PT.

Administrasi Medika
Gedung Telkom STO Gambir (Gedung C Lt. 3-4-5)

Jl. Medan Merdeka Selatan No.12, Jakarta Pusat 10110

Tlp. 62 21 348 31100 Fax. 62 21 348 30101

Website : www. admedika.co.id

 KODE KODE
ICD 10 NAMA DIAGNOSA
TERMINAL

1. POLIKLINIK GIGI
TOP DIAGNOSIS
K02 Dental Caries 1102
K03.6 Deposits (Accretions) of teeth (karang gigi) 11036
K04.1 Necrosis of pulp (pulpal ganggrene) 11041
K05.0 Acute Gingivitis 11050
K05 Gingivitis and Periodontal disease 1105
K05.1 Chronic Gingivitis 11051
K01.1 Impacted Teeth 11011
K08.1 Loss of teeth due to accident,extraction or local periodontal disease 11081
K07.4 Malocclusion, unsfecified 11074
K04.7 Periapical abscess without sinus 11047
K05.2 Acute Periodontitis 11052
K05.3 Chronic Periodontitis 11053
K05.4 Periodontosis 11054
K04.0 Pulpitis 11040
Lainnya
K04.3 Abnormal hard tissue formation in pulp 11043
K00.2 Abnormalities of size and form of teeth 11002
K03.1 Abration of teeth 11031
K00.0 Anodontia, Hypodontia, Oligodontia (Tidak ada gigi) 11000
K07.2 Anomalies of dental arch relationship 11072
K07.1 Anomalies of jaw-cranial base relationship 11071
K07.3 Anomalies of tooth position (crowding, displacement, spacing,transposition, e 11073
K08.2 Atrophy of edentulous alveolar ridge 11082
K07 Dentofacial Anomalies 1107
K00.6 Disturbances in tooth eruption 11006
K00.4 Disturbances in tooth formation 11004
K01 Embedded and impacted teeth 1101
K01.0 Embedded teeth 11010
K03.2 Erotion of teeth 11032
K03.0 Excessive attrition of teeth 11030
K08.0 Exfoliation of teeth due to systemic causes 11080
K06.2 Ginggival and edentulous alveolar ridge lesions associated with trauma 11062
K06.1 Ginggival enlargement 11061
K06.0 Ginggival recession 11060
K06.9 Disorder of gingiva and edentulous alveolar ridge, unspecified 11069
K03 Other disease of hard tissues of teeth 1103
K03.9 Diseases of hard tissues of teeth, unsfecified 11039
K03.4 Hypercementosis (cementation hyperplasia) 11034

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 K07.0 Major anomalies of jaw size (hyperplasia/hypoplasia of mandibular and maxil 11070
K09 Cysts of oral region, not elsewhere classified 1109
K04.8 Radicular cyst 11048
C03 Malignant Neoplasm of gum 0303
K00.3 Mottled teeth, dental fluorosis, mottling of enamel, non fluoride enamel opaci 11003
K03.3 Pathological resorption of teeth (internal granuloma of pulp, resorption of tee 11033
Z01.2 Dental Examination 26012
K04.6 Periapical abscess with sinus 11046
K04.4 Acute apical periodontitis of pulpal origin 11044
K04.5 Chronic apical periodontitis 11045
K03.7 Posteruptive colour change of dental hard tissues 11037
K04.2 Pulp degeneration 11042
K08.3 Retained dental root 11083
K08.9 Disorder of teeth and supporting structures, unspecified 11089
K08 Other disorder of teeth and supporting structures 1108
K00 Disorder of tooth development and eruption 1100
K00.8 Other disorder of tooth development (gangguan pertumbuhan gigi) 11008
2. POLIKLINIK SPESIALIS MATA
TOP DIAGNOSIS
H53.1 Asthenopia (mata lelah) 08531
H52.2 Astigmatism 08522
H10.5 Blepharoconjunctivitis 08105
H26 Other Cataract 0826
H25 Senile Catharact 0825
H00.1 Chalazion (bintilan) 08001
H11.3 Conjunctival haemorrhage (perdarahan conjunctiva) 08113
H10 Conjunctivitis (infeksi conjunctiva) 0810
B30 Viral conjunctivitis 0230
H40 Glaucoma 0840
H00 Hordeolum and Chalazion 0800
H16 Keratitis (infeksi kornea) 0816
H52.1 Myopia (rabun jauh) 08521
H11.0 Pterygium 08110
Lainnya
H53.0 Amblyopia ex anopsia 08530
H52.3 Anisometropia and aniseikonia 08523
H27.0 Aphakia 08270
H54 Blindness and low vision (buta dan penglihatan berkurang) 0854
C69 Malignant neoplasm of eye and adnexa 0369
T26 Burn and corrosion confined to eye and adnexa 2026
S05.1 Contusion of eyeball and orbital tissues 19051
H18 Other disorders of cornea 0818
H17 Corneal scars and opacities 0817
T15 Foreign body on external eye (corpus alineum di mata) 2015
H33.2 Serous retinal detachment 08332

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 H53.2 Diplopia (pandangan ganda) 08532
H02.1 Ectropion of eyelid 08021
H02.0 Entropion and trichiasis of eyelid 08020
H57 Other disorders of eye and adnexa 0857
H03 Disorder of eyelid in diseases classified elsewhere 0803
H52 Disorder of refraction and accommodation (gangguan refraksi dan akomodasi 0852
H40.0 Glaucoma suspect 08400
H52.0 Hypermetropia (rabun dekat) 08520
H21.0 Hyphaema (hypema) 08210
S05.8 Other injuries of eye and orbit 19058
H20 Iridocyclitis 0820
H16.2 Keratoconjunctivitis 08162
H04 Disorders of lacrimal system 0804
H27 Other disorders of lens 0827
G70.0 Myastenia gravis 07700
H53.6 Night blindness (rabun malam) 08536
H55 Nystagmus and other irregular eye movement 0855
H57.1 Ocular pain 08571
Z01.0 Examination of eyes and vision (test mata dan penglihatan) 26010
H52.4 Presbyopia 08524
H02.4 Ptosis of eyelid 08024
H35 Other Retinal disorders 0835
H15 Disorders of sclera 0815
H15.0 Scleritis 08150
H50 Other Strabismus (mata juling) 0850
A71 Trachoma 0171
D31 Benign neoplasm of eye and adnexa 0431
H43 Disorders of vitreous body 0843
H02.6 Xanthelasma of eyelid 08026
3. POLIKLINIK SPOG ( KANDUNGAN DAN KEBIDANAN )
TOP DIAGNOSIS
N91.2 Amenorrhoea,unspecified 14912
Z36 Antenatal screening 2636
N75 Diseases of Bartholin's gland 1475
O02.0 Blighted ovum and nonhydatidiform mole 15020
B37.3 Candidiasis of vulva and vagina (Fluor albus) 02373
O21 Excessive vomiting in pregnancy/Hyperemesis Gravidarum 1521
Z34 Supervision of normal pregnancy (kontrol kehamilan normal) 2634
Z30 Contraceptive management (kontrasepsi) 2630
O04 Medical Abortion 1504
Z39 Postpartum care and examination (perawatan post melahirkan) 2639
N81.9 Prolapse uterus 14819
N70 Salpingitis and oophoritis 1470
D27 Benign neoplasm of ovary 0427
D24 Benign neoplasm of breast 0424

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Lainnya
N75.1 Abscess of Bartholin's gland 14751
O02 Other abnormal products of conception 1502
N93 Other abnormal uterine and vaginal bleeding 1493
O62 Abnormalities of forces of labour 1562
O03 Spontaneous abortion 1503
N76.4 Abscess of Vulva 14764
N61 Inflammatory disorders of breast (Abses, Mastitis) 1461
N91.0 Primary Amenorrhoea 14910
N91.1 Secondary Amenorrhoea 14911
O99.0 Anaemia complicating pregnancy, childbirth and the puerperium 15990
O46 Antepartum haemorrhage, not elsewhere classified 1546
C53 Malignant neoplasm of cervic uteri 0353
D06 Carcinoma in situ of cervic utery 0406
C54 Malignant neoplasm of corpus uteri 0354
C56 Malignant neoplasm of ovari 0356
C57 Malignant neoplasm of other unspecified female genital organs 0357
C52 Malignant neoplasm of vagina 0352
C51 Malignant neoplasm of vulva 0351
N72 Inflammatory disease of cervix uteri 1472
O24 Diabetes Mellitus in pregnancy 1524
N94.6 Dysmenorrhoea, unspecified (Nyeri sewaktu haid) 14946
N94.1 Dyspareunia (nyeri sewaktu bersetubuh) 14941
N87 Dysplasia of cervix uteri 1487
O15 Eclampsia 1515
N85.1 Endometrial adenomatous hyperplasia 14851
N80 Endometriosis 1480
N86 Erosion and ectropion of cervix uteri 1486
O47 False labour 1547
N60.2 Fibroadenosis of Breast/FAM 14602
N83.0 Follicular cyst of ovary 14830
O20 Haemorrhage in early pregnancy 1520
O72 Postpartum haemorrhage (perdarahan post melahirkan) 1572
O21.0 Mild hyperemesis gravidarum 15210
N62 Hypertrophy of breast 1462
N97 Female Infertility 1497
N76 Other inflammation of vagina and vulva 1476
N92.6 Irreguler Menstruation,unspecified/Menomethrrorhagia 14926
O00 Ectopic Pregnancy ( Kehamilan Ektopik Terganggu ) 1500
O48 Prolonged Pregnancy 1548
N83.1 Corpus luteum cyst 14831
N75.0 Cyst of Bartholin's gland 14750
N83 Cyst Ovarium (kista ovarium) 1483
N90.7 Vulvar cyst (kista vulva) 14907
O25 Malnutrition in pregnancy 1525

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 N85.4 Malposition of uterus 14854
N60 Benign mammary dysplasia 1460
O91.1 Abscess of Breast associated with childbirth 15911
O81 Single delivery by forceps and vacuum extractor 1581
O80 Single spontaneous delivery (melahirkan normal spontan) 1580
N95 Menopausal and other perimenopausal disorders 1495
N95.1 Menopausal and female climacteric states 14951
N92.0 Excessive and frequent menstruation with regular cycle/Menorrhagia 14920
N92.1 Excessive and frequent menstruation with irregular cycle/Methrorrhagia 14921
O02.1 Missed Abortion 15021
O01 Hydatidiform mole 1501
O30 Multiple gestation 1530
D25 Leiomyoma of Uterus/Myoma Uteri 0425
O41.0 Oligohydramnions 15410
E28 Ovarian Dysfunction 0528
O60 Preterm delivery 1560
Z01.4 Gynaecological Examination (general)(routine) 26014
O70 Perineal laceration during delivery 1570
O44 Placenta praevia 1544
O40 Polyhydramnions (cairan ketuban yang berlebihan) 1540
N84 Polyp of female genital tract 1484
O08 Complications following abortion and ectopic and molar pregnancy 1508
O10 Pre-existing hypertension complicating pregnancy,childbirth & the puerperium 1510
O14.9 Preeclampsia, unspecified 15149
N81 Female genital prolapse 1481
O85 Puerperal sepsis 1585
N70.0 Acute salpingitis and oophoritis 14700
N70.1 Chronis salpingitis and oophoritis 14701
O82 Single delivery by caesarean section (melahirkan secara SC) 1582
Z32 Pregnancy examination and test (test kehamilan) 2632
O71 Other obstetric trauma 1571
D28 Benign neoplasm of other and unspecified female genital organs 0428
D26 Other benign neoplasm of uterus 0426
N76.0 Acute Vaginitis (infeksi akut vagina) 14760
N76.2 Acute Vulvitis (Infeksi akut vulva) 14762
4. POLIKLINIK SPESIALIS THT
TOP DIAGNOSIS
H61.2 Impacted Cerumen (kotoran di telinga) 08612
T16 Foreign body in ear 2016
H91.9 Hearing loss, unspecified 08919
H70 Mastoiditis and related conditions 0870
H92.0 Otalgia (nyeri telinga) 08920
H60 Otitis Externa 0860
H65 Nonsuppurative Otitis Media 0865
H66 Suppurative and unspecified otitis media 0866

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 H92.1 Otorrhoea 08921
J31 Chronic Rhinitis, Nasopharyngitis and Pharyngitis 1031
J34.2 Deviated nasal septum 10342
J01 Acute Sinusitis 1001
H93.1 Tinnitus (telinga berdengung) 08931
J03 Acute Tonsilitis 1003
J35 Chronic diseases of tonsils and adenoids 1035
H69.9 Eusthacian tube disorder, unspecified 08699
Lainnya
J36 Peritonsilar abscess 1036
C30 Malignant neoplasma of nasal cavity and middle ear 0330
C11 Malignant neoplasma of nasopharinx 0311
C31 Malignant neoplasm of accessory sinuses 0331
C09 Malignant neoplasma of tonsil 0309
H71 Cholesteatoma of middle ear 0871
H90.2 Conductive hearing loss, unspecified. 08902
H94 Other disorder of ear in diseases classified elsewhere 0894
J35.2 Hypertrophy of adenoids 10352
J35.1 Hyperthropy of tonsils 10351
H83 Other diseases of inner ear 0883
J04 Acute Laryngitis and Tracheitis 1004
J37.0 Chronic laryngitis 10370
H70.9 Mastoiditis, unspecified 08709
H73 Other disorders of tympanic membranes 0873
H74 Other disorders of middle ear and mastoid 0874
J34 Other disorders of nose and sinuses 1034
J31.1 Chroonic nasopharyngitis 10311
H72 Perforation of tympanic membrane 0872
J31.2 Chronic pharyngitis 10312
J33 Nasal polyp 1033
J30 Vasomotor and Allergic Rhinitis 1030
C31.0 Maxillary Sinus 03310
C31.3 Sphenoidal Sinus 03313
C31.1 Ethmoidal Sinus 03311
J32 Chronic Sinusitis 1032
H90 Conductive and sensorineural hearing loss 0890
D14 Benign neoplasm of middle ear and respiratory system 0414
5. POLIKLINIK SPESIALIS KULIT DAN KELAMIN
TOP DIAGNOSIS
L70 Acne (jerawat) 1270
T78.4 Allergy,unspecified 20784
B37 Candidiasis 0237
L03 Cellulitis 1203
L25 Unspecified Contact Dermatitis 1225
L23 Allergic Contact Dermatitis 1223

Page 7 of 22
 L30 Other Dermatitis 1230
L02 Cutaneous Abscess, Furuncle and Carbuncle 1202
L28 Lichen simplex chronicus and prurigo 1228
L10 Pemphigus 1210
B36.0 Pityriasis Versicolor 02360
L29 Pruritus (gatal gatal) 1229
L40 Psoriasis 1240
B00.0 Eczema Herpeticum / Pyoderma 02000
L50 Urticaria/Pruritus (gatal-gatal) 1250
Lainnya
L73.0 Acne keloid 12730
D69.0 Allergic Purpura 04690
L63 Alopecia Aerata 1263
L90.9 Atrophic disorder of skin,unspecified 12909
D04 Carcinoma in situ of skin 0404
T30 Burn and corrosion, body region unspecified 2030
T25 Burn and corrosion of ankle and foot 2025
T20 Burn and corrosion of head and neck 2020
T24 Burn and corrosion of hip and lower limb 2024
T29 Burn and corrosion of multiple body regions 2029
T22 Burn and corrosion of shoulder and upper limb 2022
T23 Burn and corrosion of wrist and hand 2023
L20 Atopic Dermatitis 1220
L30.3 Infective Dermatitis 12303
L24 Irritant contact dermatitis 1224
B35.9 Dermatophytosis, unspecified 02359
L81.9 Disorder of pigmentation, unspecified 12819
L30.1 Dyshidrosis (Pompholyx) 12301
A46 Erysipelas 0146
L51 Erythema Multiforme 1251
L08.1 Erythrasma 12081
L72 Follicular cyst of skin and subcutaneous tissue 1272
R02 Gangrene,not elsewhere classified 1802
A54.9 Gonococcal infection, unspecified 01549
L92.9 Granulamatous disorder of skin and subcutaneus tissue, unspecified 12929
L92.0 Granuloma Annulare 12920
A58 Granuloma Inguinale 0158
A60 Anogenital Herpesviral (herpes simplex) infection 0160
B02 Zoster (Herpes zoster) 0202
B00.9 Herpesviral, unspecified 02009
B08.4 Enteroviral vesicular stomatitis with exanthem (Hand, Foot and Mouth Disease) 02084
L01 Impetigo 1201
L91.0 Keloid scar 12910
L11.0 Acquired keratossis follicularis (Keratosis folicularis) 12110
L72.0 Epidermal cyst (kista epidermal) 12720

Page 8 of 22
 A30.9 Leprosy, unspecified 01309
L43 Lichen Planus 1243
L93 Lupus Erythematosus 1293
C43 Malignant melanoma of skin 0343
L74.0 Miliaria rubra (keringat buntet) 12740
A19 Milliary Tubercullosis 0119
B08.1 Moluscum Contangiosum 02081
B49 Unspecified Mycosis 0249
L60 Nail disorders 1260
L60.2 Onychogryphosis 12602
L60.1 Onycholysis (infeksi kuku) 12601
B85.4 Mixed Pediculosis and Phithyriosis 02854
A64 Unspecified sexually transmitted disease 0164
L30.5 Pityriasis alba (Panu) 12305
L42 Pityriasis rosea 1242
L28.1 Prurigo nodularis 12281
L28.2 Other Prurigo 12282
L29.0 Pruritus ani 12290
L08.0 Pyoderma 12080
L71 Rosacea 1271
B06 Rubella 0206
B86 Scabies 0286
L21 Seborrhoic Dermatitis (ketombe) 1221
B03 Smallfox 0203
L55 Sunburn 1255
A51 Early syphillis 0151
A50 Congenital Syphillis 0150
B35.0 Tinea Barbae and Tinea Capitis 02350
B35.4 Tinea Corporis 02354
B35.6 Tinea Cruris 02356
B35.3 Tinea Pedis 02353
B35.1 Tinea Unguium 02351
A18.4 Tuberculosis of skin and subcutaneous tissue 01184
D23 Other benign neoplasm of skin 0423
L89 Decubitus Ulcer 1289
B01 Varicella (chickenpox) 0201
B07 Viral Warts (verucca) 0207
L80 Vitiligo 1280
6. POLIKLINIK SPESIALIS ANAK
TOP DIAGNOSIS
T78.4 Allergy, unspecified 20784
A06 Amoebiasis 0106
J20 Acute Bronchitis 1020
K59.0 Constipation (susah buang air besar) 11590
R05 Cough (batuk) 1805

Page 9 of 22
 A91 Dengue Haemorrhagic Fever (demam berdarah dengue) 0191
A09 Diarrhoea and Gastroenteritis of presumed infectious origin(GED) 0109
K30 Dyspepsia 1130
Z24.4 Need immunization againts measles alone 26244
Z27.1 Need immunization againts diphtheria-tetanus-pertussis, combined 26271
Z24.6 Need immunization againts viral hepatitis 26246
Z24.61 Need immunization againts viral hepatitis Other Than Hepatitis B 262461
Z23.2 Need immunization againts tuberculosis (immunisasi BCG) 26232
Z23.8 Need immunization againts other single bacterial diseases (vaksin HIB) 26238
Z27.11 Need immunization againts diphtheria-tetanus-pertussis, combined (Infantrix) 262711
Z24.0 Need immunization againts poliomyelitis (immunisasi polio) 26240
Lainnya
A42 Actinomycosis 0142
R10.0 Acute Abdomen 18100
J35 Chronic diseases of tonsils and adenoids (Adenotonsilitis) 1035
A85.1 Adenoviral Enchephalitis 01851
L23 Allergic Contact Dermatitis 1223
B76.0 Ancylostomiasis 02760
R63.0 Anorexia 18630
F41 Other anxiety disorders 0641
K35 Acute Appendicitis 1135
B77.9 Ascariasis,unspecified 02779
P21 Birth asphyxia 1621
T71 Asphyxiation 2071
P24 Neonatal aspiration syndromes 1624
J45 Asthma 1045
Q42.3 Congenital Abscence, Atresia and Stenosis of Anus without fistula 17423
Q21.1 Atrial septal defect (ASD) 17211
Q21.2 Atrioventricular septal defect 17212
F84.1 Atypical autism 06841
P05 Slow fetal growth and fetal malnutrition (Berat Bayi Lahir Rendah /BBLR) 1605
J21 Acute Brochiolitis 1021
J47 Bronchiectasis 1047
J42 Unspecified Chronis Bronchitis 1042
B37 Candidiasis 0237
A00.9 Cholera, unspecified 01009
K59.1 Functional Diarrhoea 11591
A36 Diptheria 0136
Q43.0 Meckel's diverticulum 17430
A06.0 Acute amoebiatic dysentry 01060
G04 Encephalitis Myelitis and Encephalomyelitis 0704
Q01 Encephalocele 1701
A08.3 Other viral enteritis 01083
G40 Epilepsy 0740
R04.0 Epistaxis (mimisan) 18040

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R56.0 Febrile Convulsions 18560
P92 Feeding problems of newborn 1692
R50.9 Fever,unspecified (demam, tidak specifik) 18509
R14 Flatulence and related conditions 1814
T02 Fractures involving multiple body regions 2002
K31.9 Disease of stomach and duodenum, unspecified 11319
K25 Gastric Ulcer 1125
K29 Gastritis and Duodenitis 1129
K92.0 Haematemesis (muntah darah ) 11920
R04.2 Haemoptysis (batuk darah) 18042
R58 Haemorrhage, not elsewhere classified 1858
J94.2 Haemothorax 10942
B16 Acute Hepatitis B 0216
K41 Femoral Hernia 1141
B02 Zoster (Herpes Zoster) 0202
P59 Neonatal jaundice from other and unspecified causes 1659
Q43.1 Hirschprung's disease 17431
N43 Hydrocele and Spermatocele 1443
Q03 Congenital hydrocephalus 1703
G91 Hydrocephalus 0791
J35.2 Hyperthropy of adenoids 10352
J35.1 Hyperthropy of tonsils 10351
Q54 Hypospadias 1754
T68 Hypothermia 2068
R57.1 Hypovolaemic Shock 18571
Z24.3 Need immunization againts yellow fever 26243
Z25.1 Need immunization againts influenza 26251
Z25.0 Need immunization againts mumps alone 26250
Z24.5 Need immunization againts rubella alone 26245
Z24.1 Need immunization againts arthropod-borne viral encephalitis 26241
Z27.4 Need for immunisation against measles-mumps-rubella (MMR) 26274
Z24.2 Need immunization againts rabies (immunisasi rabies) 26242
Z23.5 Need immunization againts tetanus alone (immunisasi tetanus) 26235
Z23.1 Need immunization againts typhoid-paratyphoid alone 26231
Z25.8 Need immunization againts other single Viral diseases (Imunisasi Cacar) 26258
J10 Influenza due to identified influenza virus 1010
W57 Bitten/stung by nonvenommous insect & other nonvenomous arthropods/Insect Bite 2357
P76 Other intestinal obstruction of newborn 1676
K59 Other functional intestinal disorders 1159
E73 Lactose intolerance 0573
J06 Acute upper respiratory infections of multiple and unspecified sites/URTI/ ISPA 1006
P90 Convulsions of newborn 1690
P57 Kernicterus (icterus) 1657
Z00.1 Routine child health examination 26001
E40 Kwashiorkor 0540

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 B54 Unspecified Malaria 0254
E64 Sequelae Of malnutrition and other nutritional deficiencies 0564
E42 Marasmic Kwashiorkor 0542
B05 Measles (campak) 0205
K92.1 Melaena (melena, bab berdarah) 11921
G03 Meningitis due to other and unspecified causes 0703
G00 Bacterial meningitis ot elsewhere classified 0700
A39.0 Meningococcal Meningitis 01390
B26 Mump (gondok) 0226
B26.8 Mump with other complications 02268
J00 Acute Nasopharyngitis (common cold) 1000
R11 Nausea and Vomiting (mual dan muntah) 1811
E63 Other nutritional deficiencies 0563
E63.9 Nutritional deficiency, unspecified 05639
E66 Obesity 0566
P38 Omphalitis of newborn with or without mild haemorrhage 1638
R52 Pain, not elsewhere classified 1852
Q25.0 Patent ductus arteriosus 17250
J36 Peritonsilar abscess 1036
J02 Acute Pharyngitis 1002
J18 Pneumonia, organism unspecified 1018
J15 Bacterial pneumonia, not elsewhere classified 1015
P23 Congenital pneumonia 1623
J33 Nasal Polyp 1033
B00.0 Eczema Herpeticum / Pyoderma 02000
P28.5 Respiratory failure of newborn 16285
P22 Respiratory distress of newborn 1622
J30 Vasomotor and Allergic Rhinitis 1030
J31 Chronic Rhinitis, Nasopharyngitis and Pharyngitis 1031
B06 Rubella 0206
A02.9 Salmonella infection, unspecified 01029
I86.1 Scrotal varices (varicocele) 09861
P36 Bacterial sepsis of newborn (sepsis) 1636
A40 Streptococcal septicaemia 0140
A41.9 Septicaemia, unspecified 01419
T78.2 Anaphylactic shock, unspecified 20782
J01 Acute Sinusitis 1001
J32 Chronic Sinusitis 1032
Q25.3 Stenosis of aorta 17253
Q25.6 Stenosis of pulmonary artery 17256
B37.0 Candida stomatitis 02370
A15.0 Tuberculosis of lung,confirmed by sputum microscopy with/without culture 01150
A33 Tetanus Neonatorum 0133
Q21.3 Tetralogy of Fallot 17213
J03 Acute Tonsilitis 1003

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 T14 Injury of Unspecified body region 2014
P15 Other birth injuries 1615
A01.0 Typhoid Fever 01010
B01 Varicella (chicken pox) 0201
Q21.0 Ventricular septal defect 17210
B34 Viral Infection Of Unspecified sites 0234
A37 Whooping cough 0137
7. POLIKLINIK SPESIALIS SYARAF
TOP DIAGNOSIS
M54.2 Cervicalgia 13542
I67 Other cerebrovascular diseases 0967
G40 Epilepsy 0740
R51 Headache ( Cephalgia) 1851
M54.5 Low back pain (Nyeri punggung) 13545
G03 Meningitis due to other and unspecified causes 0703
G43 Migraine (nyeri kepala sebelah) 0743
M79.1 Myalgia (nyeri otot,pegal pegal) 13791
M79.2 Neuralgia and Neuritis, unspecified 13792
G62.9 Polyneuropathy, unspecified 07629
I64 Stroke not specified as haemorrhage or infarction 0964
R30.1 Vesical tenesmus 18301
G44.2 Tension type headache 07442
G44.1 Vascular headache, not elsewhere classified 07441
H82 Vertiginous syndromes in diseases classified elsewhere 0882
Lainnya
R29.2 Abnormal reflex 18292
G30 Alzheimer's disease 0730
M45 Ankylosing spondylitis 1345
R27.0 Ataxia, unspecified 18270
G51.0 Bell's Palsy 07510
G93.9 Disorder of brain, unspecified 07939
C47 Malignant neoplasm of peripheral nerves and automatic nervous system 0347
G56.0 Carpal tunnel syndrome 07560
I63 Cerebral Infarction 0963
G80 Infantile cerebral palsy 0780
M53.0 Cervicocranial syndrome 13530
Q04 Other congenital malformation of brain 1704
R25.2 Cramp and spasm 18252
F02 Dementia in other diseases classified elsewhere 0602
A86 Unspecified viral enchephalitis 0186
G25 Other extrapyramidal and movement disorders 0725
G61.0 Guillain-barre syndrome 07610
I61 Intracerebral haemorrhage (Perdarahan intracerebral) 0961
G44 Other headache syndromes (sindrom sakit kepala) 0744
G81 Hemiplegia 0781

Page 13 of 22
 I67.4 Hypertensive encephalopathy 09674
G91 Hydrocephalus 0791
F51 Nonorganic sleep disorders/Insomnia 0651
M51.2 Other Specified Intervertebral Disc Displacement 13512
M40 Kyposis and lordosis 1340
M40.5 Lordosis, unspecified 13405
M54.3 Lumbago with sciatica 13543
R29.1 Meningismus 18291
G00 Bacterial meningitis ot elsewhere classified 0700
A17.0 Tuberculosis meningitis 01170
A87 Viral meningitis 0187
G71.0 Muscular dystrophy 07710
G70.9 Myastenia gravis 07709
G72.9 Myopathy, unspecified 07729
A17 Tuberculosis of nervous system 0117
G83 Other paralytic syndromes 0783
G82 Paraplegia and tetraplegia 0782
G20 Parkinson's disease 0720
F40 Phoebic anxiety disorders 0640
G62 Other polyneuropathies 0762
M54.1 Radiculopathy 13541
M41 Scoliosis 1341
G47 Sleep disorders (gangguan tidur) 0747
M47 Spondylosis 1347
G41 Status epilepticus 0741
I60 Subarachnoid haemorrhage 0960
G45.9 Transient cerebral ischaemic attack, unspecified 07459
S04 Injury of cranial nerves 1904
S14 Injury of nerves and spinal cord at neck level 1914
G25.0 Essential tremor 07250
R25.1 Tremor, unspecified 18251
D33 Benign neoplasm of brain and other parts of central nervous system 0433
A88.1 Epidemic Vertigo 01881
A89 Unspecified viral infection of central nervous system 0189
8. POLIKLINIK SPESIALIS JANTUNG
TOP DIAGNOSIS
I20 Angina Pectoris 0920
I46 Cardiac Arrest 0946
I51.7 Cardiomegaly (pembesaran jantung) 09517
E78.5 Hyperlipidaemia, unspecified 05785
I25 Chronic Ischaemic Heart Disease 0925
I25.2 Old Myocardial Infarction 09252
I21 Acute Myocardial Infarction 0921
I47 Paroximal Tachycardia 0947
I30 Acute Pericarditis 0930

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 I27 Other pulmonary heart diseases 0927
Lainnya
R00 Abnormalities of heartbeat 1800
T78.3 Angioneurotic Oedema 20783
I48 Atrial fibrillation and flutter 0948
Q21.1 Atrial septal defect 17211
Q21.2 Atrioventricular septal defect 17212
I49 Other Cardiac Arhythmias 0949
I49.9 Cardiac arrhythmia, unspecified 09499
I51.0 Cardiac septal defect, acquired 09510
R57.0 Cardiogenic Shock 18570
I42 Cardiomyopathy 0942
B33.2 Viral carditis 02332
R07.4 Chest Pain, unspecified (nyeri dada, tidak spesifik) 18074
Q24 Other congenital malformations of heart 1724
R06.0 Dyspnoe 18060
G24 Dystonia 0724
I33 Acute and Subacute Endocarditis 0933
I50.0 Congestive heart failure (gagal jantung kongestif) 09500
I51.9 Heart disease, unspecified 09519
I50 Heart Failure (gagal jantung) 0950
I50.1 Left ventricular failure 09501
C38 Malignant neoplasm of heart-mediastrum and pleura 0338
I05.0 Mitral stenosis 09050
I40 Acute Myocarditis 0940
I51.4 Myocarditis, unspecified 09514
I01.0 Acute rheumatic pericarditis 09010
I08.0 Stenosis Mitral Disease 09080
Q25.3 Stenosis of Aorta 17253
Q25.6 Stenosis of pulmonary artery 17256
I08.2 Stenosis Trikuspid 09082
Q21.3 Tetalogy of Fallot 17213
I20.0 Unstable angina 09200
Q21.0 Ventricular septal defect 17210
9. POLIKLINIK BEDAH/EMERGENCY dan TRAUMA
TOP DIAGNOSIS
R10.0 Acute Abdomen (nyeri akut abdomen) 18100
K.60.3 Anal Fistula 11603
K35 Acute Appendicitis 1135
K81 Cholecystitis 1181
K80 Cholelithiasis 1180
N23 Renal Colic 1423
S00 Injuries to the head (contusion, open wound, laceration, fracture, etc) 1900
T02 Fractures Involving Multiple Body Regions 2002
N60 Benign mammary dysplasia 1460

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 M66 Rupture of Tendon 1366
R55 Syncope And Collapse 1855
T00 Injuries involving multiple body regions 2000
S30 Injuries to the abdomen, lower back, lumbar spine and pelvis 1930
S40 Injuries to the shoulder and upper arm (contusion, open wound, fracture, disl 1940
S70 Injuries to the hip and thigh (contusion, open wound, laceration, fracture, etc) 1970
Lainnya
N61 Inflammatory disorders of breast 1461
K62 Other disease of Anus and Rectum (polyp, haemorrhage, prolaps) 1162
K37 Other Appendicitis (chronic, recurrent) 1137
T71 Asphyxiation 2071
M71.3 Other bursal cyst 13713
M71.5 Bursitis (not elsewhere classified) 13715
M71.1 Other infective bursitis 13711
N42.0 Calculus of prostate 14420
T30 Burn and corrosion,body region unspecified (COMBUSTIO) 2030
M24.5 Contracture of Muscle 13245
R56 Convulsions, not elsewhere classified (Kejang) 1856
T15 Effects of foreign body entering throught natural orifice (Corpus Alineum) 2015
N30 Cystitis 1430
S33 Dislocation, sprain and strain of joints and ligaments of lumbar spine and pelvis 1933
R42 Dizziness and giddiness 1842
Z52 Donors of organs and tissues 2652
T40 Poisoning by narcotics and psychodysleptics (hallucinogens) 2040
T41 Poisoning by anasthetics and therapeutic gases 2041
T36 Poisoning by antibiotics, anti-invective, hormone, nonopioid analgetics,antipyretics 2036
T42 Poisoning by antiepileptic, sedative-hypnotic and antiparkinsonism drugs 2042
K60 Fissure and fistula of anal and rectal regions 1160
L02 Cutaneous Abcess, Furuncle and Carbuncle 1202
R02 Ganggrene, not elsewhere classified 1802
M67.4 Ganglion 13674
I84 Haemorrhoids (ambein) 0984
K40 Inguinal Hernia 1140
K44 Diaphragmatic Hernia 1144
K41 Femoral Hernia 1141
K42 Umbilical Hernia 1142
N43 Hydrocele and spermatocele 1443
N40 Hyperplasia of prostate 1440
N62 Hypertrophy of breast 1462
T68 Hypotermia 2168
K56.0 Ileus Paralytic 11560
K56.7 Ileus, unspecified 11567
K56.6 Others and unspecified intestinal obstruction (stenosis,ileus obstruksi,stricture,occl 11566
K56.1 Intussusception or invagination of bowel, colon, intestine, rectum 11561
Z09.0 Follow up examination after surgery for other conditions 26090

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 Z09.4 Follow up examination after treatment of fracture (kontrol sehabis pengobatan fract 26094
Z47.0 Follow up care involving removal of fracture plate and other internal fixation devic 2647
M96.6 Fracture of Bone following insertion of orthopaedic implant, joint prosthesis, bone p 14966
Z48 Other surgical follow-up care 2648
M40 Kyposis and Lordosis 1340
Q36 Cleft Lip 1736
T75.3 Motion sickness 20753
M62.6 Muscle Strain 13626
T43 Poisoning by psychotropic drugs, not elsewhere classified 2043
T51 Toxic effect of Alcohol 2051
R60 Oedema, not elsewhere classified 1860
L03.0 Onychia and Paronychia 12030
N45 Orchitis and Epididymitis 1445
M86 Osteomyelitis 1386
R52 Pain, not elsewhere classified 1852
Q35 Cleft Palate 1735
Z04.3 Examination and observation following other accident 26043
Z04.2 Examination and observation following work accident 26042
K65 Peritonitis 1165
I80 Phlebitis and Thrombophlebitis 0980
R33 Retention of Urine 1833
J34.2 Deviated Nasal Septum 10342
M47 Spondylosis 1347
N35 Urethral Stricture 1435
L55 Sunburn 1255
M65 Synovitis and Tenosynovitis 1365
R57 Shock - not elsewhere classified 1857
T79.4 Traumatic shock 20794
N44 Torsion of testis 1444
Z94 Transplanted organ and tissue status 2694
S50 Injuries to the elbow and forearm (contusion, open wound, fracture, dislocation, etc 1950
S60 Injuries to the wrist and hand (contusion, open wound, laceration, fracture, etc ) 1960
S80 Injuries to the knee and lower leg (contusion,open wound, laceration, dislocation,fra 1980
S90 Injuries to the ankle and foot (contusion, open wound, laceration, fracture, dislocati 1990
S10 Injuries to the neck (open wound, fracture, dislocation, etc) 1910
S20 Injuries to the thorax (contusion, open wound, laceration, fracture, etc) 1920
N21.1 Calculus in urethra / Urethrolithiasis 14211
N20 Urolithiasis 1420
I86.1 Scrotal varices (varicocele) 09861
10. POLIKLINIK UMUM & PENYAKIT DALAM ( INTERNIST )
TOP DIAGNOSIS
T78.4 Allergy , unspecified 20784
J45 Asthma 1045
J20 Acute Bronchitis 1020
J00 Acute Nasopharingitis (common cold) 1000

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 K30 Dyspepsia 1130
R50 Fever of Unknown origin 1850
R50.9 Fever , Unspecified 18509
L02 Cutaneous Abscess, Furuncle and Carbuncle 1202
K25 Gastric Ulcer 1125
K29 Gastritis and Duodenitis 1129
J11 Influenza virus not identified 1011
J02 Acute Pharyngitis 1002
A15.0 Tuberculosis of lung,confirmed by sputum microscopy with or without culture 01150
T14 Injury of Unspecified body region 2014
N39.0 Urinary tract infections , site not specified 14390
Lainnya
K75.0 Abcess of liver 11750
R10 Abdominal and pelvic pain 1810
R10.0 Acute Abdomen 18100
R52.0 Acute Pain 18520
K70 Alcoholic liver disease 1170
D64 Other Anaemias 0464
R63.0 Anorexia 18630
F50.0 Anorexia nervosa 06500
I71 Aortic aneurysm and dissection 0971
K35 Acute Appendicitis 1135
I74 Arterial embolism and thrombosis 0974
B77.9 Ascariasis , unspecified 02779
R09.0 Asphyxia 18090
F48.0 Neurasthenia 06480
I70 Atherosclerosis 0970
A49 Bacterial infection of unspecified site 0149
M89.9 Disorder of bone , unspecified 13899
G94 Other disorders of brain in diseases clasified elsewhere 0794
J47 Bronchiectasis 1047
J21 Acute Bronchiolitis 1021
J42 Unspecified chronic bronchitis 1042
F50.2 Bulimia nervosa 06502
B37 Candidiasis 0237
D09 Carcinoma in situ of other and unspecified sites 0409
R07.4 Chest pain , unspecified 18074
R07.1 Chest pain on breathing 18071
K83.0 Cholangitis 11830
K81 Cholecystitis 1181
K80 Cholelithiasis 1180
A00.9 Cholera , Unspecified 01009
K51 Ulcerative colitis 1151
T30 Burn and corrosion , body region unspecified ( combustio ) 2030
K59.0 Constipation / Obstipation 11590

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 R05 Cough 1805
R25.2 Cramp and spasm 18252
N30 Cystitis 1430
A91 Dengue Haemorrhagic Fever 0191
E13 Other specified Diabetes Mellitus 0513
A09 Diarrhoe and Gastroenteritis of presumed infections origin /GED 0109
T03 Dislocation , sprain and strains involving multiple body region 2003
R06.0 Dyspnoe (sesak nafas ) 18060
R30.0 Dysuria 18300
A88.1 Epidemic Vertigo 01881
R04.0 Epistaxis (perdarahan hidung) 18040
N18 Chronic Renal Failure 1418
R02 Ganggrene, not elsewhere classified 1802
K29.0 Acute haemorrhagic Gastritis 11290
M10.9 Gout , Unspecified 13109
R04.2 Haemoptysis (batuk darah/haemaptoe) 18042
D69.9 Haemorrhagic Condition , Unspecified 04699
I84 Haemorrhoids 0984
R51 Headache (sakit kepala) 1851
R31 Unspecified haematuria (kencing berdarah) 1831
K40 Inguinal Hernia 1140
K72.9 Hepatic failure, unspecified 11729
B15 Acute Hepatitis A 0215
B16 Acute Hepatitis B 0216
B17.1 Acute Hepatitis C 02171
K73.9 Chronic hepatitis, unspecified 11739
E78.0 Pure Hypercholesterolemia 05780
K76.6 Portal hypertension 11766
I15 Secondary Hypertension 0915
R06.4 Hyperventilation 18064
I95 Hypotension 0995
K56.7 Ileus , Unspecified 11567
K76.3 Infarction of liver 11763
W57 Bitten/stung by nonvenommous insect & other nonvenommous arthropods 2357
F51 Nonorganic sleep disorders (insomnia) 0651
K59 Other Functional intestinal disorder (Haematochezia) 1159
K58 Irritable bowel syndrome 1158
J06 Acute upper respiratory infections of multiple and unspecified sites (URTI/ISPA) 1006
L91.0 Keloid Scar 12910
N28.9 Disorder of kidney and ureter , Unspecified 14289
K83.5 Billiary cyst 11835
K86.2 Cyst of pancreas 11862
M54.5 Low Back Pain 13545
L04 Acute Lymphadenitis 1204
I88 Nonspecific lymphadenitis 0988

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 R53 Malaise And Fatique 1853
N51 Disorder of male genital organs in diseases classified elsewhere 1451
F99 Mental disorder, not otherwise specified 0999
R14 Flatulence and related conditions (Meteorismus) 1814
R06.5 Mouth breathing 18065
M62.9 Disorder of muscle ,umspecified 13629
M79.1 Myalgia 13791
L62 Nail disorders in diseases classified elsewhere 1262
R11 Nausea And Vomiting 1811
M79.2 Neuralgia and Neuritis, unspecified 13792
F48 Other neurotic disorders 0648
E66 Obesity (kegemukan) 0566
F52.3 Orgasmic dysfunction 06523
M86 Osteomyelitis 1386
R52 Pain, Not elsewhere classified 1852
K85 Acute Pancreatitis 1185
I73.9 Peripheral vascular disease, unspecified 09739
I80 Phlebitis and thrombophlebitis 0980
J18 Pneumonia , organism unspecified 1018
T37 Poisoning by sistemic anti invective and antiparatics 2037
F52.4 Premature ejaculation 06524
F88 Other disorders of psychological development 0688
I26 Pulmonary embolism 0926
I73.0 Raynaud's syndrome 09730
M06.9 Rheumathoid arthritis , Unspecified 13069
E64 Sequelae of malnutrition and other nutritional deficiencies 0564
F52 Sexual dysfunction, not caused by organic disorder or disease 0652
K74 Fibrosis and cirrhosis of liver (cirrhosis hepatis) 1174
R06.7 Sneezing (bersin) 18067
K12 Stomatitis and related lesions (Sariawan) 1112
R06.1 Stridor (Ngorok) 18061
M65 Synovitis and Tenosynovitis 1365
E07 Other disorders of thyroid 0507
K71 Toxic liver disease 1171
D36 Benign neoplasm of other and unspecified sites 0436
A01.0 Typhoid Fever (Demam typhoid) 01010
L89 Decubitus ulcer 1289
N21.1 Calculus in urethra / urethrolithiasis 14211
B01 Varicella ( Chicken Pox ) 0201
I86 Varicose veins of other sites (Varices) 0986
R06.2 Wheezing 18062
D72.9 Disorders of white blood cells, unspecified 04729
11. POLIKLINIK ORTHOPAEDI
TOP DIAGNOSIS
S62 Fracture at wrist and hand level 1962

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 S93.0 Dislocation of ankle joint 19930
S53.1 Dislocation of elbow, unspecified 19531
S42.4 Fracture of lower end of humerus 19424
S42.7 Multiple fractures of clavicle, scapula and humerus 19427
S62.7 Multiple fractures of fingers 19627
S92.7 Multiple fractures of foot 19927
S52.7 Multiple fractures of forearm 19527
S82.7 Multiple fractures of lower leg 19827
S52 Fracture of forearm 1952
Lainnya
S92.0 Fracture of calcaneus 19920
S42.0 Fracture of clavicle 19420
S32.2 Fracture of coccyx 19322
S72 Fracture of femur 1972
S82.4 Fracture of fibula alone 19824
S62.6 Fracture of other finger 19626
S63.1 Dislocation of fingers 19631
S92 Fracture of foot 1992
S92.4 Fracture of great toe 19924
S73.0 Dislocation of hip 19730
S42.3 Fracture of shaft of humerus 19423
S42.2 Fracture of upper end of humerus 19422
S32.3 Fracture of ilium 19323
S83.1 Dislocation of knee 19831
S82 Fracture of lower leg, including ankle 1982
S32 Fracture of lumbar spine and pelvis 1932
S32.0 Fracture of lumbar vertebra 19320
S33.1 Dislocation of lumbar vertebra 19331
S02.4 Fracture of malar and maxillary bones 19024
S82.6 Fracture of lateral malleolus 19827
S82.5 Fracture of medial malleolus 19825
S02.6 Fracture of mandible (mandibula) 19026
S92.3 Fracture of metatarsal bone 19923
T02 Fractures involving multiple body regions 2002
S02.2 Fracture of nasal bones 19022
S12 Fracture of neck 1912
S83.0 Dislocation of patella 19830
S82.0 Fracture of patella 19820
S52.5 Fracture of lower end of radius 19525
S52.3 Fracture of shaft of radius 19523
S52.1 Fracture of upper end of radius 19521
S32.1 Fracture of sacrum 19321
S42.1 Fracture of scapula 19421
S43.0 Dislocation of shoulder joint 19430
S02 Fracture of skull and facial bones 1902

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S92.1 Fracture of talus 19921
S92.2 Fracture of other tarsal bone(s) 19922
S82.3 Fracture of lower end of tibia 19823
S82.2 Fracture of shaft of tibia 19822
S82.1 Fracture of upper end of tibia 19821
S92.5 Fracture of other toe 19925
S93.1 Dislocation of toe(s) 19931
S52.0 Fracture of upper end of ulna 19520
S52.6 Fracture of lower end of both ulna and radius 19526
S52.4 Fracture of shaft of both ulna and radius 19524
S52.2 Fracture of shaft of ulna 19522
S63.0 Dislocation of wrist 19630

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