Daftar. Tindakan Yg Perlu Informed Consent
Daftar. Tindakan Yg Perlu Informed Consent
Daftar. Tindakan Yg Perlu Informed Consent
A.
NO
1
KSM/INSTALASI
/UNIT
KSM Bedah
1
Saraf
2
TINDAKAN
Amygdala Hypocampectomy (Epilepsi)
Anterior Temporomesial Lobectomi (Epilepsi)
Cingulotomy (Psichiatric)
10
11
Denervasi Facet
12
13
14
Eksisi Ensefalokel/Mielokel
Eksisi Kista Jinak Kulit Kepala
1
NO
15
Eksisi Osteoma/Osteositosis
16
17
Dura
18
KSM/INSTALASI/U
NIT
19 Dura
TINDAKAN
20
21
22
23
Hemisferektomi (Epilepsi)
24
Hemisferoktomi (Epilepsi)
25
26
28
29
30
31
32
33
34
35
Laminoplasti
36
37
38
39
Lesionectomy (Epilepsi)
40
Lobektomi (Epilepsi)
41
Mesencephalectomy (Pain)
42
Mikrodisekktomi HNP
27
NO
43
44
Neurektomi/Neurolise
45
Neuroendoskopi (Otak,Spinal)
46
Neuroplasti
47
Omaya drain
KSM/INSTALASI
/UNIT
TINDAKAN
48
49
50
51
52
53
54
Revisi VP Shunt
55
56
Rhizotomy (Pain)
57
58
59
60
Simpatektomi Perkutan
61
SLTH
62
63
64
Suturektomi Kraniostenosis
65
Thalomotomy (Pain)
Transposisi kraniostenosis,dengan orbital
advancement
Transposisi kraniostenosis,tanpa orbital
advancement
Trepanasi Cedera Kepala (<4jam)
66
67
68
NO
2.
69
70
71
72
73
74
VA Shunt
75
VP Shunt Multiple
76
KSM/INSTALASI
/UNIT
KSM Bedah
1
Kepala Leher
2
TINDAKAN
Aff Arch Barr
Aff Arch Barr dan suspensi maksila
Deseksi submandibula
10
flap lokal
11
12
13
flap lokal
14
15
16
17
18
kulit
19
20
21
22
Ekskokleasi epulis
23
24
25
26
27
28
No
3.
KSM/INSTALASI/
UNIT
KSM
Bedah THT-KL
TINDAKAN
29
30
31
32
33
34
35
36
37
38
39
1
2
3
4
5
6
7
8
9
10
11
12
Laring/Trakea)
Cald Well Luc
Cochlear Implant/Implan Baha
Dekompresi Nervus Fasialis
DCR
Eksisi Ekstostosis
Ekstirpasi Kista Branchial
5
13
14
15
16
17
18
NO
KSM/INSTALASI/
UNIT
TINDAKAN
19
20
21
22
23
24
25
26
27
28
29
30
31
32
FOL
33
Glosektomi Total/Parsial
34
Glosektomi Total/Hemiglosektomi+RND
35
Hemiglosektomi+SOHND
36
37
Inversi Grommet
38
Insisi Perikondritis
39
40
41
Imunoterapi
42
Konka Reduksi
43
44
Laringektomi
45
Laringektomi+ND
46
NO
47
48
Laringoskopi Rigid
KSM/INSTALASI/
UNIT
TINDAKAN
49
Laringoskopi Fleksible
50
Laringoskopi Direkta
51
Maksilektomi Total+Rekontruksi
52
Mastoidektomi Radikal
53
Mini FESS
54
55
Myringoplasty/Timpaniplasti
56
Mandibulekromi
57
58
Osteotomi+Septum koreksi
68
69
70
Rhinoplasti
71
72
73
74
75
Septum Koreksi+Konkotomi
76
Stapedektomi
77
78
Tiroidektomi Sub-Total
79
Tonsilektomi/Adenoidektomi
80
Tracheostomi
81
Turbinektomi
82
Tiroidektomi Total+ND
7
NO
4
83
84
85
KSM/INSTALASI
/UNIT
TINDAKAN
KSM Orthopedi
Dan
Abdominopelvic amputation
Achillotenotomy
Traumatologi
Advancement of tendon
15
16
17
18
7
8
9
10
11
12
13
14
19
21
22
Ankle fusion
23
25
26
27
Arthrocentesis
20
24
NO
KSM/INSTALASI
/UNIT
TINDAKAN
28
Arthrodesis of elbow
29
Arthrodesis of hip
30
Arthrodesis of knee
31
32
Arthrodesis of shoulder
33
40
41
42
43
34
35
36
37
38
39
44
45
Biopsy of bone
46
47
48
52
Bone graft
Bone marrow or hematopoietic stem cell transplant
(all procedures included in this class
Bunionectomy with soft tissue correction and
arthrodesis
Bunionectomy with soft tissue correction and
osteotomy of the first metatarsal
Bursectomy
53
Bursectomy of hand
54
Bursotomy
49
50
51
NO
KSM/INSTALASI
/UNIT
TINDAKAN
55
Bursotomy of hand
56
Carporadial fusion
Closed reduction of dislocation -General
anaesthesia
Closed reduction of dislocation of ankle
57
58
59
60
61
62
63
64
65
66
69
70
71
67
68
72
73
74
NO
TINDAKAN
KSM/INSTALASI
/UNIT
84
85
86
87
88
75
76
77
78
79
89
90
91
11
92
93
94
95
96
99
100
101
97
98
NO
TINDAKAN
KSM/INSTALASI
/UNIT
Fasciotomy
111
Fasciotomy of hand
112
Finger reattachment
113
114
Foot reattachment
115
116
117
118
119
NO
TINDAKAN
KSM/INSTALASI/
UNIT
130
131
132
133
134
135
136
137
138
139
140
142
143
144
148
149
150
152
153
141
145
146
147
154
NO
TINDAKAN
KSM/INSTALASI
/UNIT
14
159
Interphalangeal fusion
160 Interthoracoscapular amputation, Forequarter
amputation
161 Intra-operative neurophysiologic monitoring Neuromonitoring
162
Intervertebral chemonucleolysis
163
Limb lengthening procedures
164
Limb shortening procedures
165
Local excision of lesion or tissue of bone
166
Lower leg or ankle reattachment
167
Lower limb amputation, not otherwise specified
168 Lumbar and lumbosacral fusion of the anterior
column, anterior technique
169 Lumbar and lumbosacral fusion of the anterior
column, posterior technique
170 Lumbar and lumbosacral fusion of the posterior
column, posterior technique
171
Lysis of adhesions of hand
172 Lysis of adhesions of muscle, tendon, fascia, and
bursa
173
Lysis of adhesions of spinal cord and nerve roots
174
Metacarpocarpal fusion
175
Metacarpophalangeal fusion
176
Metatarsophalangeal fusion
177
Midtarsal fusion
178
Muscle transfer or transplantation
179
Myotomy
180
Myotomy of hand
181
Neurectasis
NO
TINDAKAN
KSM/INSTALASI/
UNIT
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
16
NO
KSM/INSTALASI
/UNIT
TINDAKAN
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
NO
KSM/INSTALASI
/UNIT
TINDAKAN
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
18
NO
TINDAKAN
KSM/INSTALASI
/UNIT
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
NO
KSM/INSTALASI
/UNIT
TINDAKAN
300 Refusion of dorsal and dorsolumbar spine, posterior
column, posterior technique
301 Refusion of lumbar and lumbosacral spine, anterior
column, anterior technique
302 Refusion of lumbar and lumbosacral spine, anterior
column, posterior technique
303 Refusion of lumbar and lumbosacral spine, posterior
column, posterior technique
304 Refusion of other cervical spine, anterior column,
anterior technique
305 Refusion of other cervical spine, posterior column,
posterior technique
306 Refusion of spine, not elsewhere classified
307 Refusion of spine, not otherwise specified
308 Release of carpal tunnel
309 Release of clubfoot, not elsewhere classified
310 Release of tarsal tunnel
311 Removal of (cement) spacer
312 Removal of bone growth stimulator (invasive)
313 Removal of foreign body from spinal canal
314 Removal of implanted devices from bone - carpals
and metacarpals-Plate & screw
315 Removal of implanted devices from bone - carpals
and metacarpals-simple implants (K-wire)
316 Removal of implanted devices from bone - External
fixator device (invasive) (
317 Removal of implanted devices from bone - femur
318 Removal of implanted devices from bone - humerus
319 Removal of implanted devices from bone - radius and
ulna
320 Removal of implanted devices from bone - scapula,
clavicle, and thorax (ribs and sternum)
321 Removal of implanted devices from bone unspecified site (Phalanges (of foot) (of hand)) - Plate
& Screw
322 Removal of implanted devices from bone 20
323
324
325
326
NO
unspecified site (Phalanges (of foot) (of hand)) simple implants (K-wire)
Removal of implanted devices from bone -patella
Removal of implanted devices from bone- tarsals and
metatarsals- simple implants (K-wire)
Removal of implanted devices from bone- tibia and
fibula
Removal of implanted devices from bone-other
(Pelvic bone and Vertebraae)
KSM/INSTALA
SI/UNIT
TINDAKAN
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
NO
prosthesis, lumbosacral
Revision or replacement of artificial spinal disc
prosthesis, not otherwise specified
Revision or replacement of artificial spinal disc
prosthesis, thoracic
Rotator cuff repair
Separation of equal conjoined twins
Separation of unequal conjoined twins
Sequestrectomy
Spinal fusion, not otherwise specified
Subtalar fusion
Subtalar joint arthroereisis
Suture of Artery
Suture of capsule or ligament of ankle and foot
KSM/INSTALASI
/UNIT
TINDAKAN
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
378
379
380
381
382
383
384
389
390
391
392
393
394
NO
KSM/INSTALASI
/UNIT
KSM BEDAH
THORAKS
DAN
KARDIOVASKULAR
Triple arthrodesis
Unspecified operation on bone injury
Upper arm reattachment
Upper limb amputation, not otherwise specified
Wedge osteotomy
TINDAKAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
NO
Pleurodesis (Pleurosklerosis)
Plikase Bulae / Bleb Emfisematous
Plikasi diafragma
Pneumonectomy
Pneumonectomy dengan VATS
Pulmonary Decortication
Pulmonary Decortication dengan VATS
Pulmonary Lobectomy/Bilobectomy
Pulmonary Lobectomy/Bilobectomy dengan VATS
Redo Torakotomi
Rekonstruksi Sternum&Dinding Dada
repair deformitas Pectus
Repair Fistula Bronkopleural
Repair Laserasi Diafragma
TINDAKAN
KSM/INSTALASI
/UNIT
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
NO
KSM/INSTALASI/
UNIT
TINDAKAN
76 Rastelli Procedure (right Ventricle-Pulonary Artery
Conduit)
77 Repair (Eksisi) Aneurisma Jantung
78 Repair Aorta Torakalis (38.34)
79 Repair Atrioventricular Septal Defect (35.54)
Repair Total Anomalous Pulmoanry Venous Connection
80
(TAPVC) (35.82)
81 Repair Transposition of Great Arteries (TGA) (35.84)
82 Repair Trunkus Arteriosus (35.83)
83 Revisi/Aff Pace Maker Permanen (diluar alat) (37.89)
84 Septostomi Terbuka Septum Atrium (35.41)
85 Total Koreksi Tetralogy of Fallot (TOF) (35.81)
86 Tricuspid Valve Repair (TVR) (35.14)
Tricuspid Valve Repair (TVR) dengan Bioprosthesis Valve
87
(35.27)
Tricuspid Valve Repair (TVR) dengan Mechanical Valve
88
(35.28)
89 Ventricle Septal Defect (VSD) Closure (35.5)
90 Amputasi Above Knee (AK) (84.17)
91 Amputasi Below Knee (BK) (84.14)
92 Arterial Pungsi, Kanulasi, Sectie (38.91)
93 Arteriovenous Shuntt (AV Shunt) Brakiosefalika (39.42)
94 Arteriovenous Shuntt (AV Shunt) Radiosefalika (39.27)
95 Bedah Varises Insisi Babcock (38.5)
25
NO
KSM/INSTALASI
/UNIT
TINDAKAN
13
14
15
16
17
18
19
20
21
22
23
24
25
26
7
KSM BEDAH
27
1
DIGESTIVE
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
NO
KSM/INSTALASI
/UNIT
TINDAKAN
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
NO
KSM/INSTALASI
/UNIT
KSM BEDAH
UROLOGI
TINDAKAN
60
61
62
63
64
65
66
67
68
69
1
2
3
4
Total pantreaktomi
Total prokto-kolektomi
Tutup burst abdomen (tanpa alat)
Tutup burst abdomen dengan penyulit mayor
Tutup burst abdomen dengan penyulit minor
Tutup kolostomi / ileostomi
Tutup kolostomi / ileostomi dengan penyulit mayor
Tutup kolostomi / ileostomi dengan penyulit minor
Repair Aorta Torakalis (38.34)
Repair Atrioventricular Septal Defect (35.54)
Adrenalektomi
Adrenalektomi (Abdominotorakal)
Anastomosis end to end Ureter
Augmentasi Buli
28
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
NO
KSM/INSTALASI
/UNIT
TINDAKAN
34
35
36
37
38
39
40
41
42
43
44
Funikokelektomi
Ganti Nefrostomy
Hidrokel per Inguinal/Ligasi Tinggi
Hidrokel per Skrotal
Hipospadia Subkoronal
Holmium YaG Laser (Sewa)
Ileal Conduit (Bricker)
Insersi DJ Stent
Insisi Abses Perineum
Insisi Abses Skrotum
Insisi Posterior Urethral Valve
29
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
NO
Johanson
Johanson I
Johanson II
Kalibrasi Uretra
Kauterisasi
Koreksi Horseshoe Kidney
Koreksi Priapismus
Laparoskopi Adrenalektomi
Laparotomi Eksplorasi
Ligasi V.Spermatika Interna (Microsurgery)
Limfadenektomi Ilioinguinal
Limfadenektomi Retroperitoneal/RPLND
Litholapaksi
Lithotripsi
Masase Prostat
Meatoplasti
Meatotomi
MMK/Sling Uretra
Nefrektomi
Nefrektomi Donor Transplant
Nefrektomi Parsial
Nefrektomi per Laparoskopi
Nefrektomi Radial
Nefropeksi/Renopeksi
Nefrostomi Perkutan/Temporer
Nefrostomi Terbuka/Permanen
Nefroureterektomi
Neobladder
Operasi Priapismus (prosedur Winter)
Operasi Repair Buli Trauma
Operasi Sistokel
KSM/INSTALASI
/UNIT
TINDAKAN
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
115
116
117
118
119
NO
Pasang Kateter
Pasang Kateter dengan Mandrain
Pasang Kateter Tenckhoff untuk CAPD
PCNL/PNL
Penektomi Parsial
Penektomi Total/Amputasi Penis
PER (Primary Endoscopic Realignment)
Pielokalikotomi
Pielolitotomi
Pieloplasti
Pieloplasti per Laparoskopi
Prostatektomi Radikal
Prostatektomi Retropubik
Prostatektomi Terbuka
Prostatektomi Terbuka dan Sectio Alta
Psoas Hitch/Boari Flap
Punksi dan sklerosing Kista Ginjal
Railroading Rupture Uretra
Reimplantasi Ureter Bilateral
Reimplantasi Ureter
Unilateral/Ureteroneosistostomi
Rekontruksi Renovaskuler
Repair Fistel Enterovesika
Repair Fistel Vesikokutan
Repair Fistel Vesikorektal
Repair Fistel Vesikovagina
Repair Fistel Vesikovagina Kompleks
Reparasi Penis
Reseksi-anastomosis Uretra
RPG
Sectio Alta/Vesikolithotomi
Sirkumsisi
Sistektomi Parsial/Sistoplasti Reduksi
Sistektomi Per Laparoskopi
Sistektomi Total/Radikal
Sistoskopi
Sistoskopi ODS
KSM/INSTALASI
/UNIT
TINDAKAN
120
121
122
123
Sistostomi perkutan
Sistostomi Terbuka
Skrotoplasti
Spermatokelektomi
31
NO
KSM ILMU
KESEHATAN
MATA
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Tailoring Ureter
Transplan Resipien
Transuretero-ureterostomi
TUR Prostat/TUIP/BNI
TUR Tumor Buli
TVP/TMP
Ureterokutaneostomi
Ureterolisis
Ureterolithotomi
Ureterolithotomi Distal
Ureterolithotomi Proksimal
Ureterosigmoidostomi (Caffey)
Ureterostomi
Ureterouretostomi
Uretroplasti Hipospadia
Uretroskopi/Uretrosistoskopi
Uretrotomi Interna (Sachse)
URS/Lithotripsi
Varikokelektomi (Palomo)
Vasektomi (anestesi lokal)
Vasektomi (narkose)
Vasoepididimostomi
Vasografi
Vasovasostomi
Angkat Jahitan
Angkat Jahitan dengan GA
Anterior Chamber Tap/Parasintesis
Aspirasi Massa Lensa
Blefaroplasty (2 Kelopak Mata)
Claw Lens
Cryopexy Kornea
Cyclo Cryo
Dacryocystorinostomi (Without Silicon Tube)
Dekompresi Orbital/Lateral Orbitotomi
Disisi Aspirasi & IOL
ECCE
ECCE & IOL
Eksenterasi
Eksisi Hordeolum / Chalazion
Ekstirpasi Corpus Alienum di Kornea
Ekstirpasi Pterygium + Graft Konjungtiva
KSM/INSTALASI
/UNIT
TINDAKAN
32
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
33
NO
KSM/INSTALASI
/UNIT
TINDAKAN
34
10
Divisi Onkologi
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
NO
KSM/INSTALASI
/UNIT
TINDAKAN
47
48
Advancement Flap
49
50
51
52
Diseksi Axilla
53
Diseksi Inguinal
54
55
56
57
58
Ismulobectomy
59
Kemoterapi Perinfus
60
61
Maksilektomi Total
62
Mastopexy
63
Modifikasi RND
64
65
Ovariectomy Bilateral
66
Reseksi Mandibula
67
Rotation Flap
68
Skin Grafting
69
70
Superficial Parotidectomy
71
72
Total Parotidectomy
36
NO
11
KSM/INSTALASI
/UNIT
DIVISI BEDAH
ANAK
73
Total Thyyroidectomy
74
TINDAKAN
1
2
Appendektomi laparoskopik
10
Divertikulektomy
11
12
13
14
15
16
17
18
19
20
21
22
23
Eksisi urachus
24
37
NO
25
Ekstirpasiranula
26
Endoskopik diagnostik
27
28
Endoskopik terapeutik
29
Hemikolektomi
30
31
Herniotomi laparoskopik
Gastrostomi
KSM/INSTALASI
/UNIT
TINDAKAN
32
33
Hidrokolektomi
34
Intraoperatif kolangiografi
35
36
37
38
39
40
Kolesistektomi
41
Kolesistektomi laparoskopik
42
43
44
45
Ligasihemoroid (49.4)
46
47
Orchidopexy (62.5)
48
50
51
49
38
53
54
55
56
57
58
59
60
52
NO
KSM/INSTALASI
/UNIT
TINDAKAN
61
62
RPLND (40.59)
63
64
65
66
Splenektomi (41.5)
67
69
70
71
72
73
74
68
12
NO
KSM BEDAH
PLASTIK
1
2
3
Abdominoplasty
Aff archbar, Lokal Anastesi
Aff Suspensi, Lokal Anastesi
Amputasi digital
Augmentasi mamae
10
11
12
Blefaroptosis
KSM/INSTALASI
/UNIT
TINDAKAN
13
14
15
Cheilonasoraphy
16
Chordectomy
17
Chordectomy+urethroplasty
18
19
Comisuroplasty
20
21
22
23
24
25
26
27
28
40
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
NO
KSM/INSTALASI
/UNIT
TINDAKAN
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
LD flap
Le fort I osteotomy
Liposuction
Lobuloplasti
Malarplasty
Mamma aberan unilateral
Mandibular distraksi
Mandibular rekonstruksi dengan costochondral graft
Mastopexi
Mentoplasty
Microsurgery
Multiple facial fraktur + implant
Muskulokutaneus flap
Myokutaneus flap/pectoralis mayor flap
Nasal repair dan rekonstruksi
Neo vagina
Operasi bedah mikro
Orif fraktur zygoma
Orif fraktur hand
41
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
NO
KSM/INSTALASI
/UNIT
TINDAKAN
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
Rekonstruksi palpebra
Released buried penis
Released syndactyly kompleks
Repair canalis lacrimalis (without silicon tube)
Repair coloboma palpebra (skin/mucosal graft)
Repair ductus nasolacrimalis
Repair fingertip injury
Repair fistel urethra
Replantation
Reposisi fraktur nasal sederhana
Reposisi fraktur os nasalis (complicated)
Reseksi mandibula + bone graft
Rhinoplasty
Rotation flap
Sagital Split osteotomi mandibula
Simple bone grafting
42
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
NO
13
KSM/INSTALASI/
UNIT
KSM
OBGYN
TINDAKAN
1
2
3
Cauter serviks
Cordosentesis
Debulking tumor ovarium
Eksplorasi vagina
Embryotomi
10
Histeroctomy radikal
11
Kistektomi
12
Konisasi serviks
13
14
16
17
Laparoskopi steril
18
Laparoskopik Diagnostik
19
20
21
22
LEEP
23
24
Mikrokuret
25
Miomectomy
26
Neovagina
27
Operasi Ca vagina
28
29
30
31
Overectomi
15
NO
KSM/INSTALASI
/UNIT
TINDAKAN
32
Painless labor
33
Persalinan normal
34
35
36
Persalinan sungsang
44
37
Rekanalisasi
38
Rekanalisasi tuba
39
Salfingektomi unilateral
40
Salvingoovarectomi unilateral
41
42
Seksio sesaria
43
44
Sirklase serviks
45
46
Sirklase serviks
47
48
Surgical staging
49
51
52
Tubektomi klinik
53
50
NO
KSM/INSTALASI
/UNIT
TINDAKAN
14
KSM
GIGI dan
MULUT
2
3
4
10
11
13
14
Extirpasi Sialolith
15
17
18
19
20
22
23
24
25
27
28
Genioplasty
29
12
16
21
26
NO
KSM/INSTALASI
/UNIT
TINDAKAN
30
31
32
33
Mandibular Distraksi
34
36
37
38
39
40
41
DIVISI PEDIATRI
GAWAT
DARURAT
ILMU
KESEHATAN
ANAK
KSM PENYAKIT
JANTUNG &
PEMBULUH
DARAH
1
2
3
4
5
Intubasi Endotrakea
Krikotirotomi
Kanulasi vena perifer
Vena sectie
Pungsi lumbal
Pungsiv Pleura
Diagnostik Kateterisasi Jantung
PTMC
PTCA/Stenting
Pacemaker Temporer&Permanen
IABP
Perikardiosintesis
Pemasangan Amplatzer/ADO/Coilling
CVC
10
35
15
16
17
KSM PENYAKIT
DALAM
2
3
4
5
6
Endoscopy
47
KSM /
INSTALASI
KSM Anak
NAMA TINDAKAN
1
2
Chest tube
Tindakan kemotherapi
48
3
4
5
THT-KL
KSM Patologi
Anatomi
Inst.
Radiotherapi
KSM
Neurologi
3
4
5
6
7
8
9
1
0
11
1
2
1
3
1
4
1
5
1
6
1
2
3
4
5
6
Pemasangan Ventilator
Intubasi Endotrakea
Pemasangan Laryngeal mask
Krikotirotomi
Infus intraosseus
Kanulasi vena perifer
Vena sectie
Pengambilan darah intra vena dan intra arteri
Pungsi lumbal
Pungsiv Pleura
Pemasangan kateter urine
Pemasangan keteter rectal
Pemasangan orogastrik tube
Pemasangan nasogastrik tube
Pemeriksaan Audiometri
Pemeriksaan Timpanometri
Pemeriksaan Audiometri Tutur
Pemeriksaan Sisi&Tore Decay
Pemeriksaan Pendengaran Pada Anak
Pemeriksaan Brainstem Evoked Response
Audiometry
Cerebral Angiografi
AVM&Embolisasi
Aneurisma Coiling
Embolisasi pre operasi
Diagnosis DSA
Lumbal Punksi
Pain Intervention
Injeksi Triger point
Injeksi Triger Fringer
Injeksi CTS
49
Poli
Andrologi
KSM
Kardiologi
dan
Kedokteran
Vaskular
10
11
KSM
Pulmonologi
dan Ilmu
Kedokteran
Respirasi
KSM
Radiologi
1
2
3
4
5
6
7
8
9
1
0
11
1
2
1
2
Bronchoscopy/FOB
Tindakan kemotherapi
Thoracoscopy
Contra Ventil/WSD
Punctie Pleura
FNAB
Scalene Biopsy
Reposisi
Pleurodesis
AFF WSD
Perawatan Luka WSD
USG Thorax Marker
Tindakan Radiologi Injectee contrast
Tindakan Radiologi pada pasien dengan kelainan
cardiovaskuler
Tindakan Radiologi pada pasien dengan alergi
berat
50
4
5
KSM
12
13
14
16
15
Neurologi
1
2
3
4
5
6
7
8
9
1
0
11
1
2
1
3
1
4
Instalasi
Hemodialisis
KSM
Rehabilitasi
Medik
IRNA Jiwa
Psycho Analisa
52