Page 88 - MODUL UNIVERSAL HEALTH COVERAGE

Kode
Tipe
Jenis
Specia List Item Peraw Kode INA- Kode ICD 10 dan ICD Special
9 CM Diagnosa/
l Special CMG CBG
CMG atan Prosedur CMG
Tumor pienal- Rawat E-1-01-I Special
YY01 Endoskopy Inap E-1-01-II 0713,0714,0715,0717 Procedure
E-1-01-III
YY02 Hip Rawat M-1-04-I 8151,8152,8153,8154, Special
Replacement/ Inap M-1-04-II 8155 Procedure
Knee M-1-04-IIII
replacment
YY03 PCI Rawat I-1-40-I 3606,3607,3609 Special
Inap I-1-40-II Procedure
I-1-40-III
YY04 Rawat H-1-30-I 1160,1161,1162,1163, Special
Keratoplasty Inap H-1-30-II 1164,1169 Procedure
H-1-30-III
YY05 Pancreatectom Rawat B-1-10-I 5251,5252,5253,5259, Special
y Inap B-1-10-II 526 Procedure
B-1-10-III
YY06 Repair of Rawat I-1-06-I 3550,3551,3552,2553, Special
septal defect Inap I-1-06-II 3555 Procedure
of heart with I-1-06-III
prosthesis
YY08 Stereotactic Rawat C-4-12-I Z510,9221,9222,9223, Special
Surgery & Inap C-4-12-II 9224,9225 Procedure
Radiotherapy C-4-12-III ,9226,9227,9228,9229,
9230,923
1,9232,9233,9239
YY09 Toraktomi J-1-30-I Special
Rawat Procedure
Inap J-1-30-I 3402, 3403
J-4-30-III
YY10 Lobektomi / J-1-10-I Special
bilobektomi Rawat J-1-10-II 3241-3249 Procedure
Inap
J-1-10-III
YY11 Air plumbage J-4-20-I Special
Rawat J-4-20-I 3332 Procedure
Inap
J-4-20-I
YY12 Timektomi D-1-20-I Special
Rawat Procedure
Inap D-1-20-II 0780,0781,0782
D-1-20-III
YY13 Vitrectomy H-1030-I Special
Rawat H-1030-II 1473 Procedure
Inap
H-1030-III
YY14 Phacoemulsif Rawat H-2-36-0 Special
ication Inap 1341 Procedure

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