Lampiran : Surat Keputusan Pengurus Pusat Perhati-KL Nomor : No. 008/SKEP/PP.PERHATI-KL/V/2017 Tanggal : 16 Mei 2017
T e n t a n g
Kode ICD-9 CM dan ICD-10 di Bidang T.H.T.K.L.
KODE ICD-9 CM
1. Tindakan di Poli THT
NO TIPE TINDAKAN KODE ICD 9 CM
1. TINDAKAN MEDIK NON OPERATIF RAWAT JALAN
MIKROSKOPI TELINGA LUAR 18.19
MIKROSKOPI TELINGA TENGAH 20.39
ENDOSKOPI TELINGA 18.19
PASANG TAMPON ANTERIOR HIDUNG 21.01 PASANG TAMPON POSTERIOR HIDUNG 21.02
KAUSTIK HIDUNG EPISTAKSIS 21.03
TES FUNGSI PENGHIDU 21.29
IRIGASI SINUS 22.00
IRIGASI SINUS DARI OSTIUM ALAMIAH 22.02
NASOENDOSKOPI 22.19
NASOENDOSKOPI FLEKSIBEL 22.19
NASOFARINGOSKOPI RIGID/ FLEKSIBEL 22.19 FLEXIBLE ENDOSCOPIC EVALUATION of
SWALLOWING (FEES) 29.19
KAUSTIK FARING 29.39
TRAKEOSKOPI DENGAN BSO MELALUI
STOMA TRAKEOSTOMI 31.41
RINOLARINGOSKOPI FLEKSIBEL/
TELELARINGOSKOPI RIGID 31.42
PENUTUPAN STOMA TRAKEOSTOMI 31.72
SKIN PRICK TEST 86.19
TES FUNGSI N. VII 89.15
CANALITH REPOSITIONAL THERAPY
(CRT) 93.89
VESTIBULAR REHABILITATION THERAPY 93.89
TES PENALA/ GARPU TALA 95.42
TES BERBISIK 95.42
TES VESTIBULAR KLINIS/TES KALORI 95.44 TES DIX HALPIKE DENGAN FRENZEL 95.46
PASANG NGT 96.07
PASANG NGT DENGAN ENDOSKOPI 96.07
PASANG TAMPON TELINGA 96.11
EKSTRAKSI / IRIGASI SERUMEN 96.52
IRIGASI HIDUNG 96.53
CUCI KANUL TRAKEOSTOMI PADA
MUCOUS PLUG 96.55
CUCI LUKA (OPERASI HIDUNG / TELINGA) 96.59
GANTI NGT 97.01
ANGKAT NGT 97.01
GANTI VERBAN / DRAIN 97.16
GANTI TAMPON HIDUNG 97.21
ANGKAT TAMPON HIDUNG ANTERIOR 97.32 ANGKAT TAMPON HIDUNG POSTERIOR 97.32
ANGKAT KANUL TRAKEOSTOMI 97.37
ANGKAT JAHITAN OPERASI 97.38
EKSTRAKSI BENDA ASING MULUT 98.01
EKSTRAKSI BENDA ASING TELINGA 98.11 EKSTRAKSI BENDA ASING HIDUNG 98.12 EKSTRAKSI BENDA ASING TONSIL-FARING 98.13 EKSTRAKSI BENDA ASING FARING
DENGAN ENDOSKOPI 98.13
IMMUNOTHERAPY 99.12
KEMOTERAPI 99.25
TERAPI TARGET 99.25
2. TINDAKAN MEDIK OPERATIF RAWAT JALAN
TINDIK TELINGA 18.01
INSISI PSEUDOKISTA / HEMATOMA
AURIKULA 18.09
INSISI PSEUDOKISTA / HEMATOMA
AURIKULA DENGAN PASANG GIPS 18.09
BIOPSI TELINGA LUAR 18.12
INSISI ABSES PREAURIKULAR 18.21
EKSTRAKSI GRANULASI TELINGA 18.29
EKSTRAKSI KOLESTEATOMA EKSTERNA 18.29
JAHIT LUKA TELINGA LUAR 18.4
MIRINGOPLASTI LEMAK / PATCH
MIRINGOPLASTY 19.4
PEMASANGAN PIPA VENTILASI
(GROMMET) 20.01
MIRINGOTOMI / ASPIRASI TELINGA
TENGAH 20.09
PELEPASAN PIPA VENTILASI (GROMMET) 20.1
INSISI ABSES RETROAURIKULAR 20.21 BIOPSI TELINGA TENGAH & DALAM 20.32
INJEKSI INTRA TIMPANI 20.94
INSISI HIDUNG, INSISI SEPTUM HIDUNG 21.1
BIOPSI HIDUNG 21.22
EKSTRAKSI MASSA / POLIP INTRANASAL 21.31 EKSISI LESI HIDUNG LAINNYA (SINEKIA,
PELEBARAN OSTIUM) 21.32
REDUKSI TERTUTUP FRAKTUR OS NASAL 21.71
JAHIT LUKA HIDUNG 21.81
ANTROSTOMI 22.01
BIOPSI SINUS 22.11
BIOPSI LIDAH 25.02
INSISI ABSES WAJAH, SUBMANDIBULA,
ANGINA LUDOVICI 27.0
BIOPSI ORAL CAVITY 27.24
REVISI SINEKIA HIDUNG 21.91
JAHIT LASERASI BIBIR 27.51
JAHIT LASERASI MULUT 27.52
HECTING LASERASI PALATUM 27.61
INSISI UVULA 27.71
EKSISI UVULA 27.72
INSISI ABSES PERITONSIL 28.0
BIOPSI TONSIL & ADENOID 28.11
BIOPSI FARING (NASOFARING /
OROFARING / HIPOFARING) 29.12
KRIKOTIROTOMI 31.3
BIOPSI LARING PER ENDOSKOPIK 31.43
BIOPSI KELENJAR LIMFE 40.29
GANTI KANUL TRAKEOSTOMI 97.23
GANTI VOICE PROSTHESES 97.29
3. TINDAKAN DIAGNOSTIK ELEKTROMEDIK
ELECTROCOCHLEOGRAPHY (ECoG) 20.31
RHINOMANOMETRY 89.12
ELECTRONYSTAGMOGRAPHY 95.24
AUDIOMETRI NADA MURNI 95.41
AUDIOMETRI TES GLISEROL 95.41
TIMPANOMETRI 95.41
REFLEKS STAPEDIUS IPSILATERAL/
KONTRALATERAL 95.41
EUSTACHIAN TUBE FUNCTION TEST 95.41
SISI 95.41
ABLB 95.41
TONE DECAY 95.41
REFLEKS DECAY 95.41
AUDIOMETRI TUTUR (SPEECH
AUDIOMETRI) 95.41
AUDIOMETRI TUTUR DALAM BISING 95.41
OTO-ACOUSTIC EMISSION (OAE) 95.46
BEHAVIORAL OBSERVATION
AUDIOMETRY (BOA) 95.46
VISUAL REINFORCEMENT AUDIOMETRY
(VRA) 95.46
CONDITIONED ORIENTATION REFLEX
(COR) 95.46
CONDITIONED PLAY AUDIOMETRY (CPA) 95.46
BERA 95.46
ASSR 95.46
eABR 95.46
AIDED AUDIOMETRI 95.46
AIDED ASSR 95.46
AUDITORY CORTICAL TESTING (ACR) 95.46
P300 95.46
NRT 95.46
VHIT 95.46
VEMP 95.46
FITTING ALAT BANTU DENGAR 95.48
MAPPING KOKLEAR IMPLAN 95.49
2. Tindakan Bedah THT Otologi
NO TIPE TINDAKAN KODE ICD 9 CM
1. TELINGA
Eksisi neuroma akustik 04.01
Dekompresi saraf fasialis 04.42
Graft saraf kranial/perifer 04.5
Transposisi saraf kranial/perifer 04.6 Anastomosis saraf hipoglosus-fasialis 04.71 Anastomosis saraf asesorius-fasialis 04.72 Anastomosis asesorius-hipoglosus 04.73 Revisi operasi saraf kranial/perifer 04.75 Eksplorasi dan reparasi trauma saraf
kranial/perifer 04.76
Tindik telinga Dalam Narkose Umum 18.01
Insisi drenase liang telinga 18.02
Insisi pseudokista/hematoma aurikula 18.09
Biopsi liang telinga 18.12 Eksisi fistel/abses preaurikular 18.21
Eksisi lesi liang telinga 18.29
Eksisi luas liang telinga 18.31
Hecting laserasi telinga luar 18.4
Kanaloplasti/Meatoplasty 18.6
Ossiculoplasty 19.0
Stapedektomi 19.1
Stapedektomi revisi 19.21
Ossiculoplasy tahap II 19.3
Timpanoplasti tipe I/Miringoplasti 19.4
Timpanoplasti tipe II 19.52
Timpanoplasti tipe III 19.53
Timpanoplasti tipe IV 19.54
Timpanoplasti tipe V 19.55
Timpanoplasti revisi 19.6
Obliterasi mastoid/penutupan fistel
mastoid 19.9
Pemasangan grommet 20.01
Miringotomi 20.09
Pelepasan grommet 20.1
Insisi drenase abses
retroaurikular/mastoid 20.21
Atikotomi 20.23
Biopsi telinga tengah dan dalam 20.32
Mastoidektomi sederhana 20.41
Mastoidektomi radikal 20.42
Atticoantrostomi/Mastoidektomi
modifikasi 20.49
Eksisi lesi telinga tengah 20.51
Petrosectomy 20.59
Fenestrasi telinga dalam 20.61
Revisi fenestrasi telinga dalam 20.62
Shunt endolimfatik 20.71
Injeksi telinga dalam 20.72
Labirinectomy 20.79
Operasi tuba eustachius 20.8
Mastoidektomi revisi 20.92
Reparasi oval/round window 20.93
Pemasangan Bone Anchored Hearing Aid
(BAHA) 20.95
Implan koklea 20.96
Ekstraksi benda asing telinga 98.11
3. Tindakan Bedah THT Rinologi
NO TIPE TINDAKAN KODE ICD 9 CM
1. HIDUNG
Reparasi fistel kebocoran LCS 02.12 Reparasi kebocoran LCS dengan graft
abdomen 02.12
Dekompresi saraf optikus 04.42
Ganglionektomi sfenopalatina 05.21
Neurektomi posterior 05.25
Biopsi kelenjar hipofisis transsfenoid 07.14 Eksisi parsial kelenjar hipofisis
transsfenoid 07.62
Eksisi total kelenjar hipofisis transsfenoid 07.65
Dakriosistorinostomi (DCR) 09.81
Kontrol epistaksis dengan tampon anterior 21.01 Kontrol epistaksis dengan tampon
posterior dan anterior 21.02
Kontrol epistaksis dengan kauterisasi dan
tampon 21.03
Kontrol epistaksis dengan ligasi arteri
etmoid/sfenopalatina 21.04
Kontrol epistaksis dengan ligasi arteri
maksilaris transantral 21.05
Kontrol epistaksis dengan ligasi arteri
karotis eksterna 21.06
Kontrol epistaksis dengan eksisi mukosa hidung dan graft kulit ke septum dan
dinding lateral hidung 21.07
Insisi abses hidung/septum 21.1
Insisi abses hidung/septum 21.1
Biopsi hidung 21.22
Eksisi lesi hidung 21.30
Polipektomi nasal 21.31
Reduksi konka dengan kauter/RDF 21.61
Konkotomi 21.62
Reduksi fraktur nasal tertutup 21.71
Hecting laserasi hidung 21.81
Penutupan fistel hidung 21.82
Revisi sinekia hidung 21.91
Irigasi sinus 22.00
DAWO/SAWO 22.01
Irigasi sinus dari ostium alamiah 22.02 Biopsi sinonasal dengan endoskopi 22.11
Biopsi sinonasal terbuka 22.12
Antrotomi intranasal (FESS) 22.2
Sinusektomi sinus frontal (FESS) 22.42
Trepanasi sinus frontal 22.42
Caldwell Luc 22.61
Etmoidektomi (FESS) 22.63
Sfenoidektomi (FESS) 22.64
Penutupan fistel sinus 22.71
Sleep endoscopy 89.19
Dilatasi duktus frontonasal 96.21
Penggantian tampon hidung 97.21
Pengangkatan tampon hidung 97.32
Ekstraksi benda asing hidung 98.12
4. Tindakan Bedah THT Laring Faring, Endoskopi, Head and Neck Onkologi
NO TIPE TINDAKAN KODE ICD 9 CM
1. FARING
Insisi drenase abses wajah/ submandibula/
angina ludovici 27.0
Insisi palatum 27.1
Biopsi palatum durum 27.21
Biopsi uvula/ palatum mole 27.22
Eksisi lesi palatum durum 27.31
Eksisi luas lesi palatum durum 27.32
Hecting laserasi palatum 27.61
Implan palatum 27.64
Insisi uvula 27.71
Eksisi uvula 27.72
Insisi drenase abses
tonsil/peritonsil/parafaring/ retrofaring 28.0
Biopsi tonsil dan adenoid 28.11
Biopsi tonsil dan adenoid 28.11
Tonsilektomi 28.2
Tonsilektomi dengan adenoidektomi 28.3
Eksisi tonsil lingual 28.3
Eksisi tag tonsil 28.4
Eksisi tonsil lingual 28.5
Adenoidektomi 28.6
Kontrol perdarahan pasca tonsilektomi dan
adenoidektomi 28.7
Ekstraksi benda asing tonsil/adenoid
dengan insisi 28.91
Eksisi lesi di tonsil dan adenoid 28.92
Faringotomi 29.0
Biopsi nasofaring/orofaring/hipofaring 29.12
Eksisi kista brakial 29.2
Miotomi krikofaring 29.31
Divertikulektomi faring 29.32
Faringektomi 29.33
Eksisi lesi di faring 29.39
Nasofaringektomi 29.39
Ekstirpasi angiofibroma nasofaring 29.39
Faringoplasti 29.4
Hecting laserasi faring 29.51
Penutupan fistel celah brakial 29.52
Penutupan fistel faring 29.53
Ekstraksi benda asing faring 98.13
2. LARING-TRAKEA-ESOFAGUS-HEAD NECK
Biopsi kelenjar tiroid 06.12
Biopsi kelenjar paratiroid 06.13
Lobectomy tiroid unilateral 06.2
Hemitiroidektomi 06.2
Eksisi lesi tiroid (kista tiroid) 06.31
Tiroidektomi parsial 06.39
Near total tiroidektomi 06.39
Tiroidektomi total 06.4
Eksisi tiroid lingual 06.6
Eksisi duktus tiroglosus 06.7
Paratiroidektomi total 06.81
Ligasi pembuluh darah tiroid 06.92
Hecting kelenjar tiroid 06.93
Rhinotomi lateral 21.30
Maksilektomi medial 22.31
Frontal sinusotomi (onkologi) 22.41
Etmoidektomi eksternal (onkologi) 22.51 Sfenoidektomi eksternal (onkologi) 22.52
Pendekatan sublabial 22.61
Midfasial degloving 22.62
Glosektomi parsial/ hemiglosektomi 25.2
Glosektomi total 25.3
Glosektomi radikal 25.4
Sialendoskopi Diagnostik 26.19
Sialolithektomi 26.29
Ekstirpasi kelenjar sublingual/
submandibula/ parotis parsial 26.31
Parotidektomi parsial 26.31
Parotidektomi superfisial 26.31
Ekstirpasi kelenjar sublingual/
submandibula/ parotis total 26.32
Parotidektomi total 26.32
Sialendoskopi Diagnostik dan Dilatasi 26.91 Sialendoskopi Diagnostik dan Terapeutik 26.99
Radiofrekuensi Dasar Lidah 27.99
Eksplorasi Abses Multiple 28.0
Marsupialisasi kista laring 30.01
Eksisi lesi laring (papiloma, nodul) 30.09
Hemilaringektomi 30.1
Epiglotiktomi 30.21
Kordektomi 30.22
Laringektomi parsial 30.29
Laringektomi total 30.3
Laringektomi radikal 30.4
Injeksi laring 31.0
Trakeostomi temporer 31.1
Trakeostomi dengan penyulit 31.1
Trakeostomi permanen 31.29
Trakeoskopi melalui stoma trakea 31.41 Trakeoskopi melalui stoma trakea 31.41
Laringoskopi/trakeoskopi 31.42
Laringoskopi/trakeoskopi 31.42
Biopsi laring dengan endoskopi 31.43 Biopsi trakea dengan endoskopi 31.44 Biopsi terbuka laring atau trakea 31.45
Eksisi lesi trakea 31.5
Laringofisure 31.6
Hecting laserasi laring 31.61
Hecting laserasi laring 31.61
Penutupan fistel laring 31.62
Revisi laringostomi/ repair stoma 31.63
Reparasi fraktur laring 31.64
Eksisi neoplasma laring dengan laser 31.69
Penutupan fistel trakea 31.72
Revisi trakeostomi 31.74
Rekonstruksi trakea dan konstruksi laring 31.75 Lisis penyempitan trakea/laring 31.92 Penggantian stent laring/trakea 31.93
Pemasangan T-Tube/ganti T stent 31.93 Injeksi obat terapetik ke trakea 31.94
Fistulasasi trakeoesofagus 31.95
Bronkoskopi melalui stoma 33.21
Bronkoskopi fiber optik 33.22
Bronkoskopi 33.23
Biopsi bronkus dengan endoskopi 33.24 Ligasi arteri karotis eksterna 38.82 Biopsi eksisi kelenjar limfe leher simpel 40.29 Biopsi insisi kelenjar limfe leher simpel 40.29
Eksisi kelenjar limfe regional 40.3
Diseksi leher selektif 40.3
Diseksi leher radikal unilateral 40.41 Diseksi leher radikal modifikasi 40.41 Diseksi leher radikal bilateral 40.42
Esofagotomi 1/3 proksimal 42.0
Insisi web esofagus 42.01
Esofagostomi 42.10
Esofagostomi servikal 42.11
Esofagoskopi 42.23
Biopsi esofagus per endoskopi 42.24
Biopsi esofagus per endoskopi 42.24
Biopsi esofagus per endoskopi 42.24
Eksisi divertikulum esofagus 42.31
Tindakan esofagus kompleks (eksisi,
varises) 42.33
Reseksi esofagus 42.40
Reparasi fistel esofagus 42.84
Reparasi striktur esofagus 42.85
Dilatasi esofagus 42.92
Dilatasi esofagus 42.92
Dilatasi esofagus 42.92
Mandibulektomi parsial 76.31
Maksilektomi parsial 76.39
Maksilektomi total 76.39
Maksilektomi radikal 76.39
Mandibulektomi total 76.41
Reduksi terbuka fraktur malar dan zigoma 76.72 Reduksi terbuka fraktur maksila 76.74 Reduksi terbuka fraktur mandibula 76.76
Eksisi kulit luas 86.4
Esofageal manometri 89.32
Intubasi dengan Flexible Bronkoskopi 96.04
Pembersihan kanul trakeostomi 96.55
Cuci trakea dan bronkus 96.56
Penggantian NGT 97.01
Penggantian kanul trakeostomi 97.23
Pengangkatan kanul trakeostomi 97.37 Ekstraksi benda asing esofagus 98.02
Ekstraksi benda asing laring 98.14
Ekstraksi benda asing trakea 98.15
Ekstraksi benda asing bronkus 98.15
3. BIBIR MULUT
Biopsi sinonasal app gingivobuccal 22.61
Biopsi Lidah 25.02
Hecting laserasi lidah 25.51
Frenektomi lingual 25.92
Insisi drenase kelenjar liur 26.0
Biopsi kelenjar liur 26.12
Marsupialisasi kista kelenjar liur 26.21 Hecting laserasi kelenjar liur 26.41
Probing saluran liur 26.91
Insisi drenase abses wajah, submandibula,
angina ludovici 27.0
Biopsi bibir 27.23
Biopsi mulut/ basis lidah 27.24
Biopsi eksisi rongga mulut 27.29
Frenektomi labial 27.41
Hecting laserasi bibir 27.51
Hecting laserasi mulut 27.52
Penutupan fistel mulut 27.53
Ekstraksi benda asing mulut 98.01
5. Tindakan Bedah THT Plastik Rekonstruksi
NO TIPE TINDAKAN KODE ICD 9 CM
Blefaroplasty 08.70
Rekonstruksi palpebra superior 08.89 Rekonstruksi palpebra inferior 08.89
Otoplasti pada makrotia 18.5
Aurikuloplasti mikrotia tahap 1 18.71 Aurikuloplasti mikrotia tahap 2 18.71 Aurikuloplasti mikrotia tahap 3 18.71
Aurikuloplasti rekonstruksi 18.71
Rekonstruksi daun telinga putus 18.72
Reseksi hidung 21.4
Submukosa reseksi septum (SMR) 21.5
Reduksi fraktur nasal terbuka 21.72
Fistulektomi
nasolabial/nasofaringeal/oronasal 21.82
Rekonstruksi ala nasi 21.83
ekstirpasi silikonoma 21.83
Ekstirpasi & rekonstruksi silikonoma 21.83
Rinoplasti rekonstruksi 21.83
Rinoplasti revisi 21.84
Rinoplasti augmentasi 21.85
Open septorhinoplasty 21.88
Septoplasti 21.88
Repair perforasi septum hidung 21.88
pemasangan Arch bar 24.7
Revisi Arch bar 24.7
Buka Arch bar 24.8
Labioplasti pada celah bibir 27.54
Full-thickness skin graft pada bibir dan
mulut 27.55
Lokal flap pada wajah 27.57
Attachment of pedicle or flap graft pada
bibir dan mulut 27.57
Palatoplasty 27.6
Palatoplasti pada celah palatum 27.62 Revisi palatoplasti pada celah palatum 27.63
Uvuloplasty 27.73
Faringoplasti 29.4
Osteotomi medialis 76.09
Osteotomi paramedial 76.09
Osteotomi percutaneus 76.09
Rekonstruksi fraktur ramus mandibula 76.62
Augmentasi mental 76.68
Reduksi terbuka fraktur malar dan zigoma 76.72
Rekonstruksi fraktur zygoma 76.72
Rekonstruksi malar 76.72
Reduksi terbuka fraktur maksila 76.74 Reposisi fraktur os maksila le Fort 1 76.74
Intermaksilari fixation 76.74
Reposisi fraktur os maksila le Fort 2 76.74 Reduksi terbuka fraktur mandibula 76.76 Rekonstruksi fraktur sympisis mandibula 76.76
Rekonstruksi fraktur condylus 76.76
Rekonstruksi tripod fraktur 76.79
Rekonstruksi panfacial fraktur 76.79 Rekonstruksi fraktur palatum durum 76.79
Costal graft 76.91
Insersi implan sintetik di tulang wajah 76.92
STSG 86.60
conchal graft 86.60
FTSG 86.63
Ritidectomy 86.82
Pengangkatan alat fiksasi mandibula 97.36
Hecting luka kepala leher 97.38
Pengangkatan alat terapetik di kepala leher 97.39
KODE ICD-10
NO TELINGA KODE DIAGNOSIS ICD 10
1 SERUMEN PROP H612 Impacted cerumen
2 BENDA ASING TELINGA T16 Foreign body in ear 3 OE SIRKUMSKRIP H600 Abscess of external ear
H601 Cellulitis of external ear
4 OE DIFUSA H603 Diffuse otitis externa, Swimmer
ear, Hemorragic
5 OTOMIKOSIS B372 Candidiasis
B448 Aspergillosis
6 KOLESTEATOMA EKSTERNA H604 Cholesteatoma of external ear
7 OE MALIGNA H602 Malignant otitis externa
8 OTALGIA H920 Otalgia
9 STENOSIS LIANG TELINGA H613 Acquired stenosis of secondary trauma, inflammation, infection 10 EKSOTOSIS LIANG TELINGA H618 Exostosis of external canal 11 PERIKONDRITIS H610 Pericondritis of external ear 12 PSEUDOKISTA/HEMATOMA H611 Noninfective disorders of pinna 13
OKLUSI TUBA H680 Eustachian salpingitis
H681 Obstruction of Eustachius tube:
compression, stenosis, stricture 14 TUBA PATOULUS H690 Patulous Eustachian tube
15 OMA H660 Acute suppurative otitis media
16
OME AKUT H650 Acute serous otitis media
H651 Acute and subacute allergic otitis media (mucoid) (serous)
17
OME KRONIK
H652 Chronic serous otitis media H653 Chronic mucoid otitis media
(Glue Ear)
H654 Chronic allergic otitis media 18 OMSK BENIGNA AKTIF H661 Chronic tubotympanic
suppurative otitis media 19 OMSK BENIGNA TENANG H720 Central perforation of tympanic
membrane 20
OMSK MALIGNA
H662 Chronic atticoantral suppurative otitis media
H71 Cholesteatoma of middle ear H721 Attic perforation of tympanic
membrane
H722 Other marginal perforations of tympanic membrane
H728 Total & multiple perforations of tympanic membrane
H744 Polyp of middle ear
21 BAROTRAUMA T700 Otitic Barotrauma
22 OMSK TBC A186 Tuberculosis of (inner) (middle)
ear
23 PARESIS FASIALIS H519 Disorder of facial nerve, unspecified
24
ABSES/FISTEL RETROAURIKULAR
H700 Acute mastoiditis: abcess of mastoid
H701 Chronic mastoiditis: Fistula of mastoid
25
GANGGUAN KESEIMBANGAN
H811 Benign paroxysmal vertigo H832 Labyrinthine dysfunction :
paresis kanal H810 Meniere's disease H812 Vestibular neuronitis H813 Other peripheral vertigo H814 Vertigo of central origin H830 Labyrinthitis
H831 Labyrinthine fistula 26
DELAYED SPEECH F809
Developmental disorder of speech and language, unspecified
27 TINITUS H931 Tinnitus
28
GANGGUAN PENDENGARAN
H900 Conductive hearing loss, bilateral
H901 Conductive hearing loss, unilateral, normal on contralateral
H903 Sensorineural hearing loss, bilateral
H904
Sensorineural hearing loss, unilateral normal on contralateral
H906 Mixed hearing loss, bilateral H907 Mixed hearing loss, unilateral,
normal on the contralateral H911 Presbycusis
H912 Sudden idiopathic hearing loss H833 Noise effects on inner ear :
acoustic trauma, NIHL H910 Ototoxic hearing loss
29 MIRINGITIS AKUT H730 Acute myringitis
30 MIRINGITIS KRONIK H731 Chronic myringitis
31 OTITIS MEDIA ADHESIVE H741 Adhesive middle ear disease 32 TIMPANOSKLEROSIS H740 Tympanosclerosis
33
OTOSLEROSIS
H800 Otosclerosis involving oval window, nonobliterative H801 Otosclerosis involving oval
window, obliterative H802 Cochlear otosclerosis 34
GANGGUAN TULANG PENDENGARAN
H742 Discontinuity and dislocation of ear ossicles
H743 Ankylosis and partial loss of ear ossicles
35
TRAUMA TELINGA
S004 Superficial injury of ear S013 Open wound of ear S021 Fracture of Base of Skull S045 Injury of facial nerve S046 Injury of acoustic nerve
S092 Traumatic rupture of ear drum
36 HERPES B001 Herpes simpleks infection
B028 Zoster with other complications 37
PASCA OPERASI MASTOID
H950 Recurrent cholesteatoma of postmastoidectomy cavity H951 Chronic inflam, granulation,
mucosal cyst of postmastoidectomy 38 DEFORMITAS TELINGA M951 Cauliflower ear 39
KELAINAN KONGENITAL TELINGA
Q160 Congenital absence of ear auricle (anotia)
Q161 Congenital absence, atresia and stricture of auditory canal Q162 Absence of eustachian tube
Q163 Congenital malformation of ear ossicles
Q164 Other congenital malformations of middle ear
Q165 Congenital malformation of inner ear
Q169 Congenital malformation of ear causing impairment of hearing Q170 Accessory auricle
Q171 Macrotia Q172 Microtia Q175 Prominent ear
Q181 Preauricular sinus and cyst Q182 Other branchial cleft
malformations
NO HIDUNG KODE DIAGNOSIS ICD 10
1
SINUSITIS AKUT
J01 Acute sinusitis
J010 Acute maxillary sinusitis J011 Acute frontal sinusitis J012 Acute ethmoidal sinusitis J013 Acute sphenoidal sinusitis,
unspecified
J014 Acute pansinusitis, unspecified J018 Other acute sinusitis, more than
one sinus, not pansinusitis 2
RINOSINUSITIS KRONIK
J310 Chronic rhinitis : atropic, granulomatous
J320 Chronic maxillary sinusitis J321 Chronic frontal sinusitis J322 Chronic ethmoidal sinusitis J323 Chronic sphenoidal sinusitis J324 Chronic pansinusitis
J328 Other chronic sinusitis, more than one sinus, not pansinusitis J329 Chronic sinusitis, unspecified J330 Polyp of nasal cavity: choanal,
nasopharyngeal
J331 Polypoid sinus degeneration:
Woakes' Syndrome
J338 Other polyp of sinus: polyp of ethmoidal, maxillary, spenoidal J339 Nasal polyp, unspecified
3 RINITIS VASOMOTOR J300 Vasomotor rhinitis
4 RINITIS ALERGI J304 Allergic rhinitis, unspecified J450 Allergic rhinits with asthma
5 SEPTUM DEVIASI J342 Deviated nasal septum
6 HIPERTROFI KONKA J343 Hypertrophy of nasal turbinates 7 RINOLITH/PERFORASI
SEPTUM J348 Perforation of nasal septum,
rinolith
8 EPISTAKSIS R040 Epistaxis
9 ABSES/FURUNKEL J340 Abscess, furuncle and carbuncle of nose
10
KISTA/ MUKOSIL SINUS J341 Cyst and mucocele of nose and nasal sinus
11 DEFORMITAS HIDUNG M950 Acquired deformity of nose 12
TRAUMA HIDUNG
S003 Superficial injury of nose S012 Open wound of nose S021 Fracture of Base of Skull S022 Fracture of Nasal Bones
S031 Dislocation of Septal Cartilage of Nose
S040 Injury of optic nerve and pathwayas
13 BENDA ASING T170 Foreign Body in nasal sinus T171 Foreign Body in nostril
14 OSAS G4733 Obstructive sleep apnea (adult)
(pediatric)
15 LCS LEAKAGE G960 Cerebrospinal fluid leak
16 SELULITIS ORBITA H050 Cellulitis of orbit
17 ATRESIA KOANA Q300 Choanal Atresia
NO LARING FARING KODE DIAGNOSIS ICD 10
1
TONSILITIS AKUT
J030 Acute streptococcal tonsillitis J038 Acute tonsillitis due to other
specified organisms
J039 Acute tonsillitis, unspecified 2 TONSILITIS KRONIK J350 Chronic tonsillitis
3 HIPERTROFI TONSIL J351 Hypertrophy of tonsils 4 HIPERTROFI ADENOID J352 Hypertrophy of adenoids 5 HIPERTROFI TONSIL ADENOID J353 Hypertrophy of tonsils with
hypertrophy of adenoids 6
FARINGITIS AKUT
B302 Viral pharyngoconjunctivitis J00 Acute nasopharyngitis [common
cold]
J020 Streptococcal pharyngitis
J028 Acute pharyngitis due to other specified organisms
J029 Acute pharyngitis, unspecified 7
FARINGITIS KRONIK
J311 Chronic nasopharyngitis J312 Chronic pharyngitis : atrophi,
granular, hipertrophic 8
LARINGITIS AKUT
J040 Acute laryngitis
J050 Acute obstructive laryngitis [croup]
J051 Acute epiglotitis
J060 Acute laryngopharyngitis 9 LARINGITIS KRONIK J370 Chronic laryngitis
10
KELAINAN LARING
J380 Paralysis of vocal cords and larynx
J381 Polyp of vocal cord and larynx J382 Nodules of vocal cords
J383 Other diseases of vocal cords J384 Edema of larynx
J385 Laryngeal spasm J386 Stenosis of larynx
J387 Other diseases of larynx :
abscess, cellulitis, perichondritis 11
TBC LARING/KELENJAR LEHER
A155 Tuberculosis of larynx, trachea and bronchus
A182 Tuberculosis of perypheral lymphadenopathy
12 REFLUKS LARING-FARING K210 Gastro-esophageal reflux disease
13 DISFAGIA R13 Dysphagia
14 OBSTRUKSI JALAN NAFAS ATAS
J960 Acute respiratory failure J961 Chronic respiratory failure 15
KOMPLIKASI TRAKEOSTROMI
T818 Emphysema (subcutaneous) resulting from procedure J950 Tracheostomy malfunction :
haemorrhage, obstruction, fistula
16
ABSES LEHER DALAM
J36 Peritonsillar abscess J390 Retropharyngeal and
parapharyngeal abscess K122 Cellulitis and abscess of mouth
(submandibular abscess) 17
BENDA ASING
T172 Foreign body in pharynx T173 Foreign body in larynx T174 Foreign body in trachea
T175 Foreign body in bronchus T180 Foreign body in mouth T181 Foreign body in esophagus 18
KELAINAN ORAL CAVITY
B370 Cadidal stomatitis
K120 Recurrent oral aphthae : aphthos stomatitis
K132 Leukoplakia of oral mucosa, including tongue
K121 Other forms of stomatitis 19
KELAINAN KONGENITAL LARING FARING
Q310 Web of larynx
Q311 Congenital subglottic stenosis Q312 Laryngeal hypoplasia
Q313 Laryngocele
Q315 Congenital laryngomalacia Q320 Congenital tracheomalacia Q387 Congenital pharyngeal pouch Q180 Sinus, fistula and cyst of
branchial cleft
20 PAROTITIS B26 Mumps
21
KELAINAN TIROID
E040 Nontoxic diffuse goiter
E041 Nontoxic single thyroid nodule E042 Nontoxic multinodular goiter E050 Thyrotoxicosis with diffuse
goiter
E051 Thyrotoxicosis with toxic single thyroid nodule
E052 Thyrotoxicosis with toxic multinodular goiter
22 KELAINAN TMJ M266 Temporomandibular joint
disorder 23 CELAH BIBIR & LANGIT-
LANGIT
Q35 Cleft palate Q36 Cleft lip
Q37 Cleft palate with cleft lip 24
TRAUMA
S005
Superficial injury of lip and oral cavity
S014 Open wound of cheek and temporomandibular area S015
Open wound of lip and oral cavity
S100 Superficial injury of neck, contusion of throat S110
Open wound of larynx and trachea
S111 Open wound of thyroid gland S112 Open wound of pharynx and
cervical esophagus S026
25
DIFTERI
A360 Pharyngeal diphtheria A361 Nasopharyngeal diphtheria A362 Laryngeal diphtheria
26 DISFONIA R490 Disfonia
27
ANAFILAKSIS SALURAN NAPAS J393
Upper respiratory tract hypersensitivity reaction, site unspecified
28
KELAINAN ESOFAGUS
K220 Achalasia of cardia K223 Perforation of esophagus K225
Diverticulum of esophagus, acquired
29
KELAINAN KELENJAR LIUR
K110 Atrophy of salivary gland K111 Hypertrophy of salivary gland K112 Sialoadenitis
K113 Abscess of salivary gland K114 Fistula of salivary gland K115 Sialolithiasis
K116 Mucocele of salivary gland
NO TUMOR KODE DIAGNOSIS ICD 10
1
TUMOR GANAS NASOFARING
C110 Malignant neoplasm of superior wall of nasopharynx
C111 Malignant neoplasm of posterior wall of nasopharynx
C112 Malignant neoplasm of lateral wall of nasopharynx
C113 Malignant neoplasm of anterior wall of nasopharynx
C118 Malignant neoplasm of overlapping sites of nasopharynx
C119 Malignant neoplasm of nasopharynx, unspecified 2
TUMOR GANAS LARING
C320 Malignant neoplasm of glottis C321 Malignant neoplasm of
supraglottis
C322 Malignant neoplasm of subglottis C323 Malignant neoplasm of laryngeal
cartilage
C328 Malignant neoplasm of overlapping sites of larynx C329 Malignant neoplasm of larynx,
unspecified
3 TUMOR GANAS HIDUNG C300 Malignant neoplasm of nasal cavity
4
TUMOR GANAS SINUS
C310 Malignant neoplasm of maxillary sinus
C311 Malignant neoplasm of ethmoidal sinus
C312 Malignant neoplasm of frontal sinus
C313 Malignant neoplasm of sphenoid sinus
C318 Malignant neoplasm of overlapping sites of accessory sinuses
C319 Malignant neoplasm of accessory sinus, unspecified
5
TUMOR GANAS TONSIL
C090 Malignant neoplasm of tonsillar fossa
C091 Malignant neoplasm of tonsillar pillar (anterior) (posterior) C098 Malignant neoplasm of
overlapping sites of tonsil C099 Malignant neoplasm of tonsil,
unspecified 6
TUMOR GANAS OROFARING
C100 Malignant neoplasm of vallecula C101 Malignant neoplasm of anterior
surface of epiglottis
C102 Malignant neoplasm of lateral wall of oropharynx
C103 Malignant neoplasm of posterior wall of oropharynx
C104 Malignant neoplasm of branchial cleft
C108 Malignant neoplasm of
overlapping sites of oropharynx C109 Malignant neoplasm of
oropharynx, unspecified 7
TUMOR GANAS HIPOFARING
C12 Malignant neoplasm of pyriform sinus
C130 Malignant neoplasm of postcricoid region
C131
Malignant neoplasm of aryepiglottic fold, hypopharyngeal aspect
C132 Malignant neoplasm of posterior wall of hypopharynx
C138 Malignant neoplasm of overlapping sites of hypopharynx
C139 Malignant neoplasm of hypopharynx, unspecified 8
TUMOR GANAS LIANG TELINGA C4421 Basal cell carcinoma skin of ear and external auricular canal C4422 Squamous cell carcinoma of skin
of ear and external canal 9 TUMOR GANAS TELINGA
TENGAH C301 Malignant neoplasm of middle
ear 10
LIMFOMA
C81 Hodgkin's lymphoma
C85 Other and unspecifiedof non- Hodgin's Lymphoma
11
TUMOR GANAS BIBIR
C000 Malignant neoplasm of external upper lip
C001 Malignant neoplasm of external lower lip
C002 Malignant neoplasm of external lip, unspecified
C003 Malignant neoplasm of upper lip, inner aspect
C004 Malignant neoplasm of lower lip, inner aspect
C005 Malignant neoplasm of lip, unspecified, inner aspect C006 Malignant neoplasm of
commissure of lip, unspecified C008 Malignant neoplasm of
overlapping sites of lip C009 Malignant neoplasm of lip,
unspecified 12
TUMOR GANAS LIDAH
C01 Malignant neoplasm of base of tongue
C020 Malignant neoplasm of dorsal surface of tongue
C021 Malignant neoplasm of border of tongue
C022 Malignant neoplasm of ventral surface of tongue
C023 Malignant neoplasm of anterior two-thirds of tongue
C024 Malignant neoplasm of lingual tonsil
C028 Malignant neoplasm of overlapping sites of tongue C029 Malignant neoplasm of tongue,
unspecified 13
TUMOR GANAS GUSI
C030 Malignant neoplasm of upper gum
C031 Malignant neoplasm of lower gum
C039 Malignant neoplasm of gum, unspecified
14
TUMOR GANAS DASAR MULUT
C040 Malignant neoplasm of anterior floor of mouth
C041 Malignant neoplasm of lateral floor of mouth
C048 Malignant neoplasm of overlapping sites of floor of mouth
C049 Malignant neoplasm of floor of mouth, unspecified
15
TUMOR GANAS PALATUM &
UVULA
C050 Malignant neoplasm of hard palate
C051 Malignant neoplasm of soft palate
C052 Malignant neoplasm of uvula C058 Malignant neoplasm of
overlapping sites of palate C059 Malignant neoplasm of palate,
unspecified 16
TUMOR GANAS MUKOSA MULUT
C060 Malignant neoplasm of cheek mucosa
C061 Malignant neoplasm of vestibule of mouth
C062 Malignant neoplasm of retromolar area C0680 Malignant neoplasm of
overlapping sites of mouth
C0689
Malignant neoplasm of
overlapping sites of other parts of mouth
C069 Malignant neoplasm of mouth, unspecified
17 TUMOR GANAS MANDIBULA C411 Malignant neoplasm of mandible 18 TUMOR GANAS TIROID C73 Malignant neoplasm of thyroid
gland
19 TUMOR GANAS ESOFAGUS C159 Malignant neoplasm of esophagus, unspecified
20 TUMOR GANAS TIROID C73 Malignant neoplasm of thyroid gland
21
TUMOR GANAS KELENJAR LIUR
C07 Malignant neoplasm of parotid gland
C080 Malignant neoplasm of submandibular gland C081 Malignant neoplasm of
sublingual gland
C089 Malignant neoplasm of major salivary gland, unspecified 22
LIMFOMA
C81 Hodgkin lymphoma C82 Follicular lymphoma C83 Non Follicular lymphoma C84 Mature T/NK-cell lymphoma C85 Non Hodgin Lymphoma 23
TUMOR JINAK (1)
D100 lip D101 tongue
D102 floor of mouth
D103 unspecified part of mouth D104 tonsil
D105 oropharynx D106 nasopharynx D107 hypopharynx D110 parotid gland
D117 sublingual, submandibular glands
D140 middle ear, nasal cavity and accesory sinus
D141 larynx D150 thymus D170 lipomatous D180 hemangioma
24 TUMOR JINAK (2) D181 lymphangioma
D232 skin and external auricular canal D315 lacrimal gland and duct
D333 cranial nerves D34 thyroid gland D351 parathyroid gland D352 pituitary gland
D353 craniopharyngeal duct D354 pineal gland
D360 lymph nodes
D3611 peripheral & autonom nerves head neck face
NO FRAKTUR WAJAH KODE DIAGNOSIS ICD 10
1 DISLOKASI RAHANG S030 Dislocation of jaw 2
FRAKTUR WAJAH
S024 Fracture of malar and maxillary bones
S026 Fracture of mandible
S027 Multiple fractures involving skull and facial bones
S028 Fractures of other skull and facial bones
S029 Fractures of skull and facial bones, part unspecified S022 Fracture of nasal bones S023 Fracture of orbital floor
