HASIL PEER REVIEW

DIAGNOSA NON SPESIALISTIK YANG DAPAT DITANGANI TUNTAS

DI FASILITAS KESEHATAN TINGKAT PERTAMA
BPJS KESEHATAN CABANG MADIUN TAHUN 2018

DAGNOSA DAPAT TUNTAS DITA

Keterangan
Kode Diagnosa (Kompeteni) Berdasar PKM PONED PKM RANAP
No Non Spesialistik Nama Diagnosa Non Spesialistik (ICD 10) permenkes 5/2014 dan
(ICD 10) Kepmenkes 514/2015

1 A01.0 Typhoid fever 4A √ √

2 A06.0 Acute amoebic dysentery 4A √ √

3 A09.0
Other and unspecified gastroenteritis 4A √ √
and colitis of infectious origin

Respiratory tuberculosis,
4 A15.0 bacteriologically and histologically 4A √ √
confirmed
5 A27.9 Leptospirosis, unspecified 4A
6 A30.0 Indeterminate leprosy 4A √ √

7 A35 Other tetanus 4A

8 A54.9 Gonococcal infection, unspecified 4A √ √

9 A90 Dengue fever [classical dengue] 4A √ √

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 10 A91 Dengue haemorrhagic fever 4A √ √

11 B00.9 Herpesviral infection, unspecified 4A √ √

12 B01.9 Varicella without complication 4A √ √
13 B02.9 Zoster without complication 4A √ √
14 B05.9 Measles without complication 4A √ √
15 B07 Viral warts 4A √ √
16 B08.1 Molluscum contagiosum 4A √ √
17 B15 Acute hepatitis A 4A
18 B26.0 Mumps orchitis 4A
19 B35 Dermatophytosis 4A √ √
20 B35.0 Tinea barbae and tinea capitis 4A √ √
21 B35.1 Tinea unguium 4A √ √
22 B35.2 Tinea manuum 4A √ √
23 B35.3 Tinea pedis 4A √ √
24 B35.4 Tinea corporis 4A √ √
25 B35.6 Tinea cruris 4A √ √
26 B35.8 Other dermatophytoses 4A √ √
27 B36.0 Pityriasis versicolor 4A √ √
28 B37.9 Candidiasis, unspecified 4A √ √
29 B54 Unspecified malaria 4A √ √

30 B65.0
Schistosom due schis haematobium 4A √ √
[urin schistosom]

31 B65.2
Schistosomiasis due to Schistosoma 4A √ √
japonicum
32 B65.9 Schistosomiasis, unspecified 4A √ √
33 B68.0 Taenia solium taeniasis 4A √ √
34 B68.9 Taeniasis, unspecified 4A √ √

35 B74.0 Filariasis due to wuchereria bancrofti 4A √ √

36 B76.0 Ancylostomiasis 4A √ √

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 37 B76.9 Hookworm disease, unspecified 4A √ √
38 B77.9 Ascariasis, unspecified 4A √ √
39 B78.0 Intestinal strongyloidiasis 4A √ √
40 B78.9 Strongyloidiasis, unspecified 4A √ √

41 B85.0
Pediculosis due to pediculus humanus 4A √ √
capitis
42 B85.3 Phthiriasis 4A √ √
43 B86 Scabies 4A √ √

44 D17.9
Benign lipomatous neoplasm, 4A √ √
unspecified

45 D50.0
Iron deficiency anaemia secondary to 4A √ √
blood loss (chronic)

46 D50.9 Iron deficiency anaemia, unspecified 4A √ √

47 E11.9
Non-insulin-dependent diabetes 4A √ √
mellitus without complications
48 E16.2 Hypoglycaemia, unspecified 4A √ √

49 E46
Unspecified protein-energy 4A √ √
malnutrition
50 E66.9 Obesity, unspecified 4A √ √
51 E78.5 Hyperlipidaemia, unspecified 4A √ √
Hyperuricaem without sign
52 E79.0 4A √ √
inflammarthritis+tophaceous dis
53 F45.0 Somatization disorder 4A √ √
54 F51.0 Nonorganic insomnia 4A √ √

55 G43.0
Migraine without aura [common 4A √ √
migraine]
56 G43.9 Migraine, unspecified 4A √ √
57 G44.2 Tension-type headache 4A √ √
58 G51.0 Bell's palsy 4A

59 H00.0
Hordeolum and other deep 4A √ √
inflammation of eyelid
60 H01.0 Blepharitis 4A √ √
61 H02.0 Entropion and trichiasis of eyelid 4A
62 H04.1 Other disorders of lacrimal gland 4A √ √
63 H10.1 Acute atopic conjunctivitis 4A √ √
64 H10.9 Conjunctivitis, unspecified 4A √ √
65 H15.1 Episcleritis 4A √ √
66 H52.0 Hypermetropia 4A
67 H52.1 Myopia 4A
68 H52.2 Astigmatism 4A
69 H52.4 Presbyopia 4A
70 H53.6 Night blindness 4A √ √

71 H57.8
Other specified disorders of eye and 4A √ √
adnexa
72 H60.9 Otitis externa, unspecified 4A √ √

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 73 H61.2 Impacted cerumen 4A √ √
74 H65.0 Acute serous otitis media 4A √ √

75 H65.1
Other acute nonsuppurative otitis 4A √ √
media
76 H66.0 Acute suppurative otitis media 4A √ √
77 I10 Essential (primary) hypertension 4A √ √

78 I83.9
Varicose veins lower extremities 4A √ √
without ulcer or inflamm

79 I84.0 Internal thrombosed haemorrhoids 4A √ √

80 I84.2
Internal haemorrhoids without 4A √ √
complication

81 I84.9
Unspecified haemorrhoids without 4A √ √
complication

82 J00 Acute nasopharyngitis [common cold] 4A √ √

83 J02 Acute pharyngitis 4A √ √

84 J02.9 Acute pharyngitis, unspecified 4A √ √
85 J03 Acute tonsillitis 4A √ √
86 J03.9 Acute tonsillitis, unspecified 4A √ √
87 J04.0 Acute laryngitis 4A √ √
88 J11.0 Influenza, virus not identified 4A √ √

89 J18.0 Bronchopneumonia, unspecified 4A √ √

90 J18.9 Pneumonia, unspecified 4A √ √

91 J20.9 Acute bronchitis, unspecified 4A √ √
92 J30.0 Vasomotor rhinitis 4A √ √
93 J30.4 Allergic rhinitis, unspecified 4A √ √

94 J34.0
Abscess, furuncle and carbuncle of 4A √ √
nose
95 J35.0 Chronic tonsillitis 4A √ √
96 J45.9 Asthma, unspecified 4A √ √
97 K12 Stomatitis and related lesions 4A √ √

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 98 K21.9
Gastro-oesophageal reflux disease 4A √ √
without oesophagitis
99 K29.7 Gastritis, unspecified 4A √ √

100 K90.4
Malabsorption due to intolerance, not 4A √ √
elsewhere classified
101 L01.0 Impetigo [any organism] [any site] 4A √ √

102 L02.0
Cutaneous abscess, furuncle and 4A √ √
carbuncle of face

103 L02.2
Cutaneous abscess, furuncle and 4A √ √
carbuncle of trunk

104 L02.8
Cutaneous abscess, furuncle and 4A √ √
carbuncle of other sites
105 L04.9 Acute lymphadenitis, unspecified 4A √ √
106 L08.0 Pyoderma 4A √ √
107 L08.1 Erythrasma 4A √ √
108 L20.8 Other atopic dermatitis 4A √ √
109 L21.0 Seborrhoea capitis 4A √ √
110 L22 Diaper [napkin] dermatitis 4A √ √

111 L24.0
Irritant contact dermatitis due to 4A √ √
detergents

112 L27.0
Generalized skin eruption due to drugs 4A √ √
and medicaments
113 L27.2 Dermatitis due to ingested food 4A √ √
114 L42 Pityriasis rosea 4A √ √
115 L50.0 Allergic urticaria 4A √ √

116 L50.9 Atrophic disorder of skin, unspecified 4A √ √

117 L70.0 Acne vulgaris 4A √ √

118 L71.0 Perioral dermatitis 4A √ √
119 L73.2 Hidradenitis suppurativa 4A √ √
120 L74.3 Miliaria, unspecified 4A √ √

121 L97
Ulcer of lower limb, not elsewhere 4A √ √
classified
122 M10 Gout 4A √ √
123 N10 Acute tubulo-interstitial nephritis 4A

124 N39.0
Urinary tract infection, site not 4A √ √
specified

125 N47
Redundant prepuce, phimosis and 4A √ √
paraphimosis
126 N61 Inflammatory disorders of breast 4A √ √
127 N76.0 Acute vaginitis 4A √ √

128 N98.9
Complication associated with artificial 4A
fertilization, unspecified

129 O03.9
Spontaneous abortion, Complete or 4A √
unspecified, without complication

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 130 O70.0
First degree perineal laceration during 4A √
delivery

131 O80.9
Single spontaneous delivery, 4A √ √
unspecified

132 O92.0
Retracted nipple associated with 4A √ √
childbirth

133 P38
Omphalitis of newborn with or 4A √ √
without mild haemorrhage
134 R04.0 Epistaxis 4A √ √
135 R42 Dizziness and giddiness 4A √ √
136 R56.0 Febrile convulsions 4A √ √
137 T14 Injury of unspecified body region 4A √ √

138 T14.1
Open wound of unspecified body 4A √ √
region

139 T15.9
Foreign body on external eye, part 4A √ √
unspecified
140 T17.1 Foreign body in nostril 4A √ √

141 T30.1
Burn of first degree, body region 4A √ √
unspecified

142 T30.2
Burn of second degree, body region 4A √ √
unspecified
143 T63.4 Venom of other arthropods 4A √ √
144 T78.2 Anaphylactic shock, unspecified 4A √ √
Asymptomatic human
145 Z21 immunodeficiency virus [HIV] infection 4A
status
JUMLAH TOTAL DIAGNOSA MAMPU DITANGANI 132 130

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T TUNTAS DITANGANI

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