Lampiran Surat

No: 524/VII-03/0418

FORMULIR ASSESMENT REVIEW 144 DIA

Dapat Tuntas Ditangani di FKTP
(Beri tanda Checklist (√) pada salah satu
No 144 Diagnosa kolom)

YA TIDAK

1 Abortus spontan komplit Unspecified abortion, complete,

without complication

2 Alergi makanan Dermatitis due to ingested food

3 Anemia defisiensi besi pada Anemia defisiensi besi pada

kehamilan kehamilan

4 Askariasis Ascariaris unspecified

5 Asma Bronkial Asthma

6 Astigmatism ringan Astigmatisme

7 Bell's Palsy Bells’ palsy

8 Benda asing di hidung Foreign body in nostril

Foreign body on external eye,

9 Benda asing di konjungtiva
part unspecified

10 Blefaritis Blepharitis

11 Bronkitis akut Acute bronchitis, unspecified

12 Buta senja Night blindness

 Dapat Tuntas Ditangani di FKTP
(Beri tanda Checklist (√) pada salah satu
No 144 Diagnosa kolom)

YA TIDAK

13 Cutaneus larva migran Hookworm disease, unspecified

14 Demam dengue, DHF Dengue haemorrhagic fever

Typhoid fever
15 Demam tifoid

Dermatitis atopik (kecuali Dermatitis atopik (kecuali

16
recalcitrant) recalcitrant)

17 Dermatitis kontak iritan Irritant contact dermatitis

18 Dermatitis numularis Dermatitis numularis

Seborrhoeic dermatitis
19 Dermatitis seboroik

Tinea barbae and tinea capitis

20 Tinea kapitis

21 Tinea barbae Tinea barbae and tinea capitis

22 Tinea Imbricate Other dermatophytoses

23 Tinea korporis Tinea corporis

24 Tinea manum Tinea manuum

25 Tinea unguium Tinea unguium

26 Tinea kruris Tinea cruris

 Dapat Tuntas Ditangani di FKTP
(Beri tanda Checklist (√) pada salah satu
No 144 Diagnosa kolom)

YA TIDAK

Tinea pedis
27 Tinea pedis

28 Diabetes melitus tipe 1 Diabetes insulin dependent

Non-insulin-dependent diabetes
29 Diabetes melitus tipe 2 mellitus

30 Disentri basiler dan amuba Acute amoebic dysentery

31 Dislipidemia Hiperlipidemia

32 Epistaksis Epistaxis

Generalized skin eruption due

33 Exanthematous drug eruption
to drugs and medicament

Acute pharyngitis, unspecified

34 Faringitis

35 Filariasis Filariasis

Abscess, furuncle and carbuncle

36 Furunkel pada hidung
of nose

37 Gastritis Gastritis, unspecified

38 Gastroenteritis (termasuk kolera, Diarrhoea and gastroenteritis of

giardiasis) presumed infection origin

39 Gonore Gonococcal infection,

unspecified

40 Hemoroid grade 1-2 Haemorrhoids

 Dapat Tuntas Ditangani di FKTP
(Beri tanda Checklist (√) pada salah satu
No 144 Diagnosa kolom)

YA TIDAK

41 Hepatitis A Acute Hepatitis A

Herpesviral infection,
42 Herpes simpleks tanpa komplikasi
unspecified

43 Herpes zoster tanpa komplikasi Zoster without complication

44 Hipermetropia ringan Hypermetropia

Essential (primary)
45 Hipertensi esensial hypertension

46 Hiperuricemia (Gout) Gout

hypoglycaemia unspecified
47 Hipoglikemia ringan

Asymptomatic Human
48 HIV AIDS tanpa komplikasi Immunodeficiency Virus (HIV)
infection status

Hordeolum and other deep

49 Hordeolum
inflammation of eyelid

Omphalitis of newborn with or

50 Infeksi pada umbilikus
without mild haemorrhage

51 Infeksi saluran kemih Urinary tract infection, site not

specified

52 Influenza Influenza, virus not identified

53 Insomnia Insomnia non organik pada

psikiatri

54 Intoleransi makanan Malabsorption due to

intolerance
 Dapat Tuntas Ditangani di FKTP
(Beri tanda Checklist (√) pada salah satu
No 144 Diagnosa kolom)

YA TIDAK

55 Kandidiasis mulut Candidiasis unspecified

Single spontaneous delivery,

56 Kehamilan normal
unspecified

57 Kejang demam Febrile convulsions

Other Ingested (parts of

58 Keracunan makanan
plant(s))

59 Konjungtivitis Conjunctivitis, unspecified

60 Laringitis Acute laryngitis

Leprosy [Hansen disease]

61 Lepra

62 Leptospirosis (tanpa komplikasi) Leptospirosis, unspecified

63 Limfadenitis Lymphadenitis Acute

64 Lipoma Benign lipomatous neoplasm

65 Luka bakar derajat 1 dan 2 burn and corrosion, body region

unspecified

66 Malaria Unspecified malaria

67 Malnutirisi energi-protein Unspecified protein-energy

malnutrition

68 Mastitis Inflammatory disorders of

breast
 Dapat Tuntas Ditangani di FKTP
(Beri tanda Checklist (√) pada salah satu
No 144 Diagnosa kolom)

YA TIDAK

Otherdisorders of lacrimal
69 Mata kering
gland

Migraine, unspecified
70 Migren

71 Miliaria Miliaria, unspecified

72 Miopia ringan Myopia

73 Moluskum kontagiosum Molluscum contagiosum

Measles without complication

74 Morbili tanpa komplikasi
(Measles NOS).

Diaper (napkin) dermatitis

75 Napkin eczema

76 Obesitas obesity unspecified

Otitis externa, unspecified

77 Otitis eksterna

78 Otitis media akut Acute serous otitis media

79 Parotitis Mumps

Pediculosis due to Pediculus

80 Pedikulosis kapitis humanus capitis

81 Penyakit cacing tambang Ankylostomiasis

Other specified disorders of eye

82 Perdarahan subkonjungtiva and adnexa
 Dapat Tuntas Ditangani di FKTP
(Beri tanda Checklist (√) pada salah satu
No 144 Diagnosa kolom)

YA TIDAK

83 Pertusis Pertusis

84 Pitiriasis rosea Pitiriasis rosea

85 Pitiriasis versikolor Pityriasis versicolor

86 Pneumonia, bronkopneumonia Bronchopneumonia, unspecified

Presbyopia
87 Presbiopia

88 Reaksi anafilaktik Anaphylactic shock, unspecified

89 Reaksi gigitan serangga Venom of other arthropods

Gastro-oesophageal reflux
90 Refluks gastroesofageal
disease without oesophagitis

Acute nasopharyngitis
91 Rhinitis akut
(common cold)

92 Rhinitis alergika Allergic rhinitis, unspecified

93 Rhinitis vasomotor Vasomotor rhinitis

94 Ruptur perineum tingkat 1-2 First degree perineal laceration

during delivery

95 Serumen prop Impacted cerumen

96 Skabies Scabies
 Dapat Tuntas Ditangani di FKTP
(Beri tanda Checklist (√) pada salah satu
No 144 Diagnosa kolom)

YA TIDAK

97 Skistosomiasis Skistosomiasis unspecified

98 Strongiloidiasis Strongyloidiasis

99 Taeniasis Taeniasis

100 Tension headache Tension–type headache

101 Tetanus Other tetanus

102 Tonsilitis Acute tonsillitis

Respiratory tuberkulosis,
103 Tuberkulosis paru tanpa komplikasi bacteriologically and
histologically confirmed

104 Urtikaria (akut & kronis) Urticaria

105 Vaginitis Acute Vaginitis

Varicella without complication

106 Varisela tanpa komplikasi (Varicella NOS)

107 Vertigo (Benign paroxysmal Dizziness and giddiness

positional vertigo)

108 Veruka vulgaris Viral warts

109 Vulvitis Acute vulvitis

110 Gangguan somatoform Somatoform disorders

 Dapat Tuntas Ditangani di FKTP
(Beri tanda Checklist (√) pada salah satu
No 144 Diagnosa kolom)

YA TIDAK

Entropion and trichiasis of

111 Trikiasis
eyelid

112 Episkleritis Episcleritis

113 Mabuk perjalanan Mabuk perjalanan

114 Ulkus mulut (aptosa, herpes) Stomatitis and related lesions

Acute tubulo-interstitial
115 Pielonefritis tanpa komplikasi nephritis (applicable to: acute
pyelonephritis)

116 Fimosis Phimosis

117 Parafimosis Paraphimosis

Complication associated with

Sindrom duh (discharge) genital
118 artificial fertilization,
(gonore dan nongonore)
unspecified

Urinary tract infection, site not

119 Infeksi saluran kemih bagian bawah specified

120 Vaginosis bakterialis Acute Vaginitis

121 Salpingitis Salpingitis

122 Abses folikel rambut atau kelenjar *tidak ditemukan Panduan

sebasea Klinis di KMK

Cracked nipple associated with

the
123 Cracked nipple puerperium; Cracked nipple
associated with lactation
Retracted nipple associated
with the
124 Inverted nipple puerperium; Retracted nipple
associated with
lactation
 Dapat Tuntas Ditangani di FKTP
(Beri tanda Checklist (√) pada salah satu
No 144 Diagnosa kolom)

YA TIDAK

125 Defisiensi vitamin Defisiensi vitamin

*tidak ditemukan Panduan

126 Defisiensi mineral
Klinis di KMK

Iron Deficiency Anemias

127 Anemia defisiensi besi

Varicose veins of lower

extremities with ulcer; Ulcer of
128 Ulkus pada tungkai
lower limb, notelsewhere
classified

129 Sifilis stadium 1 dan 2 SIFILIS

130 Impetigo Impetigo

131 Impetigo ulseratif (ektima) Impetigo

132 Folikulitis superfisialis Pioderma

Cutaneous abscess, furuncle

133 Furunkel, karbunkel
and carbuncle

134 Eritrasma Erythrasmay

135 Erisipelas Erysipelas

136 Skrofuloderma Tuberculosis of skin and

subcutaneous tissue

137 Kandidosis mukokutan ringan Candidiasis unspecified

138 Pedikulosis pubis Pthiriasis

 Dapat Tuntas Ditangani di FKTP
(Beri tanda Checklist (√) pada salah satu
No 144 Diagnosa kolom)

YA TIDAK

139 Akne vulgaris ringan Acne vulgaris

140 Hidradenitis supuratif Hidradenitis suppurativa

141 Dermatitis perioral Perioral dermatitis

Open wound of unspecified

142 Vulnus laseratum, punctum
body region

*tidak ditemukan Panduan

143 Kekerasan tumpul
Klinis di KMK

*tidak ditemukan Panduan

144 Kekerasan tajam
Klinis di KMK
ENT REVIEW 144 DIAGNOSA DI FKTP
Keterangan Keterbatasan
(Uraikan Keterangan Alasan Diagnosa Tidak Tertangani di FKTP) Tercantum dalam PPK dokter
di FKTP berdasar KMK
514/2015
Kompetensi Sarana dan Prasarana

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA
 Keterangan Keterbatasan
(Uraikan Keterangan Alasan Diagnosa Tidak Tertangani di FKTP) Tercantum dalam PPK dokter
di FKTP berdasar KMK
514/2015
Kompetensi Sarana dan Prasarana

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA
 Keterangan Keterbatasan
(Uraikan Keterangan Alasan Diagnosa Tidak Tertangani di FKTP) Tercantum dalam PPK dokter
di FKTP berdasar KMK
514/2015
Kompetensi Sarana dan Prasarana

ADA

TIDAK ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA
 Keterangan Keterbatasan
(Uraikan Keterangan Alasan Diagnosa Tidak Tertangani di FKTP) Tercantum dalam PPK dokter
di FKTP berdasar KMK
514/2015
Kompetensi Sarana dan Prasarana

ADA

ADA

ADA

ADA

ADA

ADA

ADA

3A

ADA

ADA

ADA

ADA

ADA

ADA
 Keterangan Keterbatasan
(Uraikan Keterangan Alasan Diagnosa Tidak Tertangani di FKTP) Tercantum dalam PPK dokter
di FKTP berdasar KMK
514/2015
Kompetensi Sarana dan Prasarana

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA
 Keterangan Keterbatasan
(Uraikan Keterangan Alasan Diagnosa Tidak Tertangani di FKTP) Tercantum dalam PPK dokter
di FKTP berdasar KMK
514/2015
Kompetensi Sarana dan Prasarana

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA
 Keterangan Keterbatasan
(Uraikan Keterangan Alasan Diagnosa Tidak Tertangani di FKTP) Tercantum dalam PPK dokter
di FKTP berdasar KMK
514/2015
Kompetensi Sarana dan Prasarana

TIDAK ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA
 Keterangan Keterbatasan
(Uraikan Keterangan Alasan Diagnosa Tidak Tertangani di FKTP) Tercantum dalam PPK dokter
di FKTP berdasar KMK
514/2015
Kompetensi Sarana dan Prasarana

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA
 Keterangan Keterbatasan
(Uraikan Keterangan Alasan Diagnosa Tidak Tertangani di FKTP) Tercantum dalam PPK dokter
di FKTP berdasar KMK
514/2015
Kompetensi Sarana dan Prasarana

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

TIDAK ADA

TIDAK ADA

ADA

ADA
 Keterangan Keterbatasan
(Uraikan Keterangan Alasan Diagnosa Tidak Tertangani di FKTP) Tercantum dalam PPK dokter
di FKTP berdasar KMK
514/2015
Kompetensi Sarana dan Prasarana

TIDAK ADA

TIDAK ADA

ADA

ADA

TIDAK ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA

ADA
 Keterangan Keterbatasan
(Uraikan Keterangan Alasan Diagnosa Tidak Tertangani di FKTP) Tercantum dalam PPK dokter
di FKTP berdasar KMK
514/2015
Kompetensi Sarana dan Prasarana

ADA

ADA

ADA

ADA

TIDAK ADA

TIDAK ADA
DX Flag
Typhoid fever YA
Bacterial foodborne intoxicati.. YA
Acute amoebic dysentery YA
Tuberculosis of lung, confirme.. YA
Tuberculosis of skin and subcu.. YA
Leptospirosis icterohaemorrhag.. YA
Indeterminate leprosy YA
Other tetanus YA
Whooping cough due to Bordetella pertussis YA
Erysipelas YA
Primary genital syphilis YA
Cardiovascular syphilis YA
Gonococcal infection of lower .. YA
Dengue fever [classical dengue.. YA
Dengue haemorrhagic fever YA
Chikungunya virus disease YA
Herpesviral vesicular dermatit.. YA
Herpesviral infection, unspeci.. YA
Varicella without complication YA
Zoster without complication YA
Measles without complication YA
Viral warts YA
Molluscum contagiosum YA
Hepatitis A with hepatic coma YA
Acute hepatitis B with delta-a.. YA
Acute delta-(super)infection o.. YA
Acute hepatitis C YA
Acute hepatitis E YA
Unspecified human immunodefici.. YA
Mumps orchitis YA
Tinea barbae and tinea capitis YA
Tinea unguium YA
Tinea manuum YA
Tinea pedis YA
Tinea corporis YA
Tinea cruris YA
Dermatophytosis, unspecified YA
Pityriasis versicolor YA
Plasmodium falciparum malaria .. YA
Plasmodium vivax malaria with .. YA
Plasmodium malariae malaria wi.. YA
Plasmodium ovale malaria YA
Unspecified malaria YA
Schistosomiasis due to Schisto.. YA
Taenia solium taeniasis YA
Filariasis due to Wuchereria b.. YA
Ancylostomiasis YA
Hookworm disease, unspecified YA
Pediculosis due to Pediculus h.. YA
Intestinal strongyloidiasis YA
Pediculosis due to Pediculus h.. YA
Phthiriasis YA
Scabies YA
Benign lipomatous neoplasm, un.. YA
Iron deficiency anaemia second.. YA
Anaemia, unspecified YA
Insulin-dependent diabetes mel.. YA
Non-insulin-dependent diabetes.. YA
Hypoglycaemia, unspecified YA
Unspecified protein-energy mal.. YA
Vitamin deficiency, unspecifie.. YA
Copper deficiency YA
Obesity due to excess calories YA
Glycogen storage disease YA
Hyperlipidaemia, unspecified YA
Hyperuricaemia without signs o.. YA
Somatization disorder YA
Migraine without aura [common .. YA
Tension-type headache YA
Disorders of initiating and ma.. YA
Bell's palsy YA
Hordeolum and other deep infla.. YA
Blepharitis YA
Entropion and trichiasis of ey.. YA
Mucopurulent conjunctivitis YA
Conjunctival haemorrhage YA
Episcleritis YA
Keratoconjunctivitis YA
Hypermetropia YA
Myopia YA
Astigmatism YA
Presbyopia YA
Subjective visual disturbances YA
Abscess of external ear YA
Impacted cerumen YA
Otitis media, unspecified YA
Meniere's disease YA
Essential (primary) hypertensi.. YA
Varicose veins of lower extrem.. YA
Internal thrombosed haemorrhoi.. YA
Nonspecific mesenteric lymphad.. YA
Acute nasopharyngitis [common .. YA
Streptococcal pharyngitis YA
Streptococcal tonsillitis YA
Acute laryngitis YA
Influenza with pneumonia, infl.. YA
Adenoviral pneumonia YA
Vasomotor rhinitis YA
Allergic rhinitis, unspecified YA
Abscess, furuncle and carbuncl.. YA
Bronchitis, not specified as a.. YA
Asthma, unspecified YA
Gastro-oesophageal reflux dise.. YA
Other acute gastritis YA
Noninfective gastroenteritis a.. YA
Impetigo [any organism] [any s.. YA
Cutaneous abscess, furuncle an.. YA
Cutaneous abscess, furuncle an.. YA
Cutaneous abscess, furuncle an.. YA
Pyoderma YA
Erythrasma YA
Local infection of skin and su.. YA
Besnier's prurigo YA
Seborrhoea capitis YA
Irritant contact dermatitis du.. YA
Generalized skin eruption due .. YA
Localized skin eruption due to.. YA
Dermatitis due to ingested foo.. YA
Nummular dermatitis YA
Dermatitis, unspecified YA
Pityriasis rosea YA
Allergic urticaria YA
Acne vulgaris YA
Perioral dermatitis YA
Hidradenitis suppurativa YA
Miliaria, unspecified YA
Tubulo-interstitial nephritis .. YA
Urinary tract infection, site .. YA
Redundant prepuce, phimosis an.. YA
Other specified disorders of m.. YA
Inflammatory disorders of brea.. YA
Other signs and symptoms in br.. YA
Acute salpingitis and oophorit.. YA
Acute vaginitis YA
Acute vulvitis YA
Other specified inflammation o.. YA
Abdominal pregnancy YA
Spontaneous abortion, incomple.. YA
Malnutrition in pregnancy YA
First degree perineal lacerati.. YA
Second degree perineal lacerat.. YA
Third degree perineal lacerati.. YA
Fourth degree perineal lacerat.. YA
Cracked nipple associated with.. YA
Epistaxis YA
Febrile convulsions YA
Foreign body in conjunctival s.. YA
Foreign body in nostril YA
Burn of first degree, body reg.. YA
Burn of second degree, body re.. YA
Motion sickness YA
Anaphylactic shock, unspecifie.. YA
Accidental puncture and lacera.. YA
 1 Abortus
spontan
13 Alergi
komplit
makanan
25 Anemia
defisiensi
37 Askariasis
besi pada
49 Asma
kehamila
Bronkial
n
61 Astigmati
sm ringan
73 Bell's
Palsy
85 Benda
asing di
97 Benda
hidung
asing di
109 Blefaritis
konjungti
Bronkitis
121 va
akut
133 Buta
senja
145 Cutaneus
larva
157 Demam
migran
dengue,
169 Demam
DHF
tifoid
181 Dermatiti
s atopik
193 Dermatiti
(kecuali
s kontak
205 Dermatiti
recalcitra
iritan
sDermatiti
217 nt)
numularis
s seboroik
229 Tinea
kapitis
241 Tinea
barbae
253 Tinea
Imbricate
265 Tinea
korporis
277 Tinea
manum
289 Tinea
unguium
301 Tinea
kruris
313 Tinea
pedis
325 Diabetes
melitus
337 Diabetes
tipe 1
melitus
349 Disentri
tipe 2
basiler
361 Dislipide
dan
mia
373 Epistaksis
amuba
385 Exanthem
atous
397 Faringitis
drug
Filariasis
409 eruption
421 Furunkel
pada
433 Gastritis
hidung
445 Gastroent
eritis
457 Gonore
(termasuk
469 Hemoroid
kolera,
grade 1-2
giardiasis)
481 Hepatitis
A
493 Herpes
simpleks
505 Herpes
tanpa
zoster
517 Hipermet
komplikas
tanpa
ropia
ikomplikas
ringan
i
 529 Hipertens
i esensial
541 Hiperuric
emia
553 Hipoglike
(Gout)
mia AIDS
565 HIV
ringan
tanpa
577 Hordeolu
komplikas
m
589 Infeksi
i
pada
601 Infeksi
umbilikus
saluran
613 Influenza
kemih
625 Insomnia
637 Intolerans
i
649 Kandidiasi
makanan
s mulut
661 Kehamila
n normal
673 Kejang
demam
685 Keracuna
n
697 Konjungti
makanan
vitis
709 Laringitis
721 Lepra
733 Leptospir
osis
745 Limfadeni
(tanpa
tis
Lipoma
757 komplikas
i)
769 Luka
bakar
781 Malaria
derajat 1
793 Malnutiris
dan 2
i energi-
805 Mastitis
protein
817 Mata
kering
829 Migren
841 Miliaria
853 Miopia
ringan
865 Molusku
m
877 Morbili
kontagios
tanpa
889 Napkin
um
komplikas
eczema
901 iObesitas
913 Otitis
eksterna
925 Otitis
media
937 Parotitis
akut
949 Pedikulosi
s kapitis
961 Penyakit
cacing
973 Perdarah
tambang
an
985 Pertusis
subkonju
Pitiriasis
997 ngtiva
rosea
1009 Pitiriasis
versikolor
1021 Pneumoni
a,
1033 Presbiopi
bronkopn
aReaksi
1045 eumonia
anafilaktik
1057 Reaksi
gigitan
serangga
1069 Refluks
gastroeso
1081 Rhinitis
fageal
akut
1093 Rhinitis
alergika
1105 Rhinitis
vasomoto
1117 Ruptur
rperineum
1129 Serumen
tingkat
prop 1-
1141 Skabies
2
1153 Skistosom
iasis
1165 Strongiloi
diasis
1177 Taeniasis
1189 Tension
headache
1201 Tetanus
1213 Tonsilitis
1225 Tuberkulo
sis paru
1237 Urtikaria
tanpa
(akut &
Vaginitis
1249 komplikas
kronis)
i
1261 Varisela
tanpa
1273 Vertigo
komplikas
(Benign
1285 Veruka
iparoxysm
vulgaris
Vulvitis
1297 al
positional
1309 Gangguan
vertigo)
somatofo
1321 Trikiasis
rm
1333 Episkleriti
s
1345 Mabuk
perjalana
1357 Ulkus
n
mulut
1369 Pielonefri
(aptosa,
tis tanpa
1381 Fimosis
herpes)
komplikas
1393 iParafimos
is
1405 Sindrom
duh
1417 Infeksi
(discharg
saluran
1429 Vaginosis
e) genital
kemih
bakteriali
1441 (gonore
Salpingitis
bagian
sdan
bawah
1453 Abses
nongonor
folikel
1465 Cracked
e)
rambut
nipple
1477 Inverted
atau
nipple
1489 kelenjar
Defisiensi
sebasea
vitamin
1501 Defisiensi
mineral
1513 Anemia
defisiensi
1525 Ulkus
besi
pada
1537 Sifilis
tungkai
stadium 1
1549 Impetigo
dan 2
1561 Impetigo
ulseratif
1573 Folikulitis
(ektima)
superfisial
1585 Furunkel,
is
karbunkel
1597 Eritrasma
1609 Erisipelas
1621 Skrofulod
erma
1633 Kandidosi
s
1645 Pedikulosi
mukokuta
s pubis
1657 Akne
n ringan
vulgaris
1669 Hidradeni
ringan
tis
1681 Dermatiti
supuratif
s perioral
1693 Vulnus
laseratum
1705 Kekerasa
,npunctum
tumpul
1717 Kekerasa
n tajam

1 Abortus Unspecifi
spontan ed
13 Alergi
komplit
Dermatiti
abortion,
makanan s due to
25 Anemia Iron complete,
ingested
defisiensi deficiency
without
37 besi pada Ascariaris
Askariasis food
anaemia
complicati
unspecifie
49 kehamila Asthma
Asma
on
d
Bronkial
n
61 Astigmati Astigmati
sm ringan sme
73 Bell's Bells’
Palsy
Benda palsy
Foreign
85
asing di body in
97 Benda
hidung
Foreign
nostril
asing di body on
109 Blefaritis Blephariti
konjungti external
Bronkitis sAcute
121 va eye, part
akut
Buta bronchitis
unspecifie
Night
133 ,blindness
senja d
145 Cutaneus Hookwor
unspecifie
larva m
d
157 Demam
migran
Dengue
disease,
dengue, haemorrh
169 Demam
DHF
Typhoid
unspecifie
agic fever
tifoid
Dermatiti fever
d
Atopic
181
s atopik dermatitis
193 Dermatiti
(kecuali
Irritant
sDermatiti
kontak contact
Other
205 recalcitra
iritan dermatitis
snt) atopic
217 Dermatiti
numularis
Seborrhoe
seboroik dermatitis
sTinea ic
Tinea
229 dermatitis
kapitis barbae
241 Tinea Tinea
and tinea
barbae barbae
253 Tinea Other
capitis
Imbricate and tinea
dermatop
265 Tinea Tinea
capitis
hytoses
korporis corporis
277 Tinea Tinea
manum manuum
289 Tinea Tinea
unguium unguium
301 Tinea Tinea
kruris cruris
313 Tinea Tinea
pedis
Diabetes pedis
Diabetes
325
melitus insulin
337 Diabetes
tipe 1
Non-
dependen
melitus insulin-
349 Disentri
tipe 2
Acute
tdependen
basiler amoebic
361 Dislipide
dan tHiperlipid
diabetes
dysentery
mia
Epistaksis emia
mellitus
Epistaxis
373 amuba
385 Exanthem Generaliz
atous ed skin
397 Faringitis
drug
Acute
eruption
pharyngiti
409 Filariasis
eruption Filariasis
due
s, to
421 Furunkel drugsAbscess,
unspecifie and
pada medicam
furuncle
d
433 Gastritis
hidung
Gastritis,
ent
and
unspecifie
445 Gastroent Diarrhoea
carbuncle
d
eritis and
of nose
457 Gonore Gonococc
(termasuk gastroent
Hemoroid al
469 kolera, Haemorrh
eritis of
grade 1-2 infection,
giardiasis)
Hepatitis oids
presumed
Acute
481 unspecifie
A
Herpes infection
Hepatitis
d
Herpesvir
493 origin
A
simpleks al
505 Herpes
tanpa
Zoster
infection,
zoster
Hipermet without
Hypermet
517 komplikas
tanpa unspecifie
complicati
ropia
i
Hipertens ropia
d
Essential
529 komplikas
ringan on
iHiperuric
i esensial (primary)
Gout
541 hypertens
emia
553 Hipoglike
(Gout)
hypoglyca
ion
mia AIDS emia
565 HIV
ringan
Asympto
unspecifie
tanpa matic
577 komplikas Hordeolu
Hordeolu d
Human
m
Infeksi m and
Omphaliti
589 i Immunod
other
pada sUrinary
of
eficiency
601 Infeksi
umbilikus deep
newborn
saluran tractVirus
inflamma
613 Influenza
kemih
Influenza,
with
(HIV) or
infection,
Insomnia tion
virus
withoutofnot
Insomnia
625 infection
site
eyelid not
identified
Intolerans mild
non
status
specified
Malabsor
637 haemorrh
organik
i ption due
649 Kandidiasi
makanan
Candidiasi
age
pada
to
s mulut sSingle
661 Kehamila psikiatri
intoleranc
n normal unspecifie
Kejang spontane
ed
Febrile
673 ous
demam convulsio
685 Keracuna Other delivery,
ns
n Ingested
unspecifie
697 Konjungti
makanan
Conjuncti
(parts of
vitis d
vitis,
709 Laringitis plant(s))
Acute
unspecifie
laryngitis
721 Lepra Leprosy
d
Leptospir [Hansen
Leptospir
733 disease]
osis osis,
745 Limfadeni
(tanpa
Lymphad
unspecifie
tis
Lipoma enitis Benign
757 komplikas d
Acute
i)
Luka lipomatou
burn and
769 scorrosion,
bakar
781 Malaria Unspecifi
derajat 1 neoplasm
body
ed
793 Malnutiris
dan 2 Unspecifi
region
energi- malaria
iMastitis ed
805 protein unspecifie
Inflamma
protein-
Mata d
tory
Otherdiso
817 energy
disorders
kering rders of
malnutriti
829 Migren Migraine, of breast
lacrimal
on
unspecifie
841 Miliaria Miliaria,
gland
d
unspecifie
853 Miopia Myopia
d
ringan
Molusku Molluscu
865
m m
877 Morbili
kontagios
Measles
contagios
tanpa without
889 Napkin
um
komplikas
Diaper
um
complicati
eczema (napkin)
901 iObesitas on obesity
dermatitis
Otitis unspecifie
(Measles
Otitis
913
eksterna d NOS).
externa,
unspecifie
d
 925 Otitis Acute
media serous
937 Parotitis
akut
Mumps
otitis
949 Pedikulosi Pediculosi
media
s kapitis s due to
961 Penyakit Ankylosto
Pediculus
cacing miasis
973 Perdarah
tambang
Other
humanus
an specified
capitis
985 subkonju *tidak
Pertusis
disorders
ditemuka
997 Pitiriasis
ngtiva of
n eye
rosea
1009 Pitiriasis and Pityriasis
Panduan
versikolor
Pneumoni adnexa
versicolor
Klinis di
Bronchop
1021
a, KMK
neumonia
1033 Presbiopi
bronkopn
Presbyopi
,a
aReaksi
1045 eumonia Anaphylaunspecifie
anafilaktik ctic
d shock,
1057 Reaksi Venom
unspecifie
of
gigitan
Refluks other
Gastro-
1069 serangga d
gastroeso arthropod
oesophag
1081 Rhinitis
fageal
Acute
seal reflux
akut nasophar
1093 Rhinitis Allergicdisease
alergika yngitis
rhinitis,
1105 Rhinitis without Vasomoto
(common
unspecifie
vasomoto
Ruptur roesophagi
rhinitis
cold)
First
1117 r d
tis
perineum degree
1129 Serumen
tingkat
Impacted
1- perineal
prop cerumen
1141 Skabies
2 Scabies
laceration
1153 Skistosom during Skistosom
iasis
Strongiloi delivery
iasis
Strongyloi
1165 unspecifie
diasis diasis
1177 Taeniasis Taeniasis
d
1189 Tension Tension–
headache type
1201 Tetanus Other headache
tetanus
1213 Tonsilitis Acute
tonsillitis
1225 Tuberkulo Respirato
sis paru ry
1237 Urtikaria
tanpa
Urticaria
tuberkulo
(akut &
Vaginitis sis, Acute
1249 komplikas
kronis)
i
Varisela Vaginitis
bacteriolo
Varicella
1261
tanpa gically
without
1273 Vertigo
komplikas
Dizziness
and
complicati
(Benign and
1285 Veruka Viral
iparoxysm histologic
on
giddiness
vulgaris
Vulvitis warts ally
(Varicella
Acute
1297 al
positional
Gangguan confirmed
NOS)
Vaginitis
Somatofo
1309
vertigo)
somatofo rm
1321 Trikiasis
rm
Entropion
disorders
and
1333 Episkleriti Episcleriti
trichiasis
s s*tidak
1345 Mabuk of eyelid
perjalana
Ulkus ditemuka
Stomatitis
1357 n n
mulut and
1369 Pielonefri
(aptosa,
Acute
Panduan
related
tis tanpa tubulo-
Klinis di
1381 Fimosis
herpes) Phimosis
komplikas lesions
interstitial
KMK
1393 iParafimos nephritis
Paraphim
is
Sindrom osis
(applicabl
Complica
1405
duh eUrinary
to:
tion
1417 Infeksi
(discharg acute
associate
saluran tract
1429 Vaginosis
e)
kemih
Acute
genital pyelonep
d with
infection,
bakteriali
Salpingitis Vaginitis
(gonore hritis)
artificial
*tidak
1441 bagian
sdan site not
bawah
Abses fertilizatio
ditemuka
specified
*tidak
1453 nongonor n n,
folikel ditemuka
e)
rambut Panduan unspecifie
n
atau d
Klinis
Panduandi
kelenjar KMK Klinis di
sebasea KMK
1465 Cracked Cracked
nipple nipple
1477 Inverted Retracted
associate
nipple nipple
1489 Defisiensi *tidak
d with the
vitamin associate
ditemuka
1501 Defisiensi puerperiu
*tidak
d
n with the
mineral
Anemia m;
ditemuka
puerperiu
Iron
1513 Panduan
Cracked
n
defisiensi
Ulkus m;
Deficiency
Klinis
Varicose di
1525 besi nipple
Panduan
Retracted
Anemias
pada KMK
veins
associate
Klinis of
di
1537 Sifilis
tungkai
SIFILIS
nipple
lower
stadium 1 d
KMK with
associate
1549 Impetigo
dan 2
Impetigo
extremitie
lactation
Impetigo d with
sImpetigo
with
1561 lactation
ulseratif ulcer;
1573 Folikulitis
(ektima)
Pioderma
Ulcer of
superfisial
1585 Furunkel,
is
Cutaneou
lower
karbunkel sErythrasm
abscess,
1597 Eritrasma limb,furuncle
notelsewh
ay
1609 Erisipelas Erysipelas
and
ere
1621 Skrofulod carbuncle
Tuberculo
classified
erma sis of skin
1633 Kandidosi Candidiasi
and
s sPthiriasis
1645 Pedikulosi
mukokuta subcutan
unspecifie
sAkne
pubis eous
1657 n ringan Acne d
vulgaris
Hidradeni tissue
vulgaris
Hidradeni
1669 ringan
tis tis
1681 Dermatiti
supuratif
Perioral
perioral suppurati
sVulnus dermatitis
Open
1693 va
laseratum wound of
1705 , punctum *tidak
Kekerasa
n tumpul unspecifie
ditemuka
1717 Kekerasa *tidak d body
n tajam n ditemuka
region
Panduan
n
Klinis
Panduandi
KMK
Klinis di
KMK
Diagnosa Pcare (Non Spsesialistik) NO KMK
Malnutrition in pregnancy
139
Mumps orchitis
30
Unspecified protein-energy mal..
60

Nonspecific mesenteric lymphad..

91
Pityriasis rosea 121

Noninfective gastroenteritis a..

105

Dermatitis, unspecified
120
Cutaneous abscess, furuncle an.. 109
Otitis media, unspecified
86

Acute nasopharyngitis [common ..

92
Other acute gastritis
104

Essential (primary) hypertensi..

88

Tuberculosis of skin and subcu..

5
Leptospirosis icterohaemorrhag..
6

Indeterminate leprosy
7
Glycogen storage disease
64
Erysipelas 10

Primary genital syphilis

11

Hyperlipidaemia, unspecified
65
Acne vulgaris

123

Acute salpingitis and oophorit..

133

Dengue fever [classical dengue..

14
Bacterial foodborne intoxicati..
2

Chikungunya virus disease

16
Viral warts
22
Erythrasma
111
Local infection of skin and su.. 112
Tinea unguium 32
Acute vulvitis 135
Acute vaginitis 134

Taenia solium taeniasis

45
Insulin-dependent diabetes mel..
57
Tinea corporis
35

Streptococcal tonsillitis
94

Whooping cough due to Bordetella pertussis

9
Other tetanus
8

Internal thrombosed haemorrhoi..

90
Tinea manuum

33

Plasmodium falciparum malaria ..

39
Plasmodium malariae malaria wi.. 41

Plasmodium ovale malaria

42

First degree perineal lacerati..

140

Gonococcal infection of lower ..

13

Pediculosis due to Pediculus h..

49

Tinea barbae and tinea capitis

31
Schistosomiasis due to Schisto.. 44

Ancylostomiasis
47
Acute laryngitis 95
Other specified disorders of m.. 130
Inflammatory disorders of brea..
131

Vitamin deficiency, unspecifie..

61

Migraine without aura [common ..

68
Phthiriasis
52
Acute hepatitis E
28
Vasomotor rhinitis 98

Tubulo-interstitial nephritis ..

127
Herpesviral vesicular dermatit..
17
Copper deficiency
62

Acute amoebic dysentery

3

Entropion and trichiasis of ey..

74

Disorders of initiating and ma..

70
Bell's palsy
71
Blepharitis
73
Besnier's prurigo 113

Hypoglycaemia, unspecified
59
Hypermetropia 79

Hordeolum and other deep infla..

72

Pityriasis versicolor

38

Unspecified human immunodefici..

29
Obesity due to excess calories
63
Herpesviral infection, unspeci..
18
Conjunctival haemorrhage 76

Dermatophytosis, unspecified
37
Bronchitis, not specified as a..
101

Keratoconjunctivitis
78
Tuberculosis of lung, confirme..
4

Myopia

80
Second degree perineal lacerat.. 141
Abscess of external ear 84
Impacted cerumen 85
Meniere's disease
87
Redundant prepuce, phimosis an.. 129
Other signs and symptoms in br.. 132

Generalized skin eruption due ..

116
Influenza with pneumonia, infl..
96

Varicella without complication

19

Typhoid fever

Tinea pedis
34
Asthma, unspecified 102
Allergic rhinitis, unspecified
99
Abscess, furuncle and carbuncl..
100

Zoster without complication

20

Measles without complication

21
Molluscum contagiosum
23
Acute delta-(super)infection o..
26
Hepatitis A with hepatic coma 24
Acute hepatitis C
27
Acute hepatitis B with delta-a.. 25

Other specified inflammation o..

136

Irritant contact dermatitis du..

115

Dengue haemorrhagic fever

15

Hookworm disease, unspecified

48

Hyperuricaemia without signs o..

66

Somatization disorder
67

Pediculosis due to Pediculus h..

51

Impetigo [any organism] [any s..

106

Urinary tract infection, site ..

128

Streptococcal pharyngitis
93
Cutaneous abscess, furuncle an.. 108

Hidradenitis suppurativa
125
Subjective visual disturbances 83
Unspecified malaria
43
Cardiovascular syphilis 12

Tinea cruris
36
Plasmodium vivax malaria with ..
40
Filariasis due to Wuchereria b.. 46

Intestinal strongyloidiasis

50

Scabies
53
Benign lipomatous neoplasm, un..
54

Iron deficiency anaemia second..

55

Anaemia, unspecified

56

Non-insulin-dependent diabetes..

58
Tension-type headache
69

Mucopurulent conjunctivitis
75

Episcleritis
77
Astigmatism 81

Presbyopia

82

Varicose veins of lower extrem..

89
Adenoviral pneumonia
97

Gastro-oesophageal reflux dise..

103

Cutaneous abscess, furuncle an..

107

Pyoderma
110

Seborrhoea capitis
114
Localized skin eruption due to..
117

Dermatitis due to ingested foo..

118

Nummular dermatitis

119

Allergic urticaria
122

Perioral dermatitis

124

Miliaria, unspecified
126
Abdominal pregnancy
137

Spontaneous abortion, incomple..

138
Third degree perineal lacerati..
142

Fourth degree perineal lacerat..

143

Cracked nipple associated with..

144
Epistaxis
Febrile convulsions

Foreign body in conjunctival s..

Foreign body in nostril

Burn of first degree, body reg..

Burn of second degree, body re..

Motion sickness

Anaphylactic shock, unspecifie..

Accidental puncture and lacera..

 144 Diagnosa
(SE JUKNIS PEER REVIEW) Nama DX di Pcare yg difalg Non Spesilistik
INDONESIA ENGLISH
Akne vulgaris ringan Acne vulgaris
Acne vulgaris
Disentri basiler dan amuba Acute amoebic
dysentery Acute amoebic dysentery
Laringitis Acute laryngitis
Acute laryngitis
Rhinitis akut Acute
nasopharyngitis Acute nasopharyngitis [common ..
(common cold)

Salpingitis Salpingitis Acute salpingitis and oophorit..

Vaginitis Acute Vaginitis

Acute vaginitis

Vaginosis bakterialis Acute Vaginitis

Acute vaginitis
Vulvitis Acute vulvitis Acute vulvitis
Pneumonia, bronkopneumonia Bronchopneumonia,
unspecified Adenoviral pneumonia
Rhinitis alergika Allergic rhinitis,
unspecified Allergic rhinitis, unspecified

Urtikaria (akut & kronis) Urticaria

Allergic urticaria
Reaksi anafilaktik Anaphylactic shock,
unspecified Anaphylactic shock, unspecifie..

Asma Bronkial Asthma

Asthma, unspecified

Astigmatism ringan Astigmatisme

Astigmatism
Bell's Palsy Bells’ palsy
Bell's palsy

Lipoma Benign lipomatous

neoplasm Benign lipomatous neoplasm, un..
Blefaritis Blepharitis Blepharitis
Bronkitis akut Acute bronchitis,
unspecified Bronchitis, not specified as a..
Luka bakar derajat 1 dan 2 burn and corrosion,
body region Burn of first degree, body reg..
unspecified
Cracked nipple Cracked nipple
associated with the
puerperium; Cracked
nipple associated
with lactation
Cracked nipple associated with..

Furunkel, karbunkel Cutaneous abscess,

furuncle and Cutaneous abscess, furuncle an..
carbuncle

Demam dengue, DHF Dengue

haemorrhagic fever Dengue haemorrhagic fever

Alergi makanan Dermatitis due to

ingested food Dermatitis due to ingested foo..
Dermatitis atopik (kecuali Dermatitis atopik
recalcitrant) (kecuali recalcitrant) Dermatitis, unspecified

Tinea Imbricate Other

dermatophytoses Dermatophytosis, unspecified
Trikiasis Entropion and
trichiasis of eyelid Entropion and trichiasis of ey..
Episkleritis Episcleritis Episcleritis
Epistaksis Epistaxis Epistaxis
Erisipelas Erysipelas Erysipelas
Eritrasma Erythrasmay Erythrasma
Hipertensi esensial Essential (primary)
hypertension Essential (primary) hypertensi..

Kejang demam Febrile convulsions

Febrile convulsions

Filariasis
Ruptur perineum tingkat 1-2
Filariasis
Filariasis due to Wuchereria b..
First degree perineal
laceration during First degree perineal lacerati..
delivery

Benda asing di konjungtiva Foreign body on

external eye, part Foreign body in conjunctival s..
unspecified

Benda asing di hidung Foreign body in

nostril Foreign body in nostril

Refluks gastroesofageal Gastro-oesophageal

reflux disease without
oesophagitis
Gastro-oesophageal reflux dise..
Exanthematous drug eruption Generalized skin
eruption due to drugs
and medicament Generalized skin eruption due ..

Gonore Gonococcal infection,

unspecified Gonococcal infection of lower ..

Hepatitis A Acute Hepatitis A Hepatitis A with hepatic coma

Herpes simpleks tanpa komplikasi Herpesviral infection,
unspecified Herpesviral infection, unspeci..

Hidradenitis supuratif Hidradenitis

suppurativa Hidradenitis suppurativa

Cutaneus larva migran Hookworm disease,

unspecified Hookworm disease, unspecified

Hordeolum Hordeolum and other

deep inflammation of
eyelid Hordeolum and other deep infla..

Dislipidemia Hiperlipidemia
Hyperlipidaemia, unspecified

Hipermetropia ringan Hypermetropia Hypermetropia

Hipoglikemia ringan hypoglycaemia
unspecified Hypoglycaemia, unspecified

Serumen prop Impacted cerumen Impacted cerumen

Impetigo Impetigo Impetigo [any organism] [any s..
Impetigo ulseratif (ektima) Impetigo
Impetigo [any organism] [any s..
Lepra Leprosy [Hansen
disease] Indeterminate leprosy

Mastitis Inflammatory
disorders of breast Inflammatory disorders of brea..

Influenza Influenza, virus not

identified Influenza with pneumonia, infl..

Diabetes melitus tipe 1 Diabetes insulin

dependent Insulin-dependent diabetes mel..
Strongiloidiasis Strongyloidiasis Intestinal strongyloidiasis
Anemia defisiensi besi Iron Deficiency
Anemias
Iron deficiency anaemia second..
Dermatitis kontak iritan Irritant contact
dermatitis Irritant contact dermatitis du..
Leptospirosis (tanpa komplikasi) Leptospirosis,
unspecified Leptospirosis icterohaemorrhag..
Anemia defisiensi besi pada Anemia defisiensi
kehamilan besi pada kehamilan Malnutrition in pregnancy

Morbili tanpa komplikasi Measles without

complication Measles without complication
(Measles NOS).

Migren Migraine, unspecified

Migraine without aura [common ..

Miliaria Miliaria, unspecified

Miliaria, unspecified
Moluskum kontagiosum Molluscum
contagiosum Molluscum contagiosum
Mabuk perjalanan Mabuk perjalanan Motion sickness
Konjungtivitis Conjunctivitis,
unspecified Mucopurulent conjunctivitis

Parotitis Mumps Mumps orchitis

Miopia ringan Myopia

Myopia

Gastroenteritis (termasuk kolera, Diarrhoea and

giardiasis) gastroenteritis of
presumed infection Noninfective gastroenteritis a..
origin

Diabetes melitus tipe 2 Non-insulin-

dependent diabetes
mellitus
Non-insulin-dependent diabetes..

Limfadenitis Lymphadenitis Acute

Nonspecific mesenteric lymphad..
Dermatitis numularis Dermatitis numularis
Nummular dermatitis

Obesitas obesity unspecified Obesity due to excess calories

Gastritis Gastritis, unspecified
Other acute gastritis

Tetanus Other tetanus

Other tetanus
Otitis media akut Acute serous otitis
media Otitis media, unspecified
Askariasis Ascariaris unspecified
Pediculosis due to Pediculus h..
Pedikulosis kapitis Pediculosis due to
Pediculus humanus
capitis Pediculosis due to Pediculus h..

Dermatitis perioral Perioral dermatitis Perioral dermatitis

Pitiriasis rosea Pitiriasis rosea Pityriasis rosea
Pitiriasis versikolor Pityriasis versicolor Pityriasis versicolor
Presbiopia Presbyopia
Presbyopia
Sifilis stadium 1 dan 2 SIFILIS Primary genital syphilis
Folikulitis superfisialis Pioderma Pyoderma
Fimosis Phimosis

Redundant prepuce, phimosis an..

Skabies Scabies
Scabies
Dermatitis seboroik Seborrhoeic
dermatitis
Seborrhoea capitis

Abortus spontan komplit Unspecified abortion,

complete, without
complication Spontaneous abortion, incomple..

Faringitis Acute pharyngitis,

unspecified Streptococcal pharyngitis

Tonsilitis Acute tonsillitis Streptococcal tonsillitis

Taeniasis Taeniasis
Taenia solium taeniasis
Tension headache Tension–type
headache Tension-type headache
Tinea kapitis Tinea barbae and
tinea capitis Tinea barbae and tinea capitis

Tinea barbae Tinea barbae and

tinea capitis Tinea barbae and tinea capitis

Tinea korporis Tinea corporis

Tinea corporis
Tinea kruris Tinea cruris
Tinea cruris
Tinea manum Tinea manuum Tinea manuum
Tinea pedis Tinea pedis
Tinea pedis
Tinea unguium Tinea unguium Tinea unguium
Skrofuloderma Tuberculosis of skin
and subcutaneous
tissue Tuberculosis of skin and subcu..

Pielonefritis tanpa komplikasi Acute tubulo-

interstitial nephritis
(applicable to: acute
pyelonephritis)
Tubulo-interstitial nephritis ..

Demam tifoid Typhoid fever

Typhoid fever
HIV AIDS tanpa komplikasi Asymptomatic
Human
Immunodeficiency
Virus (HIV) infection Unspecified human immunodefici..
status

Malaria Unspecified malaria

Unspecified malaria

Malnutirisi energi-protein Unspecified protein-

energy malnutrition Unspecified protein-energy mal..

Infeksi saluran kemih Urinary tract

infection, site not
specified Urinary tract infection, site ..

Varisela tanpa komplikasi Varicella without

complication
(Varicella NOS) Varicella without complication

Ulkus pada tungkai Varicose veins of

lower extremities
with ulcer; Ulcer of
lower limb,
Varicose veins of lower extrem..
notelsewhere
classified

Rhinitis vasomotor Vasomotor rhinitis

Vasomotor rhinitis

Veruka vulgaris Viral warts Viral warts

Defisiensi vitamin Defisiensi vitamin
Vitamin deficiency, unspecifie..
Pertusis Pertusis Whooping cough due to Bordetella pertussis
Herpes zoster tanpa komplikasi Zoster without
complication Zoster without complication
Buta senja Night blindness #N/A
Furunkel pada hidung Abscess, furuncle and
carbuncle of nose #N/A

Hemoroid grade 1-2 Haemorrhoids

#N/A
Hiperuricemia (Gout) Gout #N/A
Infeksi pada umbilikus Omphalitis of
newborn with or
without mild #N/A
haemorrhage

Insomnia Insomnia non organik

pada psikiatri #N/A

Intoleransi makanan Malabsorption due to

intolerance #N/A

Kandidiasis mulut Candidiasis

unspecified #N/A

Kehamilan normal Single spontaneous

delivery, unspecified
#N/A

Keracunan makanan Other Ingested (parts

of plant(s))
#N/A

Mata kering Otherdisorders of

lacrimal gland #N/A
Napkin eczema Diaper (napkin)
dermatitis #N/A

Otitis eksterna Otitis externa,

unspecified #N/A

Penyakit cacing tambang Ankylostomiasis #N/A

Perdarahan subkonjungtiva Other specified
disorders of eye and
adnexa #N/A

Reaksi gigitan serangga Venom of other

arthropods

#N/A
Skistosomiasis Skistosomiasis
unspecified #N/A
Tuberkulosis paru tanpa komplikasi Respiratory
tuberkulosis,
bacteriologically and
histologically #N/A
confirmed

Vertigo (Benign paroxysmal Dizziness and

positional vertigo) giddiness #N/A

Gangguan somatoform Somatoform

disorders #N/A

Ulkus mulut (aptosa, herpes) Stomatitis and

related lesions #N/A

Parafimosis Paraphimosis
#N/A
Sindrom duh (discharge) genital Complication
(gonore dan nongonore) associated with
artificial fertilization,
unspecified #N/A

Infeksi saluran kemih bagian bawah Urinary tract

infection, site not
specified #N/A

Abses folikel rambut atau kelenjar *tidak ditemukan

sebasea Panduan Klinis di #N/A
KMK

Inverted nipple Retracted nipple

associated with the
puerperium;
Retracted nipple
associated with #N/A
lactation

Defisiensi mineral *tidak ditemukan

Panduan Klinis di #N/A
KMK

Kandidosis mukokutan ringan Candidiasis

unspecified #N/A
Pedikulosis pubis Pthiriasis

#N/A
Vulnus laseratum, punctum Open wound of
unspecified body #N/A
region

Kekerasan tumpul *tidak ditemukan

Panduan Klinis di #N/A
KMK

Kekerasan tajam *tidak ditemukan

Panduan Klinis di
KMK
#N/A
Nama DX di Pcare Tanpa Flag Non 4A KMK
Spesialistik 524/2015

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ada

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ada

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ada

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ada

ada

ada

ada
 ada

ada
ada
ada
ada

ada
ada
ada

ada

ada

ada

ada

ada
ada

ada

ada

ada

Tinea barbae and tinea capitis

ada

ada

ada
ada
ada
ada

ada

ada

ada

ada

ada

ada

ada

ada

ada

ada
ada

ada
ada
 ada
Night blindness ada

Abscess, furuncle and carbuncle of nose

ada
Unspecified haemorrhoids without
complication ada
Idiopathic gout ada

Omphalitis of newborn with or without mild

haemorrhage

ada

Nonorganic insomnia
ada
Malabsorption due to intolerance, not
elsewhere classified ada

Candidiasis, unspecified
ada

Single spontaneous delivery, unspecified

ada

Toxic effect of other ingested (parts of)

plant(s)

ada

Other disorders of lacrimal gland

ada

Diaper [napkin] dermatitis

ada

Otitis externa, unspecified

ada
Ancylostomiasis ada

Other specified disorders of eye and adnexa

ada

Toxic effect of venom of other arthropods

ada
Schistosomiasis, unspecified
ada

Respiratory tuberculosis unspecified,

confirmed bacteriologically and
histologically

ada

Dizziness and giddiness

ada

Other somatoform disorders

ada

Other forms of stomatitis

ada
Redundant prepuce, phimosis and
paraphimosis ada

Complication associated with artificial

fertilization, unspecified

ada

Urinary tract infection, site not specified

ada

Follicular disorder, unspecified

ada

Retracted nipple associated with childbirth

ada

Deficiency of nutrient element, unspecified

ada

Candidiasis, unspecified
ada

Mixed pediculosis and phthiriasis

ada
Open wound of unspecified body region
ada

Assault by blunt object

ada

Assault by sharp object

ada