A B C D E

1 DATA 155 DIAGNOSA YANG HARUS SELESAI DI FKTP

2
3 DIAGNOSA ICD X LEVEL
NO NAMA DIAGNOSA
4 KODE NAMA DIAGNOSA KOMEPETNSI
5 1 TB PARU A15 Respiratory TB 4A
6 2 MORBILI B059 Measles without complication 4A
7 3 VARISELA B019 Varicella without complication 4A
8 4 MALARIA B54 Unspecified malaria 4A
9 5 DEMAM DENGUE DAN DEMAM BERDARAH DENGUE A90, A91 Dengue fever, DHF 4A
10 6 LEPTOSPIROSIS A279 4A
11 7 INFEKSI PADA UMBILIKUS 4A
12 8 KANDIDIASIS MULUT B379 Candidiasis unspecified 4A
13 9 LEPRA A30 Leprosy 4A
14 10 KERACUNAN MAKANAN T622 Other ingested (parts of plant(s)) 4A
15 11 ALERGI MAKANAN 4A
12 EXANTHEMATOUS DRUG ERUPTION L270 Generalized skin eruption due to drugs and medicaments 4A
16

13 FIXED DRUG ERUPTION L270 Generalized skin eruption due to drugs and medicaments 4A
17

18 14 REAKSI ANAFILAKTIK 4A
19 15 SYOK R579 Shock, unspecified 3B
16 ANEMIA D649 Anaemia, unspecified (anemia defisiensi besi-4A, anemia 4A
20 hemolitik-3A, anemia makrositik-3A, anemia aplastik-2, anemia
megaloblastik-2)
21 17 HIV/AIDS TANPA KOMPLIKASI Z21 Asymptomatic HIV infection status 4A
22 18 LIMFADENITIS B70 Lymphadenitis Acute 4A
23 19 REFLUKS GASTROESOFAGEAL K219 Gastrooesophageal reflux disease without oesophagitis 4A
24 20 GASTRITIS K297 Gastritis, unspecified 4A
25 21 INTOLERANSI MAKANAN 4A
26 22 MALABSORBSI MAKANAN 3A
27 23 DEMAM TIFOID A010 Typhoid fever 4A
24 GASTROENTERITIS ( TERMASUK DISENTRI, KOLERA, A09 Diarrhoea & gastroenteritis of presumed infection origin 4A
28
GIARDIASIS)
29 25 DISENTRI BASILER DAN DISENTRI AMUBA 4A
30 26 APENDISITIS AKUT K359 Acute appendicitis 3B
31 27 PERDARAHAN SALURAN MAKAN BAGIAN ATAS 3B
32 28 PERDARAHAN SALURAN MAKAN BAGIAN BAWAH 3A
33 29 HEMOROID GRADE 1-2 4A
34 30 HEPATITIS A 4A
35 31 HEPATITIS B 3A
36 32 PAROTITIS K11.2 Sialoadenitis 4A
37 33 ASKARIASIS B77.9 Ascariaris unspecified 4A
38 34 CUTANEUS LARVA MIGRANS B76.9 Hookworm disease, unspecified 4A
35 PENYAKIT CACING TAMBANG B76.0 Ankylostomiasis ,Necatoriasis 4A
39
B76.1
36 SKISTOSOMIASIS B65.9 Skistosomiasisunspecified , Schistomiasis due to S. Japonicum 4A
40 B65.2

41 37 STRONGILOIDIASIS B78.9 Strongyloidiasis 4A

42 38 TAENIASIS B68.9 Taeniasis 4A
43 39 PERITONISIS K65.9 Peritonitis, unspecified 3B
44 40 KOLESISTITIS K81.9 Cholecystitis, unspecified 3B
45 41 MATA KERING/DRY EYE H04.1 Other disorders of lacrimal gland 4A
46 42 BUTA SENJA H53.5 Colour vision deficiencies 4A
47 43 HORDEOLUM H00.0 Hordeolum and other deep inflammation of eyelid 4A
44 KONJUNGTIVITIS H10.9 Conjunctivitis, unspecified,,, Acute atopic conjunctivitis 4A
48
H10.1
49 45 BLEFARITIS H01.0 Blepharitis 4A
50 46 PERDARAHAN SUBKONJUNGTIVA H57.8 Other specified disorders of eye and adnexa 4A
51 47 BENDA ASING DI KONJUNGTIVA T15.9 Foreign body on external eye, part unspecified 4A
52 48 ASTIGMATISM H52.2 Astigmatism 4A
53 49 HIPERMETROPIA H52.0 Hypermetropia 4A
54 50 MIOPIA RINGAN H52.1 Myopia 4A
55 51 PRESBIOPIA H52.4 Presbyopia 4A
56 52 KATARAK PADA PASIEN DEWASA H26.9 Cataract, unspecified 2
57 53 GLAUKOMA AKUT H40.2 Primary angle-closure glaucoma 4A
54 OTITIS EKSTERNA H60.9 Otitis Externa, Unspecified 4A
58

59 55 OTITIS MEDIA AKUT H66.0 Acute suppurative otitis media 4A

60 56 SERUMEN PROP H61.2 Impacted cerumen 4A
61 57 BENDA ASING DI HIDUNG T17.1 Foreign body in nostril 4A
62 58 ANGINA PEKTORIS I20.9 Angina pectoris 3B
63 59 INFARK MIOKARD I21.9 Acute Myocardial Infarction 3B
60 TAKIKARDIA I47.1 Supraventicular Tachicardy , Ventricular Tachicardy 3B
64
I47.2
61 GAGAL JANTUNG AKUT DAN KRONIK I50.9 Heart failure Gagal jantung
akut (3B)
65 Gagal jantung
kronik (3A)

66 62 CARDIORESPIRATORY ARREST K80 Cardiac arrhytmia 3B

67 63 HIPERTENSI ESENSIAL I10 Essential (primary) hypertension 4A
68 64 INFARK SEREBRAL/STROKE I63.9 Cerebral infarction 3B
69 65 FRAKTUR TERBUKA T14. Fracture of unspecified body 3B
70 66 FRAKTUR TERTUTUP T14. Fracture of unspecified body 3B
71 67 POLIMIALGIA REUMATIK M53.3 Polymyalgia rheumatica 3A
72 68 ARTRITIS REUMATOID M53.3 Polymyalgia rheumatica 3A
73 69 ARTRITIS, OSTEOARTRITIS M19.9 Osteoarthrosis other 3A
74 70 LIPOMA D17.9 Benign lipomatous neoplasm 4A
75 71 KEJANG DEMAM R56.0 Febrile convulsions 4A
76 72 VERTIGO R42 Dizziness and giddiness 4A
77 73 DELIRIUM F05.9 Delirium 3A
78 74 TETANUS A35 Othertetanus 4A
 A B C D E
79 75 RABIES A82.9 Rabies 3B
80 76 EPILEPSI G40.9 Epilepsy 3A
81 77 STATUS EPILEPTIKUS G41.9 Status epilepticus, unspecified 3B
82 78 MIGREN G43.9 Migraine, unspecified 4A
83 79 BELLS' PALSY G51.0 Bells palsy 4A
84 80 TENSION HEADACHE G44.2 Tensiontype headache 4A
85 81 INSOMNIA G47.0 Disorders of initiating and maintaining sleep (insomnias) 4A
86
87 82 DEMENSIA F03 Unspecified dementia 3A
88 83 GANGGUAN CAMPURAN ANXIETAS DAN DEPRESI F41.2 Mixed Anxiety and Depression Disorder 3A
89 84 GANGGUAN PSIKOTIK F20 Chronic Psychotic Disorder 3A
90 85 EPISTAKSIS R04.0 Epistaxis 4A
91 86 FURUNKEL PADA HIDUNG J34.0 Abscess, furuncle and carbuncle of nose 4A
92 87 FARINGITIS J02.9 Acute pharyngitis, unspecified 4A
93 88 RHINITIS AKUT J00 Acute nasopharingitis (common cold) 4A
94 89 RHINITIS ALERGIK J30.0 Vasomotor rhinitis 4A
95 90 RHINITIS VASOMOTOR J30.0 Vasomotor rhinitis 4A
96 91 TONSILITIS R76 Acute tonsillitis, unspecified 4A
97 92 LARINGITIS J04.0 Acute laryngitis 4A
98 93 BRONKITIS AKUT J20.9 Acute bronchitis, unspecified 4A
99 94 INFLUENZA J11 Influenza 4A
100 95 PNEUMONIA ASPIRASI J69.0 Pneumonitis due to food and vomit 3B
101 96 PNEUMONIA DAN BRONKOPNEUMONIA J18.9 Pneumonia, unspecified 4A
102 97 PERTUSIS A37.8 Whooping cough 4A
103 98 ASMA BRONKIAL J45 Asthma 4A
104 99 MILIRIA L74.3 Miliaria 4A
105 100 VERUKA VULGARIS B07 Viral warts 4A
106 101 REAKSI GIGITAN SERANGGA T63.4 Venom of other arthropods 4A
107 102 HERPES ZOSTER B02.9 Zoster without complication 4A
108 103 HERPES SIMPLEKS B00.9 Herpesviral infection, unspecified 4A
109 104 SKABIES B86 Scabies 4A
110 105 PEDIKULOSIS KAPITIS B85.0 Pediculosis due to Pediculus humanus capitis 4A
111 106 DERMATOFITOSIS : TINEA KAPITIS B35.0 Tinea barbae and tinea capitis 4A
112 107 DERMATOFITOSIS : TINEA BARBAE B35.0 Tinea barbae and tinea capitis 4A
113 108 DERMATOFITOSIS : TINEA FASIALIS TINEA FASIALIS 4A
114 109 DERMATOFITOSIS : TINEA KORPORIS B35.4 Tinea corporis 4A
115 110 DERMATOFITOSIS : TINEA MANUM B35.2 Tinea manuum 4A
116 111 DERMATOFITOSIS : TINEA UNGUIUM B35.1 TINEA UNGUIUM 4A
117 112 DERMATOFITOSIS : TINEA KRURIS B35.6 Tinea cruris 4A
118 113 DERMATOFITOSIS : TINEA PEDIS B35.3 Tinea pedis 4A
119 114 PITIRIASIS VERSIKOLOR/TINEA VERSIKOLOR B36.0 Pityriasis versicolor 4A
120 115 PIODERMA L08.0 Pyoderma 4A
121 116 DERMATITIS SEBOROIK L21 Seborrhoeic dermatitis 4A
122 117 DERMATITIS ATOPIK L20 Atopic dermatitis 4A
123 118 DERMATITIS NUMULARIS L20.8 Other atopic dermatitis 4A
119 LIKE SIMPLEKS KRONIK (NEURODERMATITIS L28.0 Lichen simplex chronicus 3A
124
SIRKUMKRIPTA)
125 120 DERMATITIS KONTAK ALERGIK L23 Allergic contact dermatitis 3A
126 121 DERMATITIS KONTAK IRITAN L24 Irritant contact dermatiti 4A
127 122 NAPKIN ECZEMA 9DERMATITIS POPOK) L22 Diaper(napkin) dermatitis 4A
128 123 PITIRIASIS ROSEA L42 Pityriasis rosea 4A
129 124 MOLUSKUM KONTAGIOSUM B08.1 Molluscum contagiosum 4A
130 125 URTIKARIA L50 Urticaria 4A
131 126 FILARIASIS B74 Filariasis 4A
132 127 LUKA BAKAR DERAJAT I DAN II S24 burn 4A
133 128 OBESITAS E66.9 obesity unspecified 4A
134 129 TIROTOKSIKOSIS E05.9 Tirotoksikosis unspecified 3B
135 130 HIPERGLIKEMIA HIPEROSMOLAR NON KETOTIK R73.9 Hyperglycaemia unspecified 3B
131 HIPOGLIKEMIA E16.2 hypoglycaemia unspecified ringan 4A,
136
berat 3B
137 132 DIABETES MELITUS 1 E10 Insulin-dependent diabetes mellitus 4A
138 133 DIABETES MELITUS 2 E11 Non-insulin-dependent diabetes mellitus 4A
139 134 MALNUTRISI ENERGI PROTEIN (MEP) E46 Unspecified protein-energy malnutrition 4A
135 HIPERURICEMIA GOUT ARTHRITIS E79.0 Hyperuricemia without signs of inflammatory arthritis and 4A
140
M10 tophaceous disease
141 136 DISLIPIDEMIA E78.5 Hiperlipidemia 4A
142 137 INFEKSI SALURAN KEMIH N39.0 Urinary tarct infection, site not specified 4A
143 138 HIPERMEMESIS GRAVIDARUM O21.0 Mild hyperemis gravidarum 3B
144 139 KEHAMILAN NORMAL O80.9 Single spontaneus delivery, unspecified 4A
145 140 PRE-EKLAMPSIA O14.9 Pre-eclampsia, unspecified 3B
146 141 EKLAMSIA O15.9 Eclampsia, unspecified as to time periode 3B
147 142 ABORTUS SPONTAN KOMPLIT O03.9 Unspecified abortion complete, without complication 4A
148 143 ABORTUS MENGANCAM/INSIPIENS O06.3 Unspecified abortion incomplete, without complication 3B
149 144 ABORTUS SPONTAN INKOMPLIT O06.4 Unspecified abortion incomplete, without complication 3B
150 145 ANEMIA DEFISIENSI BESI PADA KEHAMILAN D50 Iron deficiency anemia 4A
151 146 KETUBAN PECAH DINI 042.9 Premature rupture of membrane, unspecified 3A
152 147 PERSALINAN LAMA O63.9 long labour 3B
153 148 PERDARAHAN POST PARTUM 072.1 Other Immediate Postpartum haemorhage 3B
154 149 RUPTUR PERINEUM TINGKAT 1-2 O70.0 First degree perineal laceration during delivery 4A
155 150 MASTITIS N61 Inflammatory disorders of breast 4A
156 151 FLUOR ALBUS N98.9 4A
157 152 SIFILIS A51 Early syphilis 3A
158 153 GONORE A54.9 Gonococcal infection, unspecified 4A
159 154 VAGINITIS N76.0 Acute Vaginitis 4A
160 155 VULVITIS N76.0 Acute Vaginitis 4A
1 SKABIES B86
2 OTITIS MEDIA AKUT H66.0

3 HIPERTENSI ESENSIAL I10

4 ARTRITIS REUMATOID M53.3

5 ARTRITIS, OSTEOARTRITIS M19.9
6 LIPOMA D17.9
7 VERTIGO R42
8 MIGREN G43.9
9 FARINGITIS J02.9

10 RHINITIS AKUT J00

11 RHINITIS ALERGIK J30.0

12 INFLUENZA J11
13 TONSILITIS R76
14 INFLUENZA J11
15 SKABIES B86
16 HERPES ZOSTER B02.9
17 PAROTITIS K11.2
18 URTIKARIA L50
19 DIABETES MELITUS 1 E10

20 DIABETES MELITUS 2 E11

21 INFEKSI SALURAN KEMIH N39.0

22 KEHAMILAN NORMAL O80.9

23 GASTRITIS K297
24 DEMAM TIFOID A010
25 GASTROENTERITIS ( TERMASUK DISENTRI, KOLERA, A09
GIARDIASIS)

26 APENDISITIS AKUT K359

27 PAROTITIS K11.2
28 KONJUNGTIVITIS H10.9
H10.1

29 OTITIS EKSTERNA H60.9

Scabies 4A
Acute suppurative otitis 4A
media
Essential (primary) 4A
hypertension
Polymyalgia rheumatica 3A
Osteoarthrosis other 3A
Benign lipomatous neopl 4A
Dizziness and giddiness 4A
Migraine, unspecified 4A
Acute pharyngitis, 4A
unspecified
Acute nasopharingitis 4A
(common cold)

Vasomotor rhinitis 4A
Influenza 4A
Acute tonsillitis, unspecifi 4A
Influenza 4A
Scabies 4A
Zoster without complicati 4A
Sialoadenitis 4A
Urticaria 4A
Insulin-dependent 4A
diabetes mellitus
Non-insulin-dependent 4A
diabetes mellitus

Urinary tarct infection, 4A

site not specified

Single spontaneus 4A
delivery, unspecified
Gastritis, unspecified 4A
Typhoid fever 4A
Diarrhoea & 4A
gastroenteritis of
presumed infection
origin
Acute appendicitis 3B
Sialoadenitis 4A
Conjunctivitis, 4A
unspecified,,, Acute
atopic conjunctivitis

Otitis Externa, Unspecifie 4A