144 Penyakit Ditanggung BPJS Beserta Nomor Kode

Kartu BPJS Kesehatan adalah sebuah kartu jaminan kesehatan yang dimiliki oleh peserta BPJS terdaftar.

Ada sekitar 144 jenis penyakit ditanggung harus dilayani di Faskes Pertama terlebih dahulu.

Dimana Faskes pertama sesuai yang tetera pada kartu BPJS masing-masing peserta.

Berikut diganosa penyakit tersebut dalam Bahasa Indonesia dan Inggris beserta Kode ICD 10.

Daftar Nomor Kode Diganosa Penyakit Ditanggung BPJS di Faskes Pertama

1. O03 - Abortus spontan komplit (Spontaneous abortion)

2. O20.0 - Abortus mengancam/insipiens (Threatened abortion)

3. O03.3 - Abortus spontan inkomplit (Other and unspecified complications following incomplete spontaneous abortion)

4. O03.4 - Abortus spontan inkomplit (Incomplete spontaneous abortion without complication)

5. Z91.01 - Alergi makanan (Food allergy status)

6. D50 - Anemia defisiensi besi (Iron deficiency anemia)

7. O99.019 - Anemia defisiensi besi pada kehamilan (Iron deficiency anemia in pregnancy)

8. I20 - Angina pektoris (Angina pectoris)

9. K35 - Apendisitis akut (Acute appendicitis)

10. M15-M19 - Artritis Osteoartritis (Osteoarthritis )

11. M05 - Artritis Reumatoid (Rheumatoid arthritis with rheumatoid factor)

12. B77 – Askariasis (Ascariasis)

13. J45 - Asma Bronkial (Asthma)

14. H52.2 - Astigmatism ringan (Astigmatism)

15. G51.0 - Bell’s Palsy (Bell’s palsy)

16. T17.1 - Benda asing di hidung (Foreign body in nostril)

17. T15.1 - Benda asing di konjungtiva (Foreign body in conjunctival sac)

18. H01.0 – Blefaritis (Blepharitis)

19. J20 - Bronkritis akut (Acute bronchitis)

20. H53.6 - Buta senja (Night blindness)

21. I46 - Cardiorespiratory arrest (Cardiac arrest)

22. B76.9 - Cutaneus larva migran (Hookworm disease, unspecified)

23. F05 - Delirium yang diinduksi dan tidak diinduksi oleh alkohol atau zat psikoaktif lainnya (Delirium due to known physiological condition)

24. A90-A91 - Demam dengue, DHF Demam tifoid (Dengue hemorrhagic fever)

25. F01-F03 – Demensia (Dementia)

26. L20 - Dermatitis atopik (kecuali recalcitrant) (Atopic dermatitis)

27. L23 - Dermatitis kontak alergika (Allergic contact dermatitis)

28. L24 - Dermatitis kontak iritan (Irritant contact dermatitis )

29. L30.0 - Dermatitis numularis (Nummular dermatitis)

30. L21 - Dermatitis seboroik (Seborrheic dermatitis)

31. B35.0 - Tinea kapitis (Tinea barbae and tinea capitis)

32. B35.0 - Tinea barbae (Tinea barbae and tinea capitis)

33. B35.8 - Tinea fasialis (Other dermatophytoses)

34. B35.4 - Tinea korporis (Tinea corporis)

35. B35.2 - Tinea manum (Tinea manuum)

36. B35.1 - Tinea unguium (Tinea unguium)

37. B35.6 - Tinea kruris (Tinea cruris)

38. B35.3 - Tinea pedis (Tinea pedis)

39. E10 - Diabetes melitus tipe 1 (Type 1 diabetes mellitus)

40. E11 - Diabetes melitus tipe 2 (Type 2 diabetes mellitus)

41. A06.0-A06.1 - Disentri basiler dan amuba (Acute amebic dysentery)

42. E78 – Dislipidemia (Disorders of lipoprotein metabolism and other lipidemias)

43. O15 – Eklampsia (Eclampsia )

44. G40 – Epilepsi (Epilepsy and recurrent seizures)

45. R04.0 – Epistaksis (Epistaxis )

46. L27.0 - Exanthematous drug eruption (Generalized skin eruption due to drugs and medicaments taken internally)

47. L27.1 - Fixed drug eruption (Localized skin eruption due to drugs and medicaments taken internally)

48. J02 – Faringitis (Acute pharyngitis)

49. B74 – Filariasis (Filariasis)

50. N89.8 - Fluor albus/vaginal discharge non gonorrhea (Other specified noninflammatory disorders of vagina)

51. Kode tergantung tulang yang fraktur Fraktur terbuka, tertutup (Open fracture, close fracture )

52. J34.0 - Furunkel pada hidung (Abscess, furuncle and carbuncle of nose)

53. I50.21 - Gagal jantung akut (Acute systolic (congestive) heart failure)

54. I50.22 - Gagal jantung kronik (Chronic systolic (congestive) heart failure)

55. F41.3 - Gangguan campuran anxietas dan depresi (Other mixed anxiety disorders)

56. F23-F24 - Gangguan psikotik (psychotic disorder)

57. K29 – Gastritis (Gastritis and duodenitis)

58. A09 - Gastroenteritis (termasuk kolera, giardiasis) (Infectious gastroenteritis and colitis, unspecified)

59. H40 - Glaukoma akut (Glaucoma)

60. A54 – Gonore (Gonococcal infection)

61. K64 - Hemoroid grade 1-2 (Hemorrhoids and perianal venous thrombosis)

62. B15 - Hepatitis A (Hepatitis A)

63. B16 - Hepatitis B (Acute hepatitis B)

64. B00 - Herpes simpleks tanpa komplikasi (Herpes simplex infections)

65. B02 - Herpes zoster tanpa komplikasi (Herpes zoster)

66. O21.0 - Hiperemesis gravidarum (Mild hyperemesis gravidarum)

67. R73.0 - Hiperglikemi hiperosmolar non ketotik (Hyperglycemia)

68. H52.0 - Hipermetropia ringan (Hypermetropia)

69. I10 - Hipertensi esensial (Essential (primary) hypertension)

70. E79.0 - Hiperuricemia (Gout) (Hyperuricemia)

71. E16 - Hipoglikemia ringan (Hypoglycemia)

72. B20 - HIV AIDS tanpa komplikasi (Human immunodeficiency virus [HIV] disease)

73. H00.01 - Hordeolum (Hordeolum)

74. I21.9 - Infark miokard (Acute myocardial infarction)

75. I63.9 - Infark serebral/ Stroke (Cerebral infarction)

76. P38 - Infeksi pada umbilicus (Omphalitis)

77. N39.0 - Infeksi saluran kemih (Urinary tract infection)

78. J11.81 – Influenza (Influenza)

79. G47.0 – Insomnia (Insomnia)

80. T78.0 - Intoleransi makanan (Anaphylactic reaction due to food)

81. B37.0 - Kandidiasis mulut (Candidal stomatitis)

82. H26 – Katarak (Cataract)

83. Z34.01 - Kehamilan normal (Encounter for supervision of normal first pregnancy, first trimester)

84. R56.00 - Kejang demam (Simple febrile convulsions)

85. T62.94XA - Keracunan makanan (Toxic effect of unspecified noxious substance eaten as food, undetermined, initial encounter)

86. O42.01 - Ketuban Pecah Dini (KPD) (Preterm premature rupture of membranes, onset of labor within 24 hours of rupture)

87. K81 – Kolesistitis (Cholecystitis)

88. H10 – Konjungtivitis (Conjunctivitis)

89. J04.0 – Laringitis (Acute laryngitis)

90. A30 – Lepra (Leprosy [Hansen’s disease])

91. A27 - Leptospirosis (tanpa komplikasi) (Leptospirosis)

92. L28.0 - Liken simpleks kronis/ neurodermatitis (Lichen simplex chronicus)

93. L04 – Limfadenitis (Acute lymphadenitis)

94. D17 – Lipoma (Lipomatous)

95. T20-T25 - Luka bakar derajat 1 dan 2 (Burn)

96. K90.49 - Malabsorbsi makanan ()

97. B50-B54 – Malaria (Malaria)

98. E64.0 - Malnutiris energi-protein (Sequelae of protein-calorie malnutrition)

99. N61.0 – Mastitis (Mastitis without abscess)

100. H04 - Mata kering (Dry eye)

101. G43 – Migren (Migraine)

102. L74 – Miliaria (Miliaria)

103. H52.1 - Miopia ringan (Myopia)

104. B08.1 - Moluskum kontagiosum (Molluscum contagiosum)

105. B05.9 - Morbili tanpa komplikasi (Measles without complication)

106. L22 - Napkin eczema (Diaper dermatitis)

107. E66 - Obesitas (Overweight and obesity)

108. H60 - Otitis eksterna (Otitis externa)

109. H65 - Otitis media akut (Otitis media)

110. B26 – Parotitis (Mumps)

111. B85 - Pedikulosis kapitis (Pediculosis)

112. B76.0 - Penyakit cacing tambang (Ancylostomiasis)

113. O72 - Perdarahan post partum (Postpartum hemorrhage)

114. H11.3 - Perdarahan subkonjungtiva (Subconjunctival hemorrhage)

115. K65 – Peritonitis (Peritonitis)

116. T50.A1 – Pertusis (Pertussis)

117. O63 - Persalinan lama (Prolonged labor)

118. L42 - Pitiriasis rosea (Pityriasis rosea)

119. L08.0 – Pioderma (Pyoderma)

120. B36.0 - Pitiriasis versicolor (Pityriasis versicolor)

121. J18 - Pneumonia aspirasi (Pneumonia, unspecified organism)

122. J19 - Pneumonia, bronkopneumonia (Pneumonia)

123. M35.3 - Polimialgia reumatik (Polymyalgia rheumatica)

124. O14 - Pre-eklampsia (Pre-eclampsia)

125. H52.4 – Presbiopia (Presbyopia)

126. A82 – Rabies (Rabies )

127. T78 - Reaksi anafilaktik (Anaphylactic reaction)

128. – Reaksi gigitan serangga (Insect bite (kode tergantung lokasi))

129. K21.9 - Refluks gastroesofageal (Gastro-esophageal reflux disease without esophagitis)

130. J30 - Rhinitis akut (Acute rhinitis)

131. J30.8 - Rhinitis alergika (Other allergic rhinitis)

132. J30.0 - Rhinitis vasomotor (Vasomotor rhinitis)

133. N90 - Ruptur perineum tingkat 1-2 (Other noninflammatory disorders of vulva and perineum)

134. H61.2 - Serumen prop (Impacted cerumen)

135. A53.9 - Sifilis stadium 1 dan 2 (Syphilis)

136. B86 – Skabies (Scabies)

137. B65.0 – Skistosomiasis (Schistosomiasis)

138. G40.901 - Status Epileptikus (Epilepsy with status epilepticus)

139. B78 – Strongiloidiasis (Strongyloidiasis)

140. R57.9 - Syok (septik), hipovolemik, kardiogenik, neurogenik) (Shock, unspecified)

141. B68.0 – Taeniasis (Taeniasis)

142. R00.0 – Takikardi (Tachycardia, unspecified )

143. G44.201 - Tension headache (Tension-type headache)

144. A35 – Tetanus (Other tetanus)

145. E05.00 – Tirotoksikosis (Thyrotoxicosis)

146. J03 – Tonsilitis (Acute tonsillitis)

147. A15.0 - Tuberkulosis paru tanpa komplikasi (Tuberculosis of lung)

148. L50.1 - Urtikaria (akut dan kronis) (Idiopathic urticaria)

149. N76.0 – Vaginitis (Acute vaginitis)

150. B01.9 - Varisela tanpa komplikasi (Varicella without complication)

151. H81.10 - Vertigo (Benign paroxysmal positional vertigo) (Benign paroxysmal vertigo)

152. B07 - Veruka vulgaris (Viral warts)

153. N76.2 – Vulvitis (Acute vulvitis)

Sebelumnya daftar rincian kode ICD 10 di atas biasanya untuk entri data atau kode perujukan pada Pcare BPJS Kesehatan.

Sekitar 144 penyakit tersebut bisa ditangani di Klinik umum, Puskesmas dan FKTP lainnya.

Mulai dari praktik dokter perorangan, praktik dokter gigi dan rumah sakit kelas D Pratama.

Baca: Cara Minta Surat Rujukan BPJS Via Online

Meskipun begitu, jika memang perlu dirujuk.

Maka Faskes pertama akan memberikan Surat Rujukan BPJS ke rumah sakit yang bekerjasama dengan BPJS.

Hal tersebut sesuai Permenkes terkait Panduan Praktik Klinik di Faskes Tingkat Pertama.