Daftar Diagnosis yang Dapat Ditangani di PPK1 Fasyankes BPJS

Sesuai dengan PMK No 5 Tahun 2014, Level Kemampuan 4A

No

Diagnosis ICD X Level Kemampuan

1 Tuberkulosis Paru A15 4A2 Morbili B05.9 4A3 Varicella B01.9 4A4 Malaria B54 4A5 DF & DHF A90 (DF), A91 (DHF) 4A6 Leptospirosis A27.9 4A7 Infeksi pada Umbilikus A78 4A8 Kandidiasis Mulut B37.9 4A9 Lepra/Morbus Hansen A30 4A

10 Keracunan Makanan T62.2 4A11 Alergi Makanan L27.2 4A12 Exanthematous Drug Eruption L27.0 4A13 Fixed Drug Eruption L27.0 4A14 Reaksi Anafilaktik T78.2 4A15 Anemia Defisiensi Besi D64.9 4A16 HIV/AIDS tanpa Komplikasi Z21 4A17 Limfadenitis B70 4A18 Refluks Gastroesofageal K21.9 4A19 Gastritis K29.7 4A20 Intoleransi Makanan K90.4 4A21 Demam Tifoid A01.0 4A22 Gastroenteritis Akut (Desentri, Kolera, Giardiasis) A29 4A23 Desentri Basiler dan Amuba A06.0 4A24 Hemoroid gr I-II I84 4A25 Hepatitis A B15 4A26 Parotitis K11.2 4A27 Askariasis B77.9 4A28 Cutaneous Larva Migrans )CLM) B76.9 4A29 Penyakit Cacing Tambang B76.0

(Ankylostomiasis), B76.1 (Necatoriasis)

4A

30 Skistosomiasis B65.9; B65.2 4A31 Strongiloidiasis B78.9 4A32 Taeniasis B68.9 4A33 Dry Eye H04.1 4A34 Buta Senja H53.5 4A35 Hordeolum H00.0 4A36 Konjungtivitis H10.9 4A37 Blefaritis H01.0 4A38 Perdarahan Subkonjungtiva H57.8 4A39 Benda Asing di Konjungtiva T51.9 4A40 Astigmatisme H52.2 4A41 Hipermetropi H50.2 4A42 Miopi H52.1 4A43 Presbiopi H52.4 4A44 Glaukoma Akut H40.2 4A45 Otitis Eksterna H60.9 4A46 Otitis Media Akut H66.0 4A47 Serumen Prop H61.2 4A48 Benda Asing di Hidung T17.1 4A49 Angina Pektoris I20.9 4A50 Hipertensi Essensial I10 4A

No

Diagnosis ICD X Level Kemampuan

51 Lipoma D17.9 4A52 Kejang Demam R56.0 4A53 Vertigo R42 4A54 Tetanus A35 4A55 Migrain G43.9 4A56 Bells’ Palsy G51.0 4A57 Tension Type Headache G44.2 4A58 Insomnia G47.0 4A59 Furunkel Hidung J34.0 4A60 Faringitis J02.9 4A61 Rhinitis Akut J00 4A62 Epistaksis R04.0 4A63 Rhinitis Alergi/Rhinitis Vasomotor J30.0 4A64 Tonsilitis J05.9 4A65 Laringitis J04.0 4A66 Bronkhitis Akut J20.9 4A67 Pneumonia/Bronkopneumonia J18.9 4A68 Pertusis A37.8 4A69 Asma Bronkial J45 4A70 Miliaria L74.3 4A71 Veruka Vulgaris B07 4A72 Insect Bite T63.4 4A73 Herpes Zooster B02 4A74 Herpes Simpleks B00.9 4A75 Skabies B86 4A76 Pedikulosis Kapitis B85.0 4A77 Dermatofitosis (Tinea) B35 4A78 Pitiriasis Versicolor B36.0 4A79 Pioderma (termasuk Impetigo, Abses, Furunkel,

Karbunkel)L01; l02 4A

80 Dermatitis Seboroik L21 4A81 Dermatitis Atopik L20 4A82 Dermatitis Numularis L20.8 4A83 Dermatitis Kontak Iritan L24 4A84 Napkin Eczema L22 4A85 Pitiriasis Rosea L43 4A86 Moluskum Kontagiosum B08.1 4A87 Urtikaria L50.9 4A88 Filariasis F.74 4A89 Burn grade I-II T31.0 4A90 Hipoglikemia Ringan E16.2 4A91 DM tipe I & II E10; E11 4A92 Malnutrisi Energi Protein E46 4A93 Hiperuricemia, Gout Artritis E79 (Hiperuricemia);

M10 (Gout)4A

94 Dislipidemia E78.5 4A95 ISK N39.0 4A96 Kehamilan Normal O80.9 4A97 Abortus Kompletus O03.9 4A98 ADB pada Kehamilan D50 4A99 Ruptur Perineum gr I-II O70.0 4A

100 Mastitis N61 4A

No Diagnosis ICD X Level Kemampuan101 Fluor Albus N98.9 4A102 Gonorrhea A54.9 4A103 Vaginitis N76.0 4A104 Vulvitis N76.0 4A

PENYAKIT-PENYAKIT YANG DIRUJUK (LEVEL KEMAMPUAN 3A dan 3B)

No.

Diagnosis ICD X Level Kemampuan

1 Malabsorbsi Makanan 3A2 Apendisitis Akut K35.0 3B3 Ulkus Gaster 3A4 Lesi Korosif Esofagus 3B5 Divertikulitis 3A6 Hemoroid gr. III-IV 3A7 Kolitis 3A8 Hepatitis B 3A9 Peritonitis K65.9 3A

10 Kolesistitis K81.9 3B11 Angina Pektoris I20.9 3B12 Infark Miokard I21.9 3B13 Takikardia I47.1 3B14 Gagal Jantung I50.9 3A&3B15 Pneumonia Aspirasi J69.0 3B16 Epilepsi G40.9 3A17 Status Epileptikus G41.9 3B18 Delirium F05.9 3A19 Rabies A82.9 3A20 Demensia F03 3A21 Anxietas dan Depresi F41.2 3A22 Gangguan Psikotik F20 3A23 LSK L28.0 3A24 DKA L23 3A25 Obesitas E66.9 3A & 3B26 Tirotoksikosis E05.9 3B27 Hiperglikemia HONK R73.9 3B28 Hipoglikemia Berat E16.2 3B29 Pre-Eklampsia O14.9 3B30 Abortus Inkomplet O06.4 3B31 Abortus Insipiens 3B32 Ketuban Pecah Dini O42.9 3B33 Persalinan Lama O63.9 3B34 Sifilis A53.9 3A