulative treatment using indirect forces
36 39.97 Other perfusion
37 41 Operations on bone marrow and spleen 87 93.66 Osteopathic manipulative treatment to move tissue fluids
88 93.67 Other specified osteopathic manipulative treatment
38 41.0 Bone marrow or hematopoietic stemm cell transplant 89 93.95 Hyperbaric oxygenation
39 41.00 Bone marrow transplant, not otherwise specified
40 41.01 Autologous bone marrow transplant without purging 90 94.6 Alcohol and drug rehabilitation and detoxification
91 94.61 Alcohol rehabilitation
41 41.02 Allogeneic bone marrow transplant with purging 92 94.62 Alcohol detoxification
42 41.03 Allogeneic bone marrow transplant without purging
Autologous hematopoietic stem cell transplant without 93 94.63 Alcohol rehabilitation and detoxification
43 41.04 purging 94 94.64 Drug rehabilitation
44 41.05 Allogeneic hematopoietic stem cell transplant without 95 94.65 Drug detoxification
purging 96 94.66 Drug rehabilitation and detoxification
97 94.67 Combined alcohol and drug rehabilitation
45 41.06 Cord blood stem cell transplant 98 94.68 Combined alcohol and drug detoxification
46 41.07 Autologous hematopoietic stem cell transplant with purging
47 41.08 Allogeneic hematopoietic stem cell transplant 99 94.69 Combined alcohol and drug rehabilitation and detoxification
100 95. Ophthalmologic and otologic diagnosis and treatment
48 41.09 Autologous bone marrow transplant with purging 101 99.86 Non-invasive placement of bone growth stimulator
49 41.91 Aspiration of bone marrow from donor for transplant
50 41.94 Transplantation of spleen 102 99.9 Other miscellaneous procedures
103 99.91 Acupuncture for anesthesia
51 50.5 Liver transplant 104 99.92 Other acupuncture
52 50.51 Auxiliary liver transplant
53 50.59 Other transplant of liver 105 99.99 Other -- Leech therapy
MJK-BKDK LAMPIRAN 189
0o : Alat bantu kesehatan
No KODE NAMA DIAGNOSA No KODE NAMA DIAGNOSA
1 20.95 Implantation of electromagnetic hearing device 13 84.47 Fitting of prosthesis of leg, not otherwise specified
14 84.48 Implantation of prosthetic device of leg
2 20.96 Implantation or replacement of cochlear prosthetic 15 84.6 Replacement of spinal disc
device, not otherwise specified 16 93.51 Application of plaster jacket
17 93.52 Application of neck support
3 20.97 Implantation or replacement of cochlear prosthetic 18 93.58 Application of pressure trousers
device, single channel 19 95.31 Fitting and dispensing of spectacles
20 95.32 Prescription, fitting, and dispensing of contact lens
4 20.98 Implantation or replacement of cochlear prosthetic 21 95.33 Dispensing of other low vision aids
device, multiple channel 22 95.34 Ocular prosthetics
23 95.48 Fitting of hearing aid
5 84.4 Implantation or fitting of prosthetic limb device 24 96.15 Insertion of vaginal mold
25 96.16 Other vaginal dilation
6 84.40 Implantation or fitting of prosthetic limb device, not 26 96.18 Insertion of other vaginal pessary
otherwise specified 27 97.35 Removal of dental prosthesis
28 99.97 Fitting of denture
7 84.41 Fitting of prosthesis of upper arm and shoulder
8 84.42 Fitting of prosthesis of lower arm and hand
9 84.43 Fitting of prosthesis of arm, not otherwise specified
10 84.44 Implantation of prosthetic device of arm
11 84.45 Fitting of prosthesis above knee
12 84.46 Fitting of prosthesis below knee
190 LAMPIRAN MJK-BKDK
Lampiran 20.
Simulasi Perumusan Daftar Positif dalam List Benefit
berdasarkan 8 Kriteria*
(* = berdasarkan 10 biaya terbesar RJTL & RITL Tahun 2017 s.d 2019)
GROUP GROUP CATEGORY CATEGORY ICD-10 ICD-10 Uncertainty Pelayanan
DESCRIPTION DESCRIPTION CODE DESCRIPTION of loss cost-
effective
Z00-Z13 PERSONS Z09 FOLLOW-UP Z09.8 FOLLOW-UP EXAM v v
ENCOUNTERING EXAMINATION AFTER AFTER OTHER v
HEALTH SERVICES FOR TREATMENT FOR TREATMENT FOR v
EXAMINATION AND CONDITIONS OTHER OTHER CONDITIONS v
INVESTIGATION THAN MALIGNANT v
NEOPLASMS v
v
I20-I25 ISCHAEMIC HEART I25 CHRONIC ISCHAEMIC I25.1 ATHEROSCLEROTIC v v
DISEASES HEART DISEASE HEART DISEASE
v
I60-I69 CEREBROVASCULAR I63 CEREBRAL I63.9 CEREBRAL v v
DISEASES INFARCTION INFARCTION,
UNSPECIFIED
N17-N19 RENAL FAILURE N18 CHRONIC KIDNEY N18.5 CHRONIC KIDNEY v
DISEASE DISEASE, STAGE 5
J09-J18 INFLUENZA AND PNEUMONIA, J18.0 BRONCHOPNEUMONIA, v
PNEUMONIA J18 ORGANISM UNSPECIFIED
UNSPECIFIED
J09-J18 INFLUENZA AND PNEUMONIA, J18.9 PNEUMONIA, v
PNEUMONIA J18 ORGANISM UNSPECIFIED
UNSPECIFIED
I30-I52 OTHER FORMS OF I50 HEART FAILURE I50.0 CONGESTIVE HEART v
HEART DISEASE FAILURE
K20-K31 DISEASES OF K30 DYSPEPSIA K30 DYSPEPSIA v
OESOPHAGUS,
STOMACH AND
DUODENUM
K40-K46 HERNIA K40 INGUINAL HERNIA K40.9 UNILATERAL OR v
UNSPECIFIED
INGUINAL
HERNIA, WITHOUT
OBSTRUCTION OR
GANGRENE
N17-N19 RENAL FAILURE N18 CHRONIC KIDNEY N18.9 CHRONIC RENAL v
DISEASE FAILURE, UNSPECIFIED
MJK-BKDK LAMPIRAN 191
Bukan Luas Standarisasi Unbearable Bukan Bukan REV STATUS Kode Biaya (RJTL + RITL)
pelayanan Cakupan Klinis Risk Alat Bantu Public PENJAMINAN Retriksi Tahun 2017 s.d 2019
Kesehatan Goods (NOVEMBER 2020)
didanai
dengan
program
lain
vv v v v v POSITIVE LIST 9 28,938,888,165,491
vv v v v v POSITIVE LIST 9 3,749,187,238,321
vv v
vv v v v v POSITIVE LIST 9 2,600,437,004,540
vv v
v v v POSITIVE LIST 9 2,343,328,483,371
v v v POSITIVE LIST 9 2,229,299,272,440
vv v v v v POSITIVE LIST 9 2,191,428,913,608
vv v
v v v POSITIVE LIST 9 1,866,734,886,893
vv v v v v POSITIVE LIST 9 1,812,582,418,449
vv v v v v POSITIVE LIST 9 1,400,340,876,509
vv v v v v POSITIVE LIST 9 1,307,901,106,056
192 LAMPIRAN MJK-BKDK
Lampiran 21.
Simulasi Perumusan Daftar Positif dengan Pembatasan dalam
List Benefit berdasarkan 8 Kriteria*
(* = berdasarkan 10 biaya terbesar RJTL & RITL Tahun 2017 s.d 2019)
GROUP GROUP CATEGORY CATEGORY ICD-10 ICD-10 Uncertainty Pelayanan
DESCRIPTION DESCRIPTION CODE DESCRIPTION of loss cost-
effective
Z40-Z54 PERSONS Z49 CARE INVOLVING Z49.1 EXTRACORPOREAL v v/x
ENCOUNTERING DIALYSIS DIALYSIS v v/x
HEALTH SERVICES FOR v v/x
SPECIFIC PROCEDURES v v/x
AND HEALTH CARE v v/x
v v/x
Z40-Z54 PERSONS CHEMOTHERAPY v
ENCOUNTERING Z51 OTHER MEDICAL CARE Z51.1 SESSION FOR v
HEALTH SERVICES FOR v
SPECIFIC PROCEDURES NEOPLASM v/x
AND HEALTH CARE v
v v/x
A00-A09 INTESTINAL A01 TYPHOID AND A01.0 TYPHOID FEVER v/x
INFECTIOUS DISEASES PARATYPHOID FEVERS
H25-H28 DISORDERS OF LENS H26 OTHER CATARACT H26.9 CATARACT,
UNSPECIFIED
A00-A09 INTESTINAL A09 DIARRHOEA AND A09.9 GASTROENTERITIS
INFECTIOUS DISEASES GASTROENTERITIS OF AND COLITIS OF
PRESUMED INFECTIOUS UNSPECIFIED ORIGIN
ORIGIN
Z40-Z54 PERSONS Z51 OTHER MEDICAL CARE Z51.0 RADIOTHERAPY
ENCOUNTERING SESSION
HEALTH SERVICES FOR
SPECIFIC PROCEDURES
AND HEALTH CARE
Z40-Z54 PERSONS Z50 CARE INVOLVING USE Z50.1 OTHER PHYSICAL
ENCOUNTERING OF REHABILITATION THERAPY
HEALTH SERVICES FOR PROCEDURES
SPECIFIC PROCEDURES
AND HEALTH CARE
PERSONS WITH
Z80-Z99 POTENTIAL HEALTH Z99 DEPENDENCE ON Z99.2 DEPENDENCE ON
HAZARDS RELATED TO ENABLING MACHINES RENAL DIALYSIS
FAMILY AND PERSONAL AND DEVICES,
HISTORY AND NOT ELSEWHERE
CERTAIN CONDITIONS CLASSIFIED
INFLUENCING HEALTH
STATUS
NON-INSULIN-
NON-INSULIN- DEPENDENT
E10-E14 DIABETES MELLITUS E11 DEPENDENT DIABETES E11.9 DIABETES
MELLITUS MELLITUS WITHOUT
COMPLICATIONS
NON-INSULIN-
E10-E14 DIABETES MELLITUS E11 NON-INSULIN- E11.5 DEPENDENT
DEPENDENT DIABETES DIABETES MELLITUS
MELLITUS WITH PERIPHERAL
CIRCULATORY
COMPLICATIONS
MJK-BKDK LAMPIRAN 193
Bukan Luas Standarisasi Unbearable Bukan Bukan REV STATUS Kode Biaya (RJTL + RITL)
pelayanan Cakupan Klinis Risk Alat Bantu Public PENJAMINAN Retriksi Tahun 2017 s.d 2019
Kesehatan Goods (NOVEMBER 2020)
didanai
dengan
program
lain
vv v v v v POSITIVE LIST 8 7,366,471,581,943
DENGAN RESTRIKSI
vv v v v v POSITIVE LIST 8 4,524,929,420,706
DENGAN RESTRIKSI
v v v/x v v v POSITIVE LIST 4 3,260,094,445,460
DENGAN RESTRIKSI
vv v v v v POSITIVE LIST 1b,2d 2,119,743,088,155
DENGAN RESTRIKSI
v v v/x v v v POSITIVE LIST 4 1,926,552,174,785
DENGAN RESTRIKSI
vv v v v v POSITIVE LIST 8 1,792,105,287,664
DENGAN RESTRIKSI
vv v v/x v v POSITIVE LIST 8 1,749,556,691,904
DENGAN RESTRIKSI
vv v v v v POSITIVE LIST 8 1,747,741,617,068
DENGAN RESTRIKSI
v v/x v v/x v v POSITIVE LIST 5b 1,737,150,267,526
DENGAN RESTRIKSI
v v/x v v/x v v POSITIVE LIST 5b 1,621,659,649,574
DENGAN RESTRIKSI
194 LAMPIRAN MJK-BKDK
Lampiran 22.
Simulasi Perumusan Daftar Negatif dalam List Benefit
berdasarkan 8 Kriteria*
(* = berdasarkan 10 biaya terbesar RJTL & RITL Tahun 2017 s.d 2019)
GROUP GROUP CATEGORY CATEGORY ICD-10 ICD-10 Uncertainty Pelayanan
DESCRIPTION DESCRIPTION CODE DESCRIPTION of loss cost-
effective
P00-P04 FETUS AND NEWBORN P03 FETUS AND NEWBORN P03.4 FETUS AND V X
AFFECTED BY MATERIAL AFFECTED BY OTHER NEWBORN X X
FACTORS AND BY COMPLICATIONS AFFECTED BY V V
COMPLICATIONS OF OF LABOUR AND CAESAREAN X X
PREGNANCY, LABOUR DELIVERY DELIVERY X X
AND DELIVERY X V
X X
O30-O48 MATERIAL CARE MATERNAL CARE O34.2 MATERNAL CARE X X
RELATED TO THE FOR KNOWN DUE TO UTERINE X X
FETUS AND AMNIOTIC O34 OR SUSPECTED SCAR FROM X X
CAVITY AND POSSIBLE ABNORMALITY OF PREVIOUS SURGERY
DELIVERY PROBLEMS PELVIC ORGANS
A15-A19 TUBERCULOSIS A16 RESPIRATORY A16.2 TUBERCULOSIS OF
TUBERCULOSIS, LUNG, WITHOUT
NOT CONFIRMED MENTION OF
BACTERIOLOGICALLY BACTERIOLOGICAL
OR HISTOLOGICALLY OR HISTOLOGICAL
CONFIRMATION
MATERIAL CARE PREMATURE
RELATED TO THE
O30-O48 FETUS AND AMNIOTIC O42 PREMATURE RUPTURE O42.0 RUPTURE OF
CAVITY AND POSSIBLE OF MEMBRANES MEMBRANES, ONSET
DELIVERY PROBLEMS OF LABOUR WITHIN
24 HOURS
O30-O48 MATERIAL CARE OTHER DISORDERS OF
RELATED TO THE O41 AMNIOTIC FLUID AND O41.0 OLIGOHYDRAMNIOS
FETUS AND AMNIOTIC
CAVITY AND POSSIBLE MEMBRANES
DELIVERY PROBLEMS
OEDEMA, PROTEINURIA GESTATIONAL
AND HYPERTENSIVE [PREGNANCY-
O10-O16 DISORDERS IN O14 INDUCED] O14.1 SEVERE PRE-
PREGNANCY, HYPERTENSION ECLAMPSIA
CHILDBIRTH AND THE WITH SIGNIFICANT
PUERPERIUM PROTEINURIA
MATERIAL CARE MATERNAL CARE MATERNAL
RELATED TO THE CARE FOR
O30-O48 FETUS AND AMNIOTIC O33 FOR KNOWN O33.9 DISPROPORTION,
CAVITY AND POSSIBLE OR SUSPECTED UNSPECIFIED
DELIVERY PROBLEMS
DISPROPORTION
MATERIAL CARE PREMATURE
RELATED TO THE
O30-O48 FETUS AND AMNIOTIC O42 PREMATURE RUPTURE O42.9 RUPTURE OF
CAVITY AND POSSIBLE OF MEMBRANES MEMBRANES,
DELIVERY PROBLEMS
UNSPECIFIED
O30-O48 MATERIAL CARE MATERNAL CARE O32.2 MATERNAL CARE
RELATED TO THE FOR KNOWN FOR TRANSVERSE
FETUS AND AMNIOTIC O32 OR SUSPECTED AND OBLIQUE LIE
CAVITY AND POSSIBLE MALPRESENTATION
DELIVERY PROBLEMS OF FETUS
O30-O48 MATERIAL CARE MATERNAL CARE O32.1 MATERNAL CARE
RELATED TO THE FOR KNOWN FOR BREECH
FETUS AND AMNIOTIC O32 OR SUSPECTED PRESENTATION
CAVITY AND POSSIBLE MALPRESENTATION
DELIVERY PROBLEMS OF FETUS
MJK-BKDK LAMPIRAN 195
Bukan Luas Standarisasi Unbearable Bukan Bukan REV STATUS Kode Biaya (RJTL + RITL)
pelayanan Cakupan Klinis Risk Alat Bantu Public PENJAMINAN Retriksi Tahun 2017 s.d 2019
Kesehatan Goods (NOVEMBER 2020)
didanai
dengan
program
lain
XV V V V X NEGATIVE LIST 0h 3,052,951,186,218
PADA DX UTAMA
XV V V V V NEGATIVE LIST 0j 2,595,279,896,144
PADA DX UTAMA
XV V V V V NEGATIVE LIST 0e 1,408,747,377,470
PADA DX UTAMA
XV V V V V NEGATIVE LIST 0j 1,164,137,164,087
PADA DX UTAMA
XV V V V V NEGATIVE LIST 0j 820,575,646,107
PADA DX UTAMA
XV V V V V NEGATIVE LIST 0j 771,233,998,790
PADA DX UTAMA
XV V V V V NEGATIVE LIST 0j 761,230,954,305
PADA DX UTAMA
XV V V V V NEGATIVE LIST 0j 728,501,076,957
PADA DX UTAMA
XX V V V V NEGATIVE LIST 0j 664,259,427,236
PADA DX UTAMA
XX V V V V NEGATIVE LIST 0j 541,549,827,930
PADA DX UTAMA
196 LAMPIRAN MJK-BKDK
DEWAN JAMINAN SOSIAL NASIONAL
Gedung Kementerian Koordinator Bidang PMK
Jl. Medan Merdeka Barat No.3 Jakarta Pusat 10110
Telp. (021) 3459444 ext. 422
Fax. (021) 34833039
KEMENTERIAN KESEHATAN RI
Jl. H.R. Rasuna Said Blok X-5 Kav. 4-9
Jakarta Selatan 12950
Telp. (021) 5201590 (hunting)
Fax. (021) 52921669
BPJS KESEHATAN
Jl. Letjen Suprapto Kav. 20 No. 14 Cempaka Putih
PO. BOX 1391/JKT, Jakarta Pusat 10510
Telp. (021) 4212938 (hunting)
Fax. (021) 4212940
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Naskah Akademik Kajian Manfaat Jaminan Kesehatan Berbasis Kebutuhan Dasar Kesehatan
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