DAFTAR TINDAKAN – TINDAKAN YANG PERLU INFORMED CONSENT
Sesuai Undang – Undang no 44 tahun 2009 tentang rumah sakit, terdapat beberapa tindakan kedokteran dan kedokteran gigi yang wajib diberikan informed consent.
Tindakan tersebut yaitu :
A. TINDAKAN PEMBEDAHAN DAN TINDAKAN INVASIVE ANTARA LAIN : 1. BEDAH
1 Aff Arch Barr
2 Aff Arch Barr dan suspensi maksila 3 Biopsy Insisional dengan anastesi lokal 4 Deseksi submandibula
5
Diseksi leher radikal/radikal neck dissection
6 Eksisi gld submandibula 7 Eksisi higroma leher 8 Eksisi kista tiroglosus
9 Eksisi luas tumor ganas bibir dengan rekontruksi flap lokal
10 Eksisi luas tumor ganas dengan rekontruksi flap jauh
11 Eksisi luas tumor ganas kulit dengan rekontruksi flap lokal
12 Eksisi luas tumor ganas rongga mulut dengan rekontruksi flap lokal
13 Eksisi parsial+marsupialisasi Ranula 14 Eksisi tumor ganas kulit dengan flap local
atau graft kulit
15 Eksisi tumor ganas kulit dengan flap local jauh
16 Eksisi tumor ganas kulit tanpa rekontruksi 17 Eksisi tumor jinak dengan anastesi lokal
18 Ekskokleasi epulis
19 Ekskokleasi kista folikuler 20 Ekskokleasi kista radikuler 21
Ekstirpasi/eksisi tumor jinak jaringan lunak ukuran <2cm
22 Ekstirpasi kista dermoid 23 Endoscopic thyroidectomy 24
Fiksasi interna fraktur maksilofasial 1-2 tempat patahan
25 Fiksasi interna fraktur nasal 26 Fiksasi interna pan-facial 27 Hemiglosektomi
28 Insisi abses dengan anastesi lokal 29 Insisi flegmon dasar mulut
30 Internal Fiksasi fraktur condylus mandibula 31
Internal Fiksasi fraktur maksilofasial 3-4 tempat patahan
32 Internal fiksasi fraktur maksilofasial 5 tempat patahan atau lebih
33 Laringectomi
2. BEDAH THT
1 Adenotonsilektomi 2 Anthrostomi+Sinuskopi
3 BLM Simple (Kista,Polip,Nodul,Granulasi) 4 Biopsi Tumor
5 Bronkoskopi Rigid
6 BLM Advance (Stenosis, Subjektif/Trakea, Papiloma
7 Laring/Trakea) 8 Cald Well Luc
9 Cochlear Implant/Implan Baha 10 Dekompresi Nervus Fasialis 11 DCR
12 Eksisi Ekstostosis
13 Ekstirpasi Kista Branchial
14 Ekstirpasi Kista Ductus Tiroglosus 15 Ekstraksi granulasi MAE/Kolesteatosis 16 Ekstraksi Polip
17 Ethmoidektomi (Intranasal)
18 Ekstraksi Korpus Alienum Kavum Nasi 19
Ekstraksi Korpus Alienum Kavum Nasi Endoskopi
20 Ekstirpasi Fistel Pre Aurikuler 21 Ekstraksi Korpus Alienum MAE 22 Ekstirpasi Kelenjar Sub Mandibula 23 Ekstirpasi Angiofibroma Nasofaring 24 Eksplorasi Abses Parafaringeal
25 Ekstirpasi Tumor Jinak Kepala & Leher (Aterom Lipoma)
26 Faringotomi 27 FESS
38 Insisi Perikondritis 39 Irigasi Sinus Maksila 40 Insisi Abses Peritonsil 41 Imunoterapi
42 Konka Reduksi
43 Kaustik Konka Inferior 44 Laringektomi
45 Laringektomi+ND
46 Laringo Fisur/Eksplorasi Laring 47 Ligasi A. Karotis Eksternal 48 Laringoskopi Rigid
49 Laringoskopi Fleksible 50 Laringoskopi Direkta
51 Maksilektomi Total+Rekontruksi 52 Mastoidektomi Radikal
53 Mini FESS
54 Myocutaneus Flap (Pectoral Mayor) 55 Myringoplasty/Timpaniplasti
56 Mandibulekromi
57 Neurektomi Saraf Vidian 58 Osteotomi+Septum koreksi
59 Rekontruksi Fraktur Maksila Multiple 60 Rekontruksi Fraktur Maksila Sederhana 61 Rhinoplasti
62 Rinotomi Lateral+Maksilektomi Medial 63 Rekontruksi Laring Trakea
64 Reposisi Fraktur Os Nasal
65 Reposisi & Fiksasi Fraktur Mandibula 66 Septum Koreksi+Konkotomi
28 FESS Advance 29 Frontal Sinusotomi 30 Fore Head Flap
31 Fronto Etmoidektomi (Ekstranasal) 32 FOL
33 Glosektomi Total/Parsial
34 Glosektomi Total/Hemiglosektomi+RND 35 Hemiglosektomi+SOHND
36 Insisi Abses Leher Dalam 37 Inversi Grommet
67 Stapedektomi 68 Skin Pricle Test
69 Tiroidektomi Sub-Total 70 Tonsilektomi/Adenoidektomi 71 Tracheostomi
72 Turbinektomi
73 Tiroidektomi Total+ND 74 Temporal Bone Resection
75 Terapi Wicara pada Anak-Anak dan dewasa 76 Terapi Wicara Tuna Laring
3. BEDAH THORAKS DAN KARDIOVASCULA
1 Biopsi Terbuka Bronkhus 2 Biopsi Terbuka Diafragma 3 Biopsi Terbuka Mediastinum 4 Biopsi Terbuka Paru
5 Biopsi Terbuka Pleura
6 Biopsi Terbuka Pleura dengan VATS 7 Biopsi Terbuka Tumor Dinding Thoraks 8 Debridement Mediastinum (Sternotomi) 9 Eksisi Pada Bronkhus
1
0 Eksisi Pada Paru (Lung Volume Reduction) 1
1 Eksisi Pada Paru dengan VATS 1
2 Eksisi Tumor Dinding Dada dengan Rekonstruksi Dinding Dada
1
3 Eksisi Tumor Mediastinum (Thymoma, Teratoma, Neurogenic dsb)
1
4 Ekstraksi Corpus Alienum di Regio Toraks 1
5 Ekstraksi Corpus Alienum di Regio Toraks dengan VATS
1
6 Evakuasi Efusi Pleura/Empyema secara Torakoskopik (VATS)
1
7 Fiksasi Costae (Clipp, Wire) (diluar Clipp) 1
8 Fiksasi Sternum (Wire, Plate) (diluar wire/plate)
1
9 Lobektomi Parsial (Reseksi Paru segmental) 2
0 Lobektomi Parsial (Reseksi Paru segmental) dengan
2
1 VATS 2
2 Lumbal Simpatektomi 2
3 Mediastinostomy 2
4
Pemasangan thorak drain/water sealed drainage (WSD) (diluar alat)
2
5 Pleural window (Eloeser Flap) 2
6 Pleurektomi 2
7 Pleurodesis (Pleurosklerosis) 2
8 Plikase Bulae / Bleb Emfisematous 2
9 Plikasi diafragma 3
0 Pneumonectomy 3
1 Pneumonectomy dengan VATS 3
2 Pulmonary Decortication 3
3 Pulmonary Decortication dengan VATS 3 Pulmonary Lobectomy/Bilobectomy
5 1
Aortic Valve Repair (AVR) dengan Bioprosthesis Valve
5 2
Aortic Valve Repair (AVR) dengan Mechanical Valve
5
3 Atrial septal Defect (ASD) Closure 5
4 Bidirectional Cavo-Pulmonary Shunt (BCPS) 5
5 Biopsi Jantung 5
6 Biopsi Perikardium 5
7 Blalock-Taussing Shunt (BT Shunt) 5
8 Coronary Artery Bypass Graft (CABG) 5
9 Eksisi Cardiac Myxoma 6
0 Fontan Operation (Atrium-Pulmonary Artery Conduit)
6
1 Internal Resusitasi/Cardiac Massage (Operasi Terbuka)
6
2 Ligasi Patent Ductus Arteriosus (PDA) 6
3 Mitral valve repair (MVr) 6
4 Mitral Valve Repair (MVR) dengan Bioprosthesis Valve
6
5 Mitral Valve Replacement (MVR) dengan Mechanical Valve
6 6
Operasi Redo Open Heart (Valve Replacement)
6 7
Operasi Reopen oleh Karena sebab Perdarahan, Tamponade Jantung 6
8 Pemasangan IABP 6
9
Pemasangan Pace Maker Permanen (diluar alat)
7
0 Pericardiocentesis 7
1 Perikardiektomi 7
2 Perikardiotomi/Pericardial Window 7
3 Pulmonal Valve Repair (PVR) 7
4
Pulmonal Valve Repair (PVR) dengan Bioprosthesis Valve
7 5
Pulmonal Valve Repair (PVR) dengan Mechanical Valve
7
6 Pulmonary Artery Banding (PA) 7
7 Rastelli Procedure (right Ventricle-Pulonary Artery Conduit)
7
8 Repair (Eksisi) Aneurisma Jantung 7
9 Repair Aorta Torakalis (38.34) 8
0 Repair Atrioventricular Septal Defect (35.54)
4 3 5
Pulmonary Lobectomy/Bilobectomy dengan VATS
3
6 Redo Torakotomi 3
7 Rekonstruksi Sternum&Dinding Dada 3
8 repair deformitas Pectus 3
9 Repair Fistula Bronkopleural 4
0 Repair Laserasi Diafragma 4
1 Revisi Thoraks drain/water sealed drainage (WSD) (diluar alat)
4
2 Thoracal Symphatectomy dengan Video Assissted Thoracoscopic Surgery (VATS) 4
3 Thoracocentesis 4
4 Thymectomy 4
5 Thymectomy dengan VATS 4
6 Torakoplasti (Air Plumbage/Muscle Plumbage)
4
7 Torakotomi / sternotomi Eksplorasi 4
8 Torakotomi Eksplorasi pada Trauma jantung/Repair Laserasi Jantung 4
9 Bedah Kardio (Jantung) 5
0 Aortic Valve Repair (AVR)
8
1 Repair Total Anomalous Pulmoanry Venous Connection (TAPVC) (35.82)
8
2 Repair Transposition of Great Arteries (TGA) (35.84)
8
3 Repair Trunkus Arteriosus (35.83) 8
4 Revisi/Aff Pace Maker Permanen (diluar alat) (37.89)
8
5 Septostomi Terbuka Septum Atrium (35.41) 8
6 Total Koreksi Tetralogy of Fallot (TOF) (35.81)
8
7 Tricuspid Valve Repair (TVR) (35.14) 8
8
Tricuspid Valve Repair (TVR) dengan Bioprosthesis Valve (35.27)
8 9
Tricuspid Valve Repair (TVR) dengan Mechanical Valve (35.28)
9
0 Ventricle Septal Defect (VSD) Closure (35.5) 9
1 Amputasi Above Knee (AK) (84.17) 9
2 Amputasi Below Knee (BK) (84.14) 9
3 Arterial Pungsi, Kanulasi, Sectie (38.91) 9
4
Arteriovenous Shuntt (AV Shunt) Brakiosefalika (39.42)
9 5
Arteriovenous Shuntt (AV Shunt) Radiosefalika (39.27)
9
6 Bedah Varises Insisi Babcock (38.5) 9
7 Biopsi Pembuluh Darah (Perifer) (38.21) 9
8 Debriment-Nekrotomi Luka Gangren (86.22) 9
9 Disartikulasi Sendi Ekstremitas (84.13)
4. BEDAH DIGESTIVE
1
Abdominal pull through (sfingter saving procedure)
2
Abdominoperineal resection (miles) dengan penyulit mayor
3
Abdominoperineal resection (miles) dengan penyulit minor
4
Abdominoperineal resection (miles) tanpa penyulit
5 Abdominoplasty 6 Apendektomi
7 Apendektomi dgn penyulit major 8 Apendektomi dgn penyulit minor 9 Apendektomi laparoskopik
10 Bilio-difgestif anastomosis tanpa penyulit 11 Biliodigestif dengan penyulit mayor 12 Biliodigestif dengan penyulit minor 13 Biopsi insisional, local anastesi 14 Biopsi rectum
15 Eksisi hemoroid eksterna
16
Eksplorasi duktus bilier & cholangiografi intra operatif
17 Esofagotomi 18 Fistulotomi
19 Repair Aorta Torakalis (38.34)
20 Repair Atrioventricular Septal Defect (35.54)
21 Total gastrektomi 22 Total pantreaktomi 23 Total prokto-kolektomi
24 Tutup burst abdomen (tanpa alat) 25 Tutup burst abdomen dengan penyulit
mayor
26 Tutup burst abdomen dengan penyulit minor
27 Tutup kolostomi / ileostomi 28
Tutup kolostomi / ileostomi dengan penyulit mayor
29
Tutup kolostomi / ileostomi dengan penyulit minor
5. ONKOLOGI
1 Aspirasi Kista Mamma Single dan Multiple 2 Biopsi Core Lokal Anestesi
3 Biopsi Eksisi Lokal 4 Biopsi Eksisi Narkose 5 Biopsi Insisi Lokal 6 Biopsi Narkose
7 Breast Conserving Surgery (BCS)
3 9
Biopsi Insisi Tumor Sof Tissue dengan Narcose
4 0
Biopsi Insisi Tumor Soft Tissue Lokal Anestesi
4
1 Eksisi Tumor Jinak > 3cm 4
2 Eksisi Tumor Jinak Ø<3cm
8 Breast Conserving Surgery + LD Flap 9 Debriment Mamma
1
0 Diseksi Axilla 1
1 Eksisi Fibroadenoma Lokal Anestesi Single Satu Sisi
1
2 Eksisi Fibroadenoma Multiple Narkose 1
3 Eksisi Tumor Metastase Loco-regional 1
4 Eksplorasi Duktus Mama 1
5 Eksplorasi Duktus Mama+VC 1
6 Insisi Absces Mastitis Lokal 1
7 LD Flap + Eksisi Tumor 1
8 Mastectomy + Tram Flap 1
9
Modified Radical Mastectomy + Flap/Single Grafting
2
0 Modified Radical Mastectomy Single 2
1 Quadrantectomy / Partial Mastectomy 2
2 Simple Mastektomy + Flap/Skin Grafting 2
3 Simple Mastektomy Single 2
4 Tram Flap + Eksisi Tumor 2
5 Operasi Tumor Kulit 2
6 Biopsi Insisi Tumor Kulit Lokal 2
7 Biopsi Eksisi Tumor Kulit Narcose 2
8 Eksisi Tumor Jinak ≤ 3cm 2
9 Eksisi Tumor Jinak + Flap/Skin Graft 3
0 Eksisi Tumor Jinak Kulit >3cm 3
1 Wide Eksisi + Diseksi KGB 3
2 Wide Eksisi Tumor Ganas Kulit 3
3 Wide Eksisi Tumor Ganas Kulit+Flap / Skin Graft
3
4 Operasi Soft Tissue Tumor 3
5 Amputasi + Diseksi KGB 3
6 Amputasi Jari + Flap / Skin Graft 3
7 Amputasi Tungkai / Lengan 3
8 Biopsi Core soft Tissue
4
3 Wide Eksisi + Compartement Procedure 4
4 Wide Eksisi + Diseksi KGB 4
5 Wide Eksisi Tumor Ganas 4
6 Wide Eksisi Tumor Jinak + Flap/Skin Graft 4
7 Operasi Tindakan Tertentu 4
8 Advancement Flap 4
9 Aspirasi Effusi Pleura 5
0 Aspirasi Paru + Pleurodhesis 5
1 Delto Pectoral Flap (DP Flap) 5
2 Diseksi Axilla 5
3 Diseksi Inguinal 5
4 Diseksi Para Aorta 5
5 Eksisi Tumor Lidah 5
6 Eksisi Tumor Sub Mandibula/Sub Mental 5
7 Insersi Chest Tube 5
8 Ismulobectomy 5
9 Kemoterapi Perinfus 6
0 Latissimus Dorsi Flap (LD Flap) 6
1 Maksilektomi Total 6
2 Mastopexy 6
3 Modifikasi RND 6
4 Operasi Compartement Otot 6
5 Ovariectomy Bilateral 6
6 Reseksi Mandibula 6
7 Rotation Flap 6
8 Skin Grafting 6
9 Sub Total Thyroidectomy 7
0 Superficial Parotidectomy 7
1 Thoraco Abdominal Flap (TA-Flap) 7
2 Total Parotidectomy 7
3 Total Thyyroidectomy 7
4
Transversus-Rectus Abdominis Flap (Tram Flap)
6. BEDAH ANAK
1 Abdominal pull through (sfingter saving procedure)
2 Adhesiolisis
3 Appendektomi dgn penyulit 4 Appendektomi laparoskopik 5 Appendektomi tanpa penyulit
4
1 Kolesistektomi laparoskopik 4
2 Kolostomi / sigmoidostomi (46.11) 4
3 LADD Operation (54.95) 4 Laparoskopik diagnostik (61.6)
6 Biliodigesif dengan penyulit mayor 7
Biliodigestif anastomosis tanpa penyulit atau penyulit minor
8 Biopsi rectum
9 By pass usus dengan penyulit mayor / minor 1
0 Divertikulektomy 1
1 Drainase abses dengan general anasthesia 1
2 Drainase abses local anasthesia 1
3 Eksisi hygroma colli 1
4 Eksisi kista brachialis 1
5 Eksisi kista duktus tiroglossus 1
6 Eksisi neoplasma Jinak ( lipoma, atheroma dll )
1
7 Eksisi sinus/granuloma umbilikalis 1
8 Eksisi soft tissue tumor dengan penyulit 1
9 Eksisi soft tissue tumor tanpa penyulit 2
0 Eksisi teratoma dengan penyulit dan rekonstruksi
2
1 Eksisi teratoma tanpa penyulit 2
2 Eksisi tumor jinak wajah 2
3 Eksisi urachus 2
4 Ekstirpasi fistel pre aurikulae 2
5 Ekstirpasiranula 2
6 Endoskopik diagnostik 2
7 Endoskopik terapeutik 2
8 Gastrostomi 2
9 Hemikolektomi 3
0 Herniotomi elektif tanpa penyulit 3
1 Herniotomi laparoskopik 3
2 Hernitomi dgn penyulit / komplikasi 3
3 Hidrokolektomi 3
4 Intraoperatif kolangiografi 3
5 Intraoperatif kolangiografi laparoskopik 3
6 Jejenostomi / ileostomi dengan penyulit mayor
3
7 Jejenostomi / ileostomi dengan penyulit minor
3
8 Jejenostomi / ileostomi tanpa penyulit 3
9 Koledokotomi dengan penyulit mayor 4
0 Kolesistektomi
4 4
5 Ligasihemoroid (49.4) 4
6 Operasi kelainan umbilikal lain (54.3) 4
7 Orchidopexy (62.5) 4
8 Orchidopexy laparoskopik (62.5 + 61.6) 4
9
Other Repair of Abdominal Wall (Repair Omphacele) (954.72)
5
0 Polipektomi (48.36) 5
1 Posterosagital anorectoplasty (49.79) 5
2 Posterosagital anorectoplasty urethro vaginoplasty (70.79)
5
3 Potong kolostomi (46.14) 5
4 Potong Stump (84.3) 5
5 Prosedur Heller (44.6) 5
6 Prosedur Kasai (51.37) 5
7 Repair atresia esofagus (42.5) 5
8 Repair defek diafragma (53.8) 5
9 Repair ekstrofia buli (57.8) 6
0 Repair hernia diafragma (53.7/53.8) 6
1 Repair of Gastrochisis (54.71) 6
2 RPLND (40.59) 6
3 Separasi conjoined twin (84.9) 6
4 Sirkumsisi dengan general anesthesia (64.0) 6
5 Sirkumsisi dengan local anesthesia (64.0) 6
6 Splenektomi (41.5) 6
7 Splenorenal shunt (39.1) 6
8
Transnasal endorectal pullthrough laparascopic assisted (48.42) 6
9 Transplantasi organ 7
0 Tutup burst abdomen dengan penyulit (54.61)
7
1 Tutup burst abdomen tanpa penyulit (54.61) 7
2 Tutup ileostomi dengan penyulit (46.5) 7
3 Tutup kolostomi / ileostomi (46.5) 7
4 Tutup Stoma (46.5) 7
5 Urethroplasty / chordectomy (64.42) 7
6 Vena Sectie Aksilaris (38.94) 7
7 Vena sectie Femoralis / saphena magna (38.94)
7
8 Wound repair (86.8)
7. OBGYN
1 Cauter serviks 2 Cordosentesis
2
8 Operasi kanker corpus uteri
3 Debulking tumor ovarium 4 Eksplorasi vagina
5 Embryotomi
6 Extirpasi + kuret polip endoserviks 7 Extirpasi geboren mioma
8 Extirpasi geboren mioma+kuiretasi 9 Histeroctomy pada mola / chorio Ca 1
0 Histeroctomy radikal 1
1 Kistektomi 1
2 Konisasi serviks 1
3 Kuret abortus incompletes 1
4 Lap op: myomektomi 1
5
Laparoskopi (Kistektomi Ovarium, Salphingektomi, Adhesiolisis) 1
6 Laparoskopi Histerektomi 1
7 Laparoskopi steril 1
8 Laparoskopik Diagnostik 1
9 Laparotomi dengan penyulit mayor 2
0 Laparotomi dengan penyulit minor 2
1 Laparotomi tanpa penyulit 2
2 LEEP 2
3 Micro kuretase DUB 2
4 Mikrokuret 2
5 Miomectomy 2
6 Neovagina 2
7 Operasi Ca vagina
2
9 Operasi tumor ganas ovarium 3
0 Operative histeroscopy/Ablasi endometrium 3
1 Overectomi 3
2 Painless labor 3
3 Persalinan normal 3
4 Persalinan normal dengan penyulit 3
5 Persalinan pervaginam tindakan operatif 3
6 Persalinan sungsang 3
7 Rekanalisasi 3
8 Rekanalisasi tuba 3
9 Salfingektomi unilateral 4
0 Salvingoovarectomi unilateral 4
1 Secound look surgery Ca ovarium 4
2 Seksio sesaria 4
3 Seksio sesaria dengan penyulit penyulit 4
4 Sirklase serviks 4
5 Seksio sesaria dengan penyulit penyulit 4
6 Sirklase serviks 4
7 Supra vaginal hyterectomy 4
8 Surgical staging 4
9 TAH+BSO dengan Penyulit 5
0 TAH+BSO dengan Penyulit Pemasangan Tampon Abdomen
5
1 Total abdominal hysterectomy+bilateral salfingektomi
5
2 Tubektomi klinik 5
3 Tutup burst abdomen
8. EKSISI BIOPSI PEMBULUH DARAH
1
Eksisi Tumor Pembuluh Darah Perifer (Hemangioma)
2 Eksplorasi Vaskular (Trauma/Non trauma) 3 Embolektomi/Trombektomi Aorta
4
Embolektomi/Trombektomi Pembuluh Darah Arteri Abdominal
5 Embolektomi/Trombektomi Pembuluh Darah Arteri Ekstremitas Bawah
6 Embolektomi/Trombektomi Pembuluh Darah Ekstremitas Atas (diluar alat)
7 Embolektomi/Trombektomi Pembuluh Darah Ekstremitas Bawah(diluar alat)
8 Embolektomi/Trombektomi Pembuluh Darah Regio servikal (Karotis, Jugular) (diluar alat) 9 Evakuasi Hematom di Ekstremitas (Pasca
Pungsi HD/ Traumatik) 1
0 Fasciotomy 1
1 Ligasi Vaskular Ekstremitas 1 Mutilasi Digiti Ekstermitas
1
3 Pasang Double Lumen Hemodialisis (HD) (diluar alat)
1
4 Pasang Implantable Central Venous Access (diluar alat: porth-a-cath, celsite)
1
5 Pemasangan Central Venous Catheter (CVC) (diluar alat)
1
6 Pemasangan Intra Aortic Baloon Pump (IABP) (diluar alat)
1
7 Pemasangan Peritoneal Dyalisis (PD) Catheter (diluar alat)
1
8 Pembedahan Teleangiectasis 1
9
Repair Aneurisma (True/false) Ekstremitas Superior (diluar graft)
2 0
Repair Aneurisma Aorta Abdominalis (Diluar Protesa)
2 1
Repair Pembuluh Darah Regio Servikal (Karotis, Jugular)
2
2 Repair Ruptur Pembuluh Arteri Abdominal 2 Revisi Arteriovenous Shunt
2 3 2
4 Skleroterapi Vena (Varises, Hemangioma) 2
5 Stripping Varises Ekstremitas Inferior 2
6
Vascular Shunting (Splenorenal Shunt, De Palma Shunt)
2
7 Vena Punctie, Kanulasi, Sectie
9. GIGI DAN MULUT
1 Augmentasi Tulang Per Regio (Belum Termasuk Bahan)
2 Debriment Mukosa dan Pengelolaan Luka Sayat
3 Dislokasi Sendi Mandibula 4 Eksisi Epulis Per Rahang
5 Eksisi Kelenjar Ludah Submandibula 6 Eksisi Kista Odontogenik Keratosis +
Ostektomi
7 Eksisi Neoplasma Jinak Extra Oral Ukuran Kecil
8 Eksisi Parsial + Marsupialisasi Ranula 9 Eksisi Plunging Ranula
1
0 Eksisional Biopsi Neoplasma Jinak 1
1
Enukleasi Kista Dentigerous + Extraksi Gigi Impaksi
1
2 Enukleasi Kista radikuler Per Rahang + Extraksi Gigi Penyebab
1
3 Extirpasi Kista Dermoid 1
4 Extirpasi Sialolith 1
5 Extraksi Corpus Alienum dengan Teknik Lindorf
1
6 Extraksi Gigi Anak dengan Kelainan Jantung Per Rahang
1
7 Extraksi Gigi Anak Per Rahang 1
8 Extraksi Gigi Dewasa Per Rahang 1
9 Fissure Sealant pada Autis 2
0 Fraktur Dento alveolar Dengan arch Bar 2
1 Fraktur Dento alveolar Dengan Bracket (belum termasuk bahan)
2
2 fraktur Dento Alveolar dengan Eyelet 2
3 Fraktur Maksila dengan Suspensi Wiring 2
4 Fraktur Nasal close Reduksi 2
5 Fraktur Nasal Open Reduksi 2
6 Fraktur Rahang Reduksi Tertutup dengan 2
7 Intermaksila Fiksasi 2
8 Frenektomi Per Rahang 2
9 Genioplasty 3
0 Gingivektomi Per Rahang 3
1 Hemi Maksilektomi Tanpa Rekonstruksi 3
2 Insisi Abses / Phlegmon 3
3 Insisional Biopsi Neoplasma Jinak 3
4 Mandibular Distraksi 3
5 Odontektomi Per Gigi 3
6 ORIF Maksila + Zygoma + Mandibula (belum termasuk implant)
3
7 ORIF Maksila Plating (belum termasuk implant)
3
8 ORIF Mandibula Plating (belum termasuk implant)
3 9
ORIF Zygoma Plating (belum termasuk implant)
4
0 Osteotomi Maksila le Fort I 4
1 Osteotomi Maksila le Fort II 4
2 Pelepasan Arch Bar (Intermaksila Fiksasi)
10. JANTUNG DAN PEMBULUH DARAH
1 Diagnostik Kateterisasi Jantung 2 PTMC
3 PTCA/Stenting
4 Pacemaker Temporer&Permanen 5 IABP
6 Perikardiosintesis
7 Pemasangan Swan Ganz Kateter 8 Pemasangan Amplatzer/ADO/Coilling 9 CVC
1
0 Pelepasan Arch Bar (Intermaksila Fiksasi)
11. ILMU KESEHATAN MATA
1 Angkat Jahitan
2 Angkat Jahitan dengan GA
3 Anterior Chamber Tap/Parasintesis 4 Aspirasi Massa Lensa
5 Blefaroplasty (2 Kelopak Mata) 6 Claw Lens
7 Cryopexy Kornea
3
0 Keratoplasti (Corneal Transplantation) 3
1 Konjungtival Flap/Amnion Graft 3
2 Piggy Back IOL 3 Pneumoretinopexy
8 Cyclo Cryo
9 Dacryocystorinostomi (Without Silicon Tube) 1
0 Dekompresi Orbital/Lateral Orbitotomi 1
1 Disisi Aspirasi & IOL 1
2 ECCE 1
3 ECCE & IOL 1
4 Eksenterasi 1
5 Eksisi Hordeolum / Chalazion 1
6 Ekstirpasi Corpus Alienum di Kornea 1
7 Ekstirpasi Pterygium + Graft Konjungtiva 1
8 Ekstripasi Corpus Alienum di Bilik Mata Depan
1
9 Enukleasi/Eviscerasi (DFG/Bonegraft) 2
0 Evakuasi Silikon Oil 2
1 Fornix Repair 2
2 ICCE 2
3 ICCE & IOL 2
4 Injeksi Intra Vitreal 2
5 Injeksi Periokuler Terapetik 2
6 IOL Explant 2
7 Iridectomi 2
8
Jahit Kelopak Mata Full Thickness & Lid Margin
2
9 Jahit Kornea
3 3 4
Repair Canalis Lacrimalis (Without Silicon Tube)
3 5
Repair Coloboma Palpebra (Skin/Mucosal Graft)
3
6 Reposisi IOL 3
7 Reposisi Iris 3
8 Resesi & Reseksi 2 Otot 3
9 Resesi & Reseksi 3 Otot 4
0 Resesi & Reseksi 4 Otot 4
1 Resesi/Reseksi 1 Otot 4
2 Sekunder Implant (Posterior Chamber) 4
3 Sekunder Implant Claw Lens / Fiksasi Sulcus 4
4 SICS 4
5 SICS & IOL 4
6 Simpel Vitrektomi 4
7 Skleral Buckle 4
8 Socket Repair (Contracted Socket) 4
9 Trabekulektomi 5
0 Trabekuletomi & Ollogen 5
1
Trabulektomi & Goniotomi pada Pediatric Glaucoma
5
2 Tube Shunt (Express) 5
3 Viscocanulostomy 5
4 Vitrektomi +++
5
5 Vitrektomi Lengkap & Skleral Buckle 5
6 Wide Eksisi Tumor Kelopak Mata 5
7
Wide Eksisi Tumor Kelopak Mata + Flap + graft
12. PEDIATRI GAWAT DARURAT
1 Intubasi Endotrakea 2 Krikotirotomi
3 Kanulasi vena perifer
4 Vena sectie 5 Pungsi lumbal 6 Pungsiv Pleura
13. ILMU PENYAKIT DALAM
1 Endoscopy
14. ORTHOPEDI DAN TRAUMATOLOGI
1 Abdominopelvic amputation 2 Achillotenotomy
3 Adductor tenotomy of hip 4 Advancement of tendon
5 Advancement of tendon of hand 6 Amputation above knee
7 Amputation and disarticulation of finger- general anaesthesia
8 Amputation and disarticulation of finger -local anaesthesia
9 Amputation and disarticulation of thumb-
19 1
Open reduction of dislocation of unspecified siteNeglected dislocation
19 2
Open reduction of dislocation of wrist -Fresh dislocation
19 3
Open reduction of fracture with internal fixation- radius and ulna-Simple fracture 19
4
Open reduction of fracture with internal fixationunspecified site (Periarticular Major Bone )
19 5
Open reduction of fracture with internal fixation-carpals and metacarpals - plate &
screws
general anaesthesia 10
Amputation and disarticulation of finger- general anaesthesia
11
Amputation and disarticulation of finger -local anaesthesia
12
Amputation and disarticulation of thumb- general anaesthesia
13
Amputation and disarticulation of thumb- local anaesthesia
14
Amputation of ankle through malleoli of tibia and fibula
15 Amputation of toe-general anaesthesia 16 Amputation of toe-local anaesthesia 17 Amputation through foot
18 Amputation through forearm
19 Amputation through hand, Amputation through carpals
20 Amputation through humerus, Upper arm amputation
21 Amputation, not otherwise specified 22 Ankle fusion
23 Application of external fixator device 24
Application of external fixator device, monoplanar system
25
Application of external fixator device, ring system
26
Application of hybrid external fixator device
27 Arthrocentesis 28 Arthrodesis of elbow 29 Arthrodesis of hip 30 Arthrodesis of knee
31 Arthrodesis of other specified joints 32 Arthrodesis of shoulder
33 Arthrodesis of unspecified joint 34 Arthroplasty of carpocarpal or
carpometacarpal joint with implant 35 Arthroplasty of carpocarpal or
carpometacarpal joint without implant 36 Arthroplasty of metacarpophalangeal and
interphalangeal joint with implant
37 Arthroplasty of metacarpophalangeal and interphalangeal joint without implant 38 Arthroscopy
39
Arthrotomy for removal of prosthesis without replacement
40 Aspiration of bursa
41 Aspiration of bursa of hand 42 Aspiration of other soft tissue
43 Aspiration of other soft tissue of hand 44 Atlas-axis spinal fusion
45 Biopsy of bone
46 Biopsy of joint structure
47 Biopsy of spinal cord or spinal meninges 48 Bone graft
49
Bone marrow or hematopoietic stem cell transplant (all procedures included in this class
50 Bunionectomy with soft tissue correction and arthrodesis
51 Bunionectomy with soft tissue correction and osteotomy of the first metatarsal 52 Bursectomy
53 Bursectomy of hand 54 Bursotomy
55 Bursotomy of hand
19
6 Hand NOS -Plate & Screw 19
7 Open reduction of fracture with internal fixation-carpals
19
8 and metacarpals - plate & screws 19
9 Hand NOS -Plate & Screw
20 0
Open reduction of fracture with internal fixation-carpals and metacarpals - simple implants (K-wire) Hand NOS -implant sederhana (K-wire)
20 1
Open reduction of fracture with internal fixation-femurComminutive or Segmental 20
2
Open reduction of fracture with internal fixation-femurSimple fracture
20 3
Open reduction of fracture with internal fixationhumerus - Simple fracture 20
4
Open reduction of fracture with internal fixationhumerus - Comminutive or Segmental
20 5
Open reduction of fracture with internal fixationother specified bone (Intraartikular Major Bone )
20 6
Open reduction of fracture with internal fixationphalanges of foot - simple implants (K-wire)
20
7 Open reduction of fracture with internal fixationphalanges of foot-Plate & Screws 20
8 Open reduction of fracture with internal fixationphalanges of hand- Plate & Screws 20
9 Open reduction of fracture with internal fixationphalanges of hand- simple implants 21
0
Open reduction of fracture with internal fixationtarsals and metatarsals- Plate &
Screws 21
1
Open reduction of fracture with internal fixationtarsals and metatarsals- simple implants
21 2
Open reduction of fracture with internal fixation-tibia and fibula -Simple fracture 21
3
Open reduction of fracture with internal fixation-tibia and fibula-Comminutive or Segmental
21
4 Open reduction of fracture without internal fixation
21
5 Open reduction of separated epiphysis 21
6 Osteoclasis (correction of bone deformity) Other
21
7 Other (peripheral) vascular shunt or bypass 21
8 Other amputation below knee 21
9
Other anastomosis of cranial or peripheral nerve
22 0
Other and unspecified repair of the anulus fibrosus
22
1 Other arthrotomy 22
2 Other bunionectomy 22
3
Other bunionectomy with soft tissue correction
22 4
Other cervical fusion of the anterior column, anterior technique
22 5
Other cervical fusion of the posterior column, posterior technique
22 6
Other change in hand muscle or tendon length
22
7 Other change in muscle or tendon length 22
8 Other destruction of intervertebral disc
56 Carporadial fusion 57
Closed reduction of dislocation -General anaesthesia
58 Closed reduction of dislocation of ankle 59 Closed reduction of dislocation of elbow 60
Closed reduction of dislocation of foot and toegeneral anaesthesia
61
Closed reduction of dislocation of foot and toe-local anaesthesia
62
Closed reduction of dislocation of hand and fingergeneral anaesthesia
63
Closed reduction of dislocation of hand and fingerlocal anaesthesia
64 Closed reduction of dislocation of hip 65 Closed reduction of dislocation of knee 66
Closed reduction of dislocation of other specified sites-general anaesthesia 67
Closed reduction of dislocation of other specified sites-local anaesthesia
68 Closed reduction of dislocation of other specified sites-local anaesthesia
69 Closed reduction of dislocation of shoulder 70 Closed reduction of dislocation of wrist 71 Closed reduction of dislocation-Local
anaesthesia
72 Closed reduction of fracture with internal fixation Carpal and metacarpal
73
Closed reduction of fracture with internal fixation Femur (Including : MIPO,
interlocking nail, TEN) 74
Closed reduction of fracture with internal fixation -
75
Closed reduction of fracture with internal fixation Intrarticular Major Bone
76
Closed reduction of fracture with internal fixation Phalang of foot
77
Closed reduction of fracture with internal fixation Phalang of hand
78 Closed reduction of fracture with internal fixation -
79 Radius and ulna (MIPO, TEN)
80 Closed reduction of fracture with internal fixation Tarsal and metatarsal
81 Excision of bone for graft 82 Excision of intervertebral disc 83 Excision of lesion of muscle
84 Excision of lesion of muscle of hand 85 Excision of lesion of other soft tissue 86 Dorsal and dorsolumbar fusion of the
anterior column, anterior technique 87 Dorsal and dorsolumbar fusion of the
posterior column, posterior technique 88 Excision of bone for graft
89 Excision of intervertebral disc 90 Excision of lesion of muscle
91 Excision of lesion of muscle of hand 92 Excision of lesion of other soft tissue 93 Excision of lesion of tendon sheath
94
Excision of lesion of tendon sheath of hand, Ganglionectomy of tendon sheath (wrist)-General anaesthesia
95
Excision of lesion of tendon sheath of hand, Ganglionectomy of tendon sheath (wrist)-Lokal anaesthesia
96 Excision of muscle or fascia for graft 97
Excision of muscle or fascia of hand for graft
98 Excision of other lesion of soft tissue of
22
9 Other diagnostic procedures on joint structures
23 0
Other diagnostic procedures on muscle, tendon, fascia, and bursa, including that of hand
23
1 Other division of bone 23
2 Other excision of joint 23
3 Other excision of soft tissue 23
4 Other excision of soft tissue of hand 23
5 Other excision or avulsion of cranial and peripheral nerves
23
6 Other excision, fusion and repair of toes 23
7 Other exploration and decompression of spinal canal,
23
8 Decompression 23
9 Other fasciectomy 24
0 Other fasciectomy of hand 24
1 Other fusion of foot 24
2 Other hand muscle transfer or transplantation
24
3 Other hand muscle transposition 24
4 Other hand tendon transfer or transplantation
24
5 Other hand tendon transposition 24
6 Other incision of bone without division 24
7 Other incision of soft tissue 24
8 Other incision of soft tissue of hand 24
9
Other injection of locally-acting therapeutic substance into soft tissue of hand
25 0
Other local excision or destruction of lesion of joint
25
1 Other muscle transposition 25
2 Other myectomy 25
3 Other myectomy of hand 25
4 Other neuroplasty 25
5 Other operations on muscle, tendon, fascia, and bursa
25
6 Other operations on muscle, tendon, fascia, and bursa,Suture of bursa
25
7 Other partial ostectomy (including : Bone curretage, marginal resection/excision) 25
8
Other peripheral nerve or ganglion decompression or lysis of adhesions Peripheral nerve neurolysis NOS 25
9 Other plastic operations on fascia 26
0 Other plastic operations on hand 26
1 Other plastic operations on muscle 26
2 Other repair of ankle 26
3 Other repair of elbow 26
4 Other repair of hand, fingers and wrist
hand
99 Excision of semilunar cartilage of knee 100 Excision of tendon for graft
101 Excision of tendon of hand for graft 102 Excision or correction of bunionette, That
with osteotomy
103 Excision or destruction of intervertebral disc, unspecified
104 Exploration of tendon sheath
105 Exploration of tendon sheath of hand 106 Exploratory thoracotomy
107 Fasciotomy
108 Fasciotomy of hand 109 Finger reattachment 110 Five-in-one repair of knee 111 Foot reattachment
112 Forearm, wrist, or hand reattachment 113 Fusion or refusion of 2-3 vertebrae 114 Fusion or refusion of 4- 8 vertebrae 115 Fusion or refusion of 9 or more vertebrae 116 Graft of muscle or fascia
117 Hip bearing surface, ceramic-on-ceramic
118
Hip bearing surface, ceramic-on- polyethylene, Hip bearing surface, oxidized zirconium-on-polyethylene 119 Hip bearing surface, metal-on-metal 120 Hip bearing surface, metal-on-
polyethylene
121 Implantation of internal limb lengthening device with kinetic distraction
122
Implantation of other internal limb lengthening device
123
Implantation or replacement of peripheral neurostimulator lead (s)
124
Implantation or replacement of spinal neurostimulator lead(s)
125
Incision and drainage of palmar or thenar space
126
Injection of anesthetic into peripheral nerve for analgesia
127
Injection of anesthetic into spinal canal for analgesia
128
Injection of destructive agent into spinal canal
129
Injection of locally-acting therapeutic substance into other soft tissue
130
Injection of other agent into spinal canal, Intrathecal injection of steroid,
Subarachnoid perfusion of refrigerated saline
131
Injection of therapeutic substance into bursa
132 Injection of therapeutic substance into bursa of hand
133 Injection of therapeutic substance into joint or ligament
134 Injection of therapeutic substance into tendon
135 Injection of therapeutic substance into tendon of hand
136 Insertion of bone growth stimulator 137 Insertion of bone void filler
138 Insertion of catheter into spinal canal for infusion of therapeutic or palliative substances, Insertion of catheter into epidural, subarachnoid, or subdural space of spine with intermittent or continuous infusion of drug (with creation of any
26
5 Other repair of joint 26
6 Other repair of knee 26
7 Other repair of shoulder 26
8 Other repair of the collateral ligaments 26
9 Other repair of the cruciate ligaments 27
0 Other repair or plastic operations on bone 27
1 Other suture of flexor tendon of hand 27
2 Other suture of muscle or fascia 27
3 Other suture of other tendon of hand 27
4 Other suture of tendon 27
5 Other tendon transposition 27
6 Other tenodesis of hand 27
7 Other tenonectomy 27
8 Other tenonectomy of hand 27
9 Other tenoplasty of hand 28
0 Other tenotomy 28
1 Other total shoulder replacement 28
2 Partial hip replacement 28
3 Partial shoulder replacement 28
4 Patellar stabilization 28
5 Percutaneous denervation of facet 28
6 Percutaneous vertebral augmentation 28
7 Percutaneous vertebroplasty 28
8 Peripheral nerve injection, not otherwise specified
28
9 Plastic operation on hand with graft of muscle or fascia
29
0 Plastic operation on hand with other graft or implant
29 1
Pollicization operation carrying over nerves and blood supply
29
2 Quadricepsplasty 29
3 Reattachment of muscle 29
4 Reattachment of muscle of hand 29
5 Reattachment of tendon 29
6 Reattachment of tendon of hand 29
7 Refusion of atlas-axis spine 29
8
Refusion of dorsal and dorsolumbar spine, anterior column, anterior technique
29 9
Refusion of dorsal and dorsolumbar spine, posterior column, posterior technique 30
0
Refusion of lumbar and lumbosacral spine, anterior column, anterior technique
30 1
Refusion of lumbar and lumbosacral spine, anterior column, posterior technique
reservoir)
139 Insertion of interbody spinal fusion device 140 Insertion of other spinal devices
141
Insertion of partial spinal disc prosthesis, cervical
142
Insertion of partial spinal disc prosthesis, lumbosacral
143
Insertion of recombinant bone morphogenetic protein
144
Insertion of spinal disc prosthesis, not otherwise specified, Replacement of spinal disc, NOS
145 Insertion of spinal disc prosthesis, thoracic 146
Insertion of sternal fixation device with rigid plates
147
Insertion of total spinal disc prosthesis, cervical
148 Insertion of total spinal disc prosthesis, lumbosacral
149 Insertion or replacement of (cement) spacer
150 Insertion or replacement of facet replacement device(s)
151 Insertion or replacement of interspinous process device(s)
152 Insertion or replacement of pedicle-based dynamic stabilization device(s)
153 Insertion or replacement of skeletal muscle stimulator
154 Internal fixation of bone without fracture reduction
155 Interphalangeal fusion 156
Interthoracoscapular amputation, Forequarter amputation
157
Intra-operative neurophysiologic monitoring Neuromonitoring 158 Intervertebral chemonucleolysis 159 Limb lengthening procedures 160 Limb shortening procedures
161 Local excision of lesion or tissue of bone 162 Lower leg or ankle reattachment
163
Lower limb amputation, not otherwise specified
164
Lumbar and lumbosacral fusion of the anterior column, anterior technique 165
Lumbar and lumbosacral fusion of the anterior column, posterior technique 166
Lumbar and lumbosacral fusion of the posterior column, posterior technique 167 Lysis of adhesions of hand
168 Lysis of adhesions of muscle, tendon, fascia, and bursa
169 Lysis of adhesions of spinal cord and nerve roots
170 Metacarpocarpal fusion 171 Metacarpophalangeal fusion 172 Metatarsophalangeal fusion 173 Midtarsal fusion
174 Muscle transfer or transplantation 175 Myotomy
176 Myotomy of hand 177 Neurectasis
178 Open biopsy of cranial or peripheral nerve or ganglion
179 Open biopsy of soft tissue 180
Open reduction of dislocation of ankle - Neglected dislocation
181 Open reduction of dislocation of elbow
30
2 Refusion of lumbar and lumbosacral spine, posterior column, posterior technique 30
3 Refusion of other cervical spine, anterior column, anterior technique
30
4 Refusion of other cervical spine, posterior column, posterior technique
30
5 Refusion of spine, not elsewhere classified 30
6 Refusion of spine, not otherwise specified 30
7 Release of carpal tunnel 30
8 Release of clubfoot, not elsewhere classified 30
9 Release of tarsal tunnel 31
0 Removal of (cement) spacer 31
1
Removal of bone growth stimulator (invasive)
31
2 Removal of foreign body from spinal canal 31
3
Removal of implanted devices from bone - carpals and metacarpals-Plate & screw 31
4
Removal of implanted devices from bone - carpals and metacarpals-simple implants (K- wire)
31
5 Removal of implanted devices from bone - External fixator device (invasive) (
31
6 Removal of implanted devices from bone - femur
31
7 Removal of implanted devices from bone - humerus
31
8 Removal of implanted devices from bone - radius and ulna
31 9
Removal of implanted devices from bone - scapula, clavicle, and thorax (ribs and sternum)
32
0 Removal of implanted devices from bone - 32
1 unspecified site (Phalanges (of foot) (of hand)) - Plate & Screw
32 2
Removal of implanted devices from bone unspecified site (Phalanges (of foot) (of hand)) simple implants (K-wire)
32 3
Removal of implanted devices from bone -patella
32 4
Removal of implanted devices from bone- tarsals and metatarsals- simple implants (K- wire)
32
5 Removal of implanted devices from bone- tibia and fibula
32 6
Removal of implanted devices from bone- other (Pelvic bone and Vertebraae)
32 7
Removal of implanted devices from bone- tarsals and metatarsals - Plate & Screw 32
8 Removal of internal limb lengthening device 32
9
Removal of pedicle screw(s) used in spinal fusion
33 0
Removal of peripheral neurostimulator lead(s)
33
1 Removal of skeletal muscle stimulator 33
2 Removal of spinal neurostimulator lead(s) 33
3 Reopening of laminectomy site 33
4 Repair of claw toe 33
5 Repair of cleft hand 33
6 Repair of hammer toe
-Fresh dislocation 182
Open reduction of dislocation of hand and finger -Fresh dislocation
183
Open reduction of dislocation of hip - Fresh dislocation
184
Open reduction of dislocation of hip - Neglected dislocation
185
Open reduction of dislocation of knee - Neglected dislocation
186
Open reduction of dislocation of knee -Fresh dislocation
187 Open reduction of dislocation of other specified sites
188 Open reduction of dislocation of shoulder -Fresh dislocation
189 Open reduction of dislocation of shoulder -Neglected dislocation
190 Open reduction of dislocation of unspecified site-Fresh dislocation
33
7 Repair of hip, not elsewhere classified 33
8 Repair of macrodactyly 33
9 Repair of mallet finger 34
0 Repair of old traumatic injury of cranial and peripheral nerves
34
1 Repair of recurrent dislocation of shoulder 34
2 Repair of the anulus fibrosus with graft or prosthesis
34 3
Repair of vertebral fracture, Elevation of spinal bone fragments, Reduction of fracture of vertebrae, Removal of bony spicules from spinal canal
34
4 Replacement of joint of foot and toe 34
5
Resurfacing hip, partial, acetabulum, Hip resurfacing arthroplasty, partial, acetabulum 34
6 Resurfacing hip, partial, femoral head 34
7
Revision of total knee replacement, tibial insert (liner), Replacement of tibial insert(liner)
34
8 Revision or replacement of artificial spinal disc prosthesis, cervical
34
9 Revision or replacement of artificial spinal disc prosthesis, lumbosacral
35
0 Revision or replacement of artificial spinal disc prosthesis, not otherwise specified 35
1 Revision or replacement of artificial spinal disc prosthesis, thoracic
35
2 Rotator cuff repair 35
3 Separation of equal conjoined twins 35
4 Separation of unequal conjoined twins 35
5 Sequestrectomy 35
6 Spinal fusion, not otherwise specified 35
7 Subtalar fusion 35
8 Subtalar joint arthroereisis 35
9 Suture of Artery 36
0
Suture of capsule or ligament of ankle and foot
36
1 Suture of capsule or ligament of other lower extremity
36
2 Suture of capsule or ligament of upper extremity
36
3 Suture of cranial and peripheral nerves 36
4 Suture of muscle or fascia of hand 36
5 Suture of tendon sheath 36
6 Suture of tendon sheath of hand 36
7 Suture of Vein 36
8 Synovectomy 36
9 Tarsometatarsal fusion 37
0 Tendon graft 37
1 Tendon pulley reconstruction 37 Tendon pulley reconstruction
2 37
3 Tendon transfer or transplantation 37
4 Tenotomy of hand 37
5 Thigh reattachment 37
6 Thumb reattachment 37
7 Toe reattachment 37
8 Total ankle replacement 37
9 Total elbow replacement 38
0 Total ostectomy 38
1 Total wrist replacement 38
2 Transplant from cadaver 38
3 Transposition of cranial and peripheral nerves -
38
4 Nerve transplantation 38
5 Triad knee repair 38
6 Triple arthrodesis 38
7 Unspecified operation on bone injury 38
8 Upper arm reattachment 38
9 Upper limb amputation, not otherwise specified
39
0 Wedge osteotomy
