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TARIF INA-CBG REHABILITASI MEDIK NO 1 TENS/ES 2 SWD 3 USD



TINDAKAN



ICD IX CM 93.39 93.34 93.34



4 USD PHONOPORESIS 5 LASER 6 EXERCISE (Lat.Assistif)



93.89



7 Latihan Pernafasan 8 Taping 9 Icing



93.13



10 Korset Lumbosacral 11 Infrared



93.89 93.11 93.53 99.81 93.23 93.35



TARIF RS



TARIF REHBILITASI MEDIK RS DR ETTY ASHARTO 1. PasienRawatJalanUmum Paket dasar per kunjunganpasien :Rp. 225.000,00/kunjungan meliputibiaya DPJP + penggunaan 1-2 alat modalitas, exercise), bila tindakan lebihdari itu akan mendapatkan biaya tambahan sesuai tarif di bawah ini :



tambahan sesuai tarif



NO DIAGNOSA 1 LOW BACK PAIN (LBP)



KODE ICD



M54.5



2 3 4



CEREBRAL PALSY (CP) STROKE OSTEOARTRITIS (OA )



G 80.9 J.64 M19.9



5 6



RHEUMATOID ARTHRITIS (RA)



R41.2 J 44.9



7



PENYAKIT PARU OBSTRUKSI KRONIK ( PPOK) BELL’S PALSY



G51.0



8



FROZEN SHOULDER



M75.0



9



CERVICAL ROOT SYNDROME



M50.1



(CRS)



10 CARPAL TUNNEL SYNDROME (CTS) 11 DE QUERVAIN TENOSYNOVITIS



M65.4



12 CEDERA PLEKSUS BRAKHIALIS 13 TRIGGER FINGER



14 CEDERA SARAF PERIFER



S14.3 M65.30



G56



15 PLANTAR FASCIITIS



M72.2



16 SINUSITIS MAXILLARIS 17 Fraktur



J32.0 M84



DIAGNOSA BANDING



Low Back Strain/Sprain Hernia Nucleus Pulposus Spondylosis/Spondyloarthrosis Spondylolisthesis Sindroma myofacial dan Fibromyalgia Stenosis Spinalis Fraktur kompresi Osteoporosis Spondilitis TB Ankylosing Spondylitis Tumor Spinal Low Back post operative ⁻ ⁻



RA   Gout artritis Septic arthritis Osteoarthritis       



Asthma Bronchiale 1.Tumor pada cerebelopontin angle yang menekan saraf fasialis 2.Ramsay Hunt syndrome 3. Infeksi telinga tengah atau sinus mastoideus 4.Patah tulang dasar tengkorak 1. Osteoarthritis glenohumeral 2.Rotator cuff tear 3. Cervical syndrome 1. Neuromuskular : ·         Brachial plexophaty ·         Peripheral nerve entrapment 2. Muskuloskeletal : ·         Shoulder disease ·         Nyeri myofascial 3. Thoracic outlet syndrome ·    Sindroma canal of guyon ·    Pronator teres syndrome ·            Carpal joint arthritis ·            Radial nerve injury ·            Ganglion cyst



·            Cervical radiculopathy ·            Scaphoid fracture • Extensor policis longus tenosynovitis ·      Thoracic Outlet Syndrome ·      Brachial Plexus Traction Injury ·     Carpal Tunnel Syndrome ·     De Quervain tenosynovitis ·     Rhematoid Arthritis ·      Thoracic Outlet Syndrome ·      Brachial Plexus Injury Inflamasi -      Juvenile rheumatoid arthritis -      Rheumatoid arthritis -      Ankylosing spondylitis -      Reiter’s syndrome -      Gout (pirai) -      Diffuse idiopathic skeletal hyperostosis Metabolik -      Migratory osteoporosis -      Osteomalacia Degeneratif -      Osteoarthritis -      Atrophy of the heel fat pad Nerve Entrapment -      Tarsal tunnel syndrome -      Entrapment of the medial calcaneal branch of the posterior tibial nerve Diagnosa lain -      Tumors -      Vascular compromise -      Infeksi Rhinosinusitis ⁻