Analisis Ketepatan Kode Diagnosis Utama Kasus Persalinan Sebelum dan Sesudah Verifikasi pada Pasien BPJS di Rsup Dr. Soeradji Tirtonegoro Klaten

Nandani Kusuma Ningtyas; Sri Sugiarsi; Astri Sri Wariyanti

doi:10.22146/jkesvo.38794

Analisis Ketepatan Kode Diagnosis Utama Kasus Persalinan Sebelum dan Sesudah Verifikasi pada Pasien BPJS di Rsup Dr. Soeradji Tirtonegoro Klaten

https://doi.org/10.22146/jkesvo.38794

Nandani Kusuma Ningtyas^(1*), Sri Sugiarsi⁽²⁾, Astri Sri Wariyanti⁽³⁾

(1) Prodi D4 Rekam Medis dan Informasi Kesehatan STIKes Mitra Husada Karanganyar
(2) Prodi D3 Rekam Medis dan Informasi Kesehatan STIKes Mitra Husada Karanganyar
(3) Prodi D4 Rekam Medis dan Informasi Kesehatan STIKes Mitra Husada Karanganyar
(*) Corresponding Author

Abstract

Background: Based on the preliminary survey at RSUP dr. Soeradji Tirtonegoro Klaten found the main diagnosis code differences in 5 out of 10 BPJS patient medical record for labor cases before and after verification.

Objective: To determine the accuracy of the main diagnosis codes of labor cases before and after verification in BPJS patients at dr. Soeradji Tirtonegoro KlatenGeneral Hospital.

Methods: Type of research is comparative analytic with cross sectional approach. The population is medical record of JKN BPJS inpatients in the first quarter of 2017. The samples are 50 documents use systematic sampling technique. The instrument is checklist and list of questions. Collecting data use observation and unstructured interviews. Data processing use collecting, editing, coding, entering, processing, cleaning and presenting data. Data analysis used Fisher exact test.

Results: The accuracy of the main diagnosis codes of labor cases before verification is 25 (50%) correct and 25 (50%) incorrect. The accuracy of the main diagnosis code for labor cases after verification is 29 (58%) correct and 21 (42%) incorrect. The results of Fisher exact test were obtained p value (0.274)> 0.05.

Conclusion : There is no difference in the accuracy of the main diagnosis codes of labor cases before and after verification in BPJS patients. It is recommended in determining the main diagnosis code based on the coding rules in ICD-10 and the internal verifier still check the diagnosis code.

Keywords

main diagnosis code; verification; BPJS; INA-CBG

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References

Hatta, G. R. (2014) Pedoman Managemen Informasi Kesehatan di Sarana Pelayanan Kesehatan. Jakarta: Penerbit Universitas Indonesia.

Permenkes RI (2014) Peraturan Menteri Kesehatan Republik Indonesia Nomor 28 Tahun 2014 Tentang Pedoman Pelaksanaan Program Jaminan Kesehatan Nasional. Jakarta, Indonesia.

Permenkes RI (2016) Peraturan Menteri Kesehatan Republik Indonesia Nomor 76 Tahun 2016 Tentang Pedoman Indonesian Case Base Groups (INA-CBG) Dalam Pelaksanaan Jaminan Kesehatan Nasional. Jakarta, Indonesia.

Setianto, D. B. (2013) Tinjauan Keakuratan Penetapan Kode Diagnosis Utama Berdasarkan Spesifikasi Penulisan Diagnosa Utama Pada Dokumen Rekam Medis Rawat Inap di Rumah Sakit Permata Medika Semarang Periode 2012. Dian Nuswantoro. Available at: http://mahasiswa.dinus.ac.id/docs/skripsi/jurnal/12863.pdf.

Widyaningrum, L. (2015) ‘Ketepatan Reseleksi Diagnosa dan Kode Utama Berdasarkan Aturan Morbiditas Pembiayaan Jaminan Kesehatan INA-CBGS’, Manajemen Informasi Kesehatan Indonesia, 3(2), pp. 27–31.

Handayani, Wahyu. 2017. Tinjauan Proses Pelaksanaan Verifikasi Administrasi Klaim Pasien Jaminan Kesehatan Nasional di Unit Rawat Inap Rumah SakitUmum Daerah Kota Salatiga. [Karya Tulis Ilmiah]. Karanganyar: STIKes Mitra Husada Karanganyar

Harjanti dan Ningtyas, NK. 2018. Strategi Keakuratan Kode Diagnosis Berdasarkan metode SWOT. Jurnal Manajemen Informasi Kesehatan Indonesia. Vol. 6. No. 1. 52 - 56

Hatta, Gemala R. 2014. Pedoman Managemen Informasi Kesehatan di Sarana Pelayanan Kesehatan. Jakarta: Penerbit Universitas Indonesia.

Hueter, Jack. 2012. ICD-10 Learn From the Canadian Experience. Journal of Healthcare Information Management. Vol 26 (4). 16 – 17

Kementerian Kesehatan Republik Indonesia. 2013. Peraturan Menteri Kesehatan Republik Indonesia Nomor 55 Tahun 2013 Tentang Penyelenggaraan Pekerjaan Perekam Medis. Jakarta: Kementerian Kesehatan Republik Indonesia.

2014. Peraturan Menteri Kesehatan Republik Indonesia Nomor 28 Tahun 2014 Tentang Pedoman Pelaksanaan Program Jaminan Kesehatan Nasional. Jakarta : Kementerian Kesehatan Republik Indonesia.

2016. Peraturan Menteri Kesehatan Republik Indonesia Nomor 76 Tahun 2016 Tentang Pedoman Indonesian Case Base Groups (INA-CBG) Dalam Pelaksanaan Jaminan Kesehatan Nasional. Jakarta : Kementerian Kesehatan Republik Indonesia.

Leveno, et al. 2009. Obstetric Williams : Panduan Ringkas, Ed.21. Jakarta: EGC.

Pain, Tilley et.al. 2017. How are allied health notes used for inpatient care and clinical decision-making? A qualitative exploration of the views of doctors, nurses and allied health professionals. Health Information Management Journal. Vol. 46. (1). 23–31

Seruni, FDA dan Sugiarsi, Sri. 2015. Problem Solving Cycle Swot Keakuratan KodeDiagnosis Kasus Obstetri Pada Lembar Masuk dan Keluar (RM 1a) Pasien Rawat Inap di Rsud Dr. Sayidiman Magetan. Jurnal Manajemen Informasi Kesehatan Indonesia. Vol. 3. No. 2. 5 – 13

Setiyanto, DB. 2013. Tinjauan Keakuratan Penetapan Kode Diagnosis Utama Berdasarkan Spesifikasi Penulisan Diagnosa Utama Pada Dokumen Rekam Medis Rawat Inap di Rumah Sakit Permata Medika Semarang Periode 2012. [Internet]. [diunduh 07 September 2017]. Tersedia pada: http://mahasiswa.dinus.ac.id/docs/skripsi/jurnal/12863.pdf

Watkins, Larry. 2013. Journal of Healthcare Information Management. Capturing the Real-World Benefits of ICD-10. Vol 27 (1). 24 – 26

Watkins, Larry. 2013. Journal of Healthcare Information Management. Capturing the Real-World Benefits of ICD-10, Part II. Vol 27 (3). 25 – 26

Widyaningrum, L. 2015. Ketepatan Reseleksi Diagnosa dan Kode Utama Berdasarkan Aturan Morbiditas Pembiayaan Jaminan Kesehatan INA-CBGS. Jurnal Manajemen Informasi Kesehatan Indonesia. Vol. 3. No. 2. 27-31

World Health Organization. 2010. International Statistical Clasification Of Diseases And Related Health Problems 10^th Revision. Volume 1 -3. Geneva : WHOPress.

DOI: https://doi.org/10.22146/jkesvo.38794