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KODE ICD

NO. TINDAKAN LEAD TERM


9 CM
Insisi drenase abses wajah/
1 Drainage - ludwig’s angina 27.0
submandibula/ angina ludovici
2 Insisi palatum Incision - plate 27.1
3 Biopsi palatum durum Biopsy - plate (bony) 27.21
4 Biopsi uvula/ palatum mole Biopsy - uvula 27.22
5 Eksisi lesi palatum durum Excision - plate(bony) 27.31
Resection - alveolar process and
6 Eksisi luas lesi palatum durum 27.32
palate
7 Hecting laserasi palatum Palatorrhaphy 27.61
8 Implan palatum Insertion - Palatal Implant 27.64
9 Insisi uvula Incision - Uvula 27.71
10 Eksisi uvula Excision - Uvula 27.72
Insisi drenase abses
11 Incision - tonsil 28.0
tonsil/peritonsil/parafaring/retrofaring
Biopsy - tonsil
12 Biopsi tonsil dan adenoid 28.11
Biopsy - adenoid
Biopsy - tonsil
13 Biopsi tonsil dan adenoid 28.11
Biopsy - adenoid
14 Tonsilektomi Tonsillectomy 28.2
Tonsillectomy - with
15 Tonsilektomi dengan adenoidektomi 28.3
adenoidectomy
16 Eksisi tonsil lingual Excision - tonsil - lingual 28.5
17 Eksisi tag tonsil Excision - tonsil - tag 28.4
18 Eksisi tonsil lingual Excision - tonsil - lingual 28.5
Adenoidectomy (without
19 Adenoidektomi 28.6
tonsillectomy)
Control - hemorrhage - adonids
Kontrol perdarahan pasca (postoperative)
20 28.7
tonsilektomi dan adenoidektomi Control - hemorrhage - tonsils
(postoperative)
Ekstraksi benda asing tonsil/adenoid
21 Incision - tonsil 28.91
dengan insisi
22 Eksisi lesi di tonsil dan adenoid Excision - tonsil 28.92
23 Faringotomi Pharyngotomy 29.0
Biopsi
24 Biopsy - nasopharinx 29.12
nasofaring/orofaring/hipofaring
Excision - branchial cleft cyst or
25 Eksisi kista brakial 29.2
vestige
26 Miotomi krikofaring Myotomy - cricopharyngeal 29.31
Diverticulectomy - Pharyngeal (by
27 Divertikulektomi faring 29.32
cricopharyngeal myotomy)
28 Faringektomi Pharyngectomy (Partial) 29.33
29 Eksisi lesi di faring Excision - pharynx 29.39
30 Nasofaringektomi Excision - nasopharynx 29.3
31 Ekstirpasi angiofibroma nasofaring Excision - pharynx 29.39
32 Faringoplasti Suture - pharynx 29.51
33 Hecting laserasi faring Pharyngoplasty 29.4
34 Penutupan fistel celah brakial Closure - branchial 29.52
35 Penutupan fistel faring Closure - pharynx 29.53
Extraction - Removal - Foreign
36 Ekstraksi benda asing faring 98.13
Body - Pharynx (Intraluminal)
37 Biopsi kelenjar tiroid Biopsy - Thyroid Gland Nec 06.11
38 Biopsi kelenjar paratiroid Biopsy - Parathyroid Gland 06.13
39 Lobectomy tiroid unilateral Lobectomy - Thyroid Unilateral 06.2
40 Hemitiroidektomi Hemithyroidectomy 06.2
41 Eksisi lesi tiroid (kista tiroid) Excision - lesion - thyroid 06.31
Thyroidectomy - partial or
42 Tiroidektomi parsial 06.39
subtotal NEC
43 Near total tiroidektomi Tiroidectomy - NEC 06.39
44 Tiroidektomi total Hyroidectomy - complete or total 06.4
45 Eksisi tiroid lingual Thyroidectomy - lingual 06.6
46 Eksisi duktus tiroglosus Excition - duct – thyroglossal 06.6
47 Paratiroidektomi total Parathyroidectomy – complete 06.81
Ligation – thyroid vessel (arteri)
48 Ligasi pembuluh darah tiroid 06.92
(vein)
49 Hecting kelenjar tiroid Suture – Thyroid Gland 06.93
50 Rhinotomi lateral Rhnotomy 21.1
51 Maksilektomi medial Maksilektomy 22.31
52 Frontal sinusotomi (onkologi) Sinusotomi - Frontal 22.41
53 Etmoidektomi eksternal (onkologi) Ethmoidectomy 22.63
54 Sfenoidektomi eksternal (onkologi) Sphenoidectomy 22.64
Sinusectomy – maxillary – with
55 Pendekatan sublabial 22.61
Caldwel - Luc approach
56 Midfasial degloving Sinusectomy – maxillary 22.62
57 Glosektomi parsial/ hemiglosektomi Glossectomy - partial 25.2
58 Glosektomi total Glossectomy (total) 25.3
59 Glosektomi radikal Glossectomy - radical 25.4
Procedure – diagnostic – salivary
60 Sialendoskopi Diagnostik 26.19
gland
Excision – lesion – salivary gland
61 Sialolithektomi 26.29
or duct NEC
Ekstirpasi kelenjar sublingual/ Extirpation – see also excision –
62 26.31
submandibula/ parotis parsial salivary gland – partial
63 Parotidektomi parsial Parotidectomy - Partial 26.31
64 Parotidektomi superfisial Parotidectomy - Partial 26.31
Ekstirpasi kelenjar sublingual/ Extirpation - see also Excisition -
65 26.32
submandibula/ parotis total salivary gland – complete
66 Parotidektomi total Parotidectomy - complete 26.32
Sialendoskopi Diagnostik dan
67 Dilation - salivary duct 26.91
Dilatasi
Sialendoskopi Diagnostik dan
68 Operation - slivary gland or duct 26.99
Terapeutik
69 Radiofrekuensi Dasar Lidah Operation - oral cavity 27.99
Drainage - abscess
• Parapharyngeal
70 Eksplorasi Abses Multiple • Peritonsilar 28.0
• Retropharyngeal
• Tonsil,tonsilar
71 Marsupialisasi kista laring Marsupialization - larynx 30.01
72 Eksisi lesi laring (papiloma, nodul) Excision - lesion - larynx 30.09
73 Hemilaringektomi Hemilaryngektomy 30.1
74 Epiglotiktomi Epiglotidectomy 30.21
75 Kordektomi Cardectomy, vocal 30.22
76 Laringektomi parsial Laryngectomy - partial 30.29
77 Laringektomi total Laryngectomy - complete 30.3
78 Laringektomi radikal Laryngectomy - radical 30.4
79 Injeksi laring Injection - larynx 31.0
80 Trakeostomi temporer Tracheostomy 31.1
81 Trakeostomi dengan penyulit Tracheostomy -Temporary 31.1
82 Trakeostomi permanen Tracheostomy - permanent 31.29
Tracheoscopy – throught
83 Trakeoskopi melalui stoma trakea 31.41
tracheostomy (stoma)
Tracheoscopy – throught
84 Trakeoskopi melalui stoma trakea 31.41
tracheostomy (stoma)
85 Laringoskopi/trakeoskopi Laryngoscopy 31.61
86 Laringoskopi/trakeoskopi Laryngoscopy 31.61
87 Biopsi laring dengan endoskopi Biopsy – larynx - closed 31.43
88 Biopsi trakea dengan endoskopi Biopsy – trachea – closed 31.44
89 Biopsi terbuka laring atau trakea Biopsy - larynx/-trachea -open 31.45
90 Eksisi lesi trakea Excision – lesion -trachea 31.5
91 Laringofisure Laryngofissure 30.29
92 Hecting laserasi laring Suture - larynx 31.61
93 Hecting laserasi laring Suture of laceration of larynx 31.61
94 Penutupan fistel laring Clouser of fistula of larynx 31.62
95 Revisi laringostomi/ repair stoma Revision of laryngostomy 31.63
96 Reparasi fraktur laring Repair of laryngeal of other 31.64
97 Eksisi neoplasma laring dengan laser Repair - larynx 31.69
98 Penutupan fistel trakea Closure – fistula - trachea 31.72
Penutupan stoma trakeostomi dengan
99 Closure - tracheostomy 31.72
repair trakea
100 Revisi trakeostomi Revision - tracheoctomy 31.74
Rekonstruksi trakea dan konstruksi Tracheoplasty - with artificial
101 31.75
laring larynx
102 Lisis penyempitan trakea/laring Lysi – adhesions - trachea 31.92
103 Penggantian stent laring/trakea Replacement - Laryngeal stent 31.93
104 Pemasangan T-Tube/ganti T stent Replacement – stent - trachea 31.93
105 Injeksi obat terapetik ke trakea Injection - trachea 31.94
106 Fistulasasi trakeoesofagus Fistulization -tracheoesophageal 31.95
Bronchoscopy - through
107 Bronkoskopi melalui stoma 33.21
tracheostomy
108 Bronkoskopi fiber optik Bronchoscopy - fiberoptic 33.22
109 Bronkoskopi Bronchoscopy 33.23
110 Biopsi bronkus dengan endoskopi Bronchoscopy - with biopsy 33.24
111 Ligasi arteri karotis eksterna Ligation – artery - external carotid 21.06
Biopsi eksisi kelenjar limfe leher
112 Excision - lymph structure 40.29
simpel
Biopsi insisi kelenjar limfe leher Excision – lymph, lymphatic -
113 40.29
simpel node(simple)
Excision - lymph,lymphatic -
114 Eksisi kelenjar limfe regional 40.3
regional
Excision – node – lymphatic
115 Diseksi leher selektif dirainage area (inchuding skin, 40.3
subcutaneous tissue, and fat)
Dissection – neck radical –
116 Diseksi leher radikal unilateral 40.41
unilatral
Dissection - see also excision -
117 Diseksi leher radikal modifikasi 40.42
neck,radical modifikasi(unilteral)
Dissection - see also excition-
118 Diseksi leher radikal bilateral 40.42
neck,radical bilteral
119 Esofagotomi 1/3 proksimal Esophgotomy 42.0
Incision – cont -
120 Insisi web esofagus 42.02
esophagus.esophageal NEC - web
121 Esofagostomi Esophagostomy 42.10
122 Esofagostomi servikal Esophagostomy – cervical 42.11
123 Esofagoskopi Esophagoscopy 42.23
Biopsy – Esophagus –
124 Biopsi esofagus per endoskopi 42.24
closed(endoscopic)
Biopsy – Esophagus –
125 Biopsi esofagus per endoskopi 42.24
closed(endoscopic)
Biopsy – Esophagus –
126 Biopsi esofagus per endoskopi 42.24
closed(endoscopic)
Excision – Diverticulus -
127 Eksisi divertikulum esofagus 42.40
Esophagus
Tindakan esofagus kompleks (eksisi, Excision – Esophagus(Local) -
128 42.33
varises) Endoscopic
129 Reseksi esofagus Reesection - esophagus 42.41
130 Reparasi fistel esofagus Repair – esophagus - fistula 42.84
131 Reparasi striktur esofagus Repair – esophagus – stricture 42.85
132 Dilatasi esofagus Dilatation - esophagus K22.8
133 Dilatasi esofagus Dilatation of esophagus 42.92
134 Dilatasi esofagus Dilatation of esophagus 42.92
135 Mandibulektomi parsial Partial mandibulectomy 76.31
Partial ostectomy of other facial
136 Maksilektomi parsial 76.39
bone
137 Maksilektomi total Hemimaxillectomy 76.39
138 Maksilektomi radikal Hemimaxillectomy 76.39
139 Mandibulektomi total Mandibulectomy -Total 76.42
Reduksi terbuka fraktur malar dan
140 Reduction - Malar - Open 76.72
zigoma
Reduction – fracture – maxilla –
141 Reduksi terbuka fraktur maksila 76.74
open
Reduction – fracture – mandible –
142 Reduksi terbuka fraktur mandibula 76.76
open
143 Eksisi kulit luas Excision – skin – radical (wide) 86.4
144 Esofageal manometri Manometry – esophageal 89.32
Intubasi dengan Flexible Insertion –Tube
145 96.04
Bronkoskopi - Endotracheal
146 Pembersihan kanul trakeostomi Toilette - Tracheostomy 96.55
Lavage –Bronchus NEC –Trachea
147 Cuci trakea dan bronkus 96.56
NEC
Replacement
148 Penggantian NGT 97.01
- Nasogastric
Replacement – tube -
149 Penggantian kanul trakeostomi 97.23
tracheostomy
150 Pengangkatan kanul trakeostomi Removal – tube - tracheostomy 97.37
Removal -
151 Ekstraksi benda asing esofagus 98.02
esophafus(intraluminal)
152 Ekstraksi benda asing laring Removal - larynx(intraluminal) 98.14
Removal – foreign body – trachea 98.15
153 Ekstraksi benda asing trakea
(instraluminal)
Removal – foreign body – 98.15
154 Ekstraksi benda asing bronkus
bronkus (instraluminal)
Excision – lesion – nasal sinus – 22.61
155 Biopsi sinonasal app gingivobuccal
with Caldwell - Luc approach
156 Biopsi Lidah Biopsy – tongue 25.01
157 Hecting laserasi lidah Suture – tongue 25.51
158 Frenektomi lingual Frenectomy – lingual 25.92
159 Insisi drenase kelenjar liur Incision – salivary gland or duct 26.0
Biopsy – salivary gland or duct –
160 Biopsi kelenjar liur 26.12
open
Marsupialization – ranula,salivary
161 Marsupialisasi kista kelenjar liur 26.21
gland
Suture (laceration) – salivary
162 Hecting laserasi kelenjar liur 26.41
gland
163 Probing saluran liur Probing – salivary duct 26.91
Insisi drenase abses wajah,
164 Drainage – Facial region 27.0
submandibula, angina ludovici
165 Biopsi bibir Biopsy - lip 27.23
166 Biopsi mulut/ basis lidah Biopsy - mouth 27.24
167 Biopsi eksisi rongga mulut Procedure - oral cavity 27.29
168 Frenektomi labial Frenectomy - labial 27.41
169 Hecting laserasi bibir Suture (laceration) - Lip 27.51
170 Hecting laserasi mulut Suture (laceration) - Mouth 27.52
171 Penutupan fistel mulut Closure - Fistula - Mouth 27.53
Removal - Foreign body - Mouth
172 Ekstraksi benda asing mulut 98.01
(intraluminal)