ICD 10 CHEPTER XIII (SISTEM OTOT) PERTEMUAN 11 DR MAYANG ANGGRAINI PRODI RMIK, FAKULTAS ILMU-ILMU KESEHATAN

KEMAMPUAN AKHIR YANG DIHARAPKAN Memahami ICD 10 Chapter XIII ( sistem otot ) dengan presisi, benar dan tepat sesuai yang diderita pasien dan ditanggulangi di sistem pelayanan kesehatan yang terkait

KEKHUSUSAN BAB XIII Diseases of the musculoskeletal system and connective tissue (M00 – M99) Gangguan muskuloskeletal dan jaringan ikat yang tidak diperkenankan diberi code Bab XIII tertampung pada kelompok [561] Excl.: kondisi tertentu yang timbul pada periode perinatal (P00- P96) penyakit infeksi dan parasitik tertentu (A00-B99) sindroma kompartmen (T79.6)

(Lanjutan) - komplikasi kehamilan, persalinan dan Nifas (O00-O99) - malformasi kongenital, deformasi dan abnormalitas kromosomal (Q00-Q99) - penyakit endokrin, nutrisi dan metabolik (E00-E90) - cedera, keracunan dan konsekuensi Tertentu akibat sebab luar (S00-T98) - neoplasma (C00-D48) - simtoma, tanda-tanda dan temuan klinis, laboratoris NEC (R00- R99)

Kode Ber-asterisk (*) M01* Direct inf. of joint in inf. & paras. d. class. elsew. M03* Post inf. & react. arthropath. In d. class. elsew. M07* Psoriasis & enteropath. arthropathies M09* Juvenile arthr. in d. class. elsew. M14* Arthropathies in other d. class. elsew. M36* Syst. disor. of conn. t. in d. class. elsew. M49* Spondylopathies in d. class. elsew. M63* Disord. of m. In d. class. elsew. M68* Disord. of synovium& tendon in. d. class. elsew. M73* Soft tis. disor. in d. class. elsew. M82* Osteoporosis in d. class. elsew. M90* Osteopathies in d. class. elsew.

Site of musculoskeletal involvement Tersedia subklasifikasi untuk menunjukkan site otot dan persendian yang terkena gangguan khusus untuk Bab XIII. Ada kemungkinan kebutuhan lokal memiliki nomor subklasifikasi sendiri, oleh karenanya klasifikasi suplementer ini hendaknya ditulis terpisah dari nomor code induk di depannya. (e.g. in an additional box). [562 , Vol. 1]

(Lanjutan) Tersedia juga subklasifikasi yang berbeda di halaman: [574 - 575] (untuk lutut), [580 - 581](untuk dorsopathy) dan [605] (untuk biomechanical lesions). Digit suplementer pada [562 – 563] Vol. 1 adalah: 0 Multiple sites 5. Pelvic region and thigh 1 Shoulder region 6. Lower leg 2 Upper arm 7. Ankle and foot 3 Forearm 8. Other 4 Hand 9. Site unspecified

Bab XIII memuat Block (Blok): M00-M25 Arthropathies [564] Incl.: .... Infectious arthropathies M00-M03 Infectious arthropathies (Gangguan sendi yang infeksi) Note: .... Contoh: Staphylococcal arthritis & polyarthritis  M00.0 Post-meningococcal arthritis A39.8 M03.0* Meningococcal arthritis A39.8 M01.0*

(Lanjutan) M00 Pyogenic arthritis [See site code ... ] Excl.: ... M00.0; M00.1; M00.2 dan M00.9 Pada M00.8 ada Use additional .... M01* Direct infections of joint in infectious & parasitic d. class, elsewhere M01.0*; M01.1* ada Excl.: ... M01.2*; M01.3*; M01.4*; M01.5* M01.6* dan M01.8*

(Lanjutan) M02 Reactive arthropathies [See site code at the ... ] Excl.: ... M02.0 s/d M02.3 dan M02.8; M02.9 M03* Postinfective & reactive arthropathies in d. class. elsewhere. M03.0*; M03.1* ; M03.2* ada Excl.: ... M03.6*

M05-M14. Inflamatory polyarthropathy M05-M14 Inflamatory polyarthropathy (Peradangan pada banyak sendi) [566] Contoh: Rheumatoid arthritis menyerang otot jantung  M05.3 I41.8* Arthropathy sendi pinggul pada ulcerative colitis  K51.9 M07.5* 5 Arthropathies pada thyrotoxicosis  E05.- M14.5* Apa arti (–) di belakang E05.- ? M05 Seropos. rheum. Arthritis [See site code ... ] Excl.: .... M05.0; M05.1 ; M05.2; M05.3 ; dan M05.8; M05.9

(Lanjutan) M06 Other rheumatoid arthritis [See site code at the beginning of this chap.) M06.0; M06.2; M06.3 dan L06.8; L06.9 Pada M06.1 dan M06.4 ada Excl.: ... M07* Psoriatic & anteropathic arthropathies [See site code at the beginning of this chap.) Excl.: juvenile psoriatic & enteropathic arthropathies (M09.-*) M07.0* s/d M07.6*

(Lanjutan) M08 Juvenile arthritis [See site code at the beginning of this chap.) Incl.: ... Excl.: ... M08.0; M08.3; M08.4 dan M08.8; M08.9 Pada M08.1 dan M08.2 ada Excl.: ... M09* Juvenil arthritis in d. class. Elsewhere M09.08*; M09.1*; M09.2* dan M09.8*

(Lanjutan) M10 Gout [See site code at the beginning of this chap.) M10.0; M10.1; M10.4 dan M10.9 Pada M10.2 ada Use additional external .... Pada M10.3 ada Use additional code ... To identify impairment of kidney disease (N17-N19) M11 Other crystal arthropathies M11.0; M11.1; M11.2 dan M11.8; M11.9

(Lanjutan) M12 Other specific arthropathies [See site code at the beginning of this chap. Excl.: ... M12.0 s/d M12.4. Pada M12.5 ada Excl.:... M12.8 M13 Other arthritis [See site code at the beginning of this chap.) Excl.: arthrosis (M15 – M19) M13.0; M13.1 dan M13.8; M13.9

(Lanjutan) M14* Arthropathies in other d. class. elsewh. Excl.: arthropathy in: - dst. M14.0*; M14.1*; M14.3*; M14.4*; M14.5* M14.6* dan M14.8* Pada M14.2* ada Excl.: ...

M15-M19 Arthrosis Note: Osteoarthritis sebagai sinonim [arthrosis] [osteoarthritis] ...... Excl.: osteoarthritis of spine (M47.-) Contoh: kumpulan Gonarthrosis  M17 Arthrosis sendi lain  M19 M15 Polyarthrosis Incl.: ... Excl.: ... M15.0 s/d M15.4 dan L15.8; L15.9 M16 Coxarthrosis [arthrosis of hip] M16.0 s/d M16.7 dan M16.9

(Lanjutan) M17 Gonarthrosis [arthrosis of knee] M17.0 s/d M17.5 dan M17.9 M18 Arthrosis of first carpometacarpal joint M18.0 s/d M18.5 dan M18.8 M19 Other arthrosis [See site code at the beginning of this chap.) Excl.: ... M19.0; M19.1; M19.2 dan M19.8; M19.9

M20-M25 Other joint disorders (Gangguan-Gangguan sendi lain) Excl.: jointsn of the spine (M40-M54) M20 Acquuired deformities of fingers and toes Excl.: ... M20.0 ada Excl.: ... M20.1 Hallux vagus (acquired) M20.2; M20.3; M20.4; M20.5 dan M20.6 M21 Other acquired deformities of limbs [See site code ... ] Excl.: .... M21.0; M21.1; M21.4; M21.5; M21,6 ada Excl.: M21.2; M21.3 dan M21.7; M21.8; M21.9

(Lanjutan) M22 Disorders of patella Excl.: dislocation of patella (S83.0) M22.0 s/d M22.4 dan M22.8; M22.9 M23 Internal derangement of knee [Khusus: 574-575] dilengkapi digit untuk subklasifikasi gangguan pada sendi lutut Excl.: ... M23.0 s/d M23.6 dan M23.8; M23.9 M23.- tersedia: angka 0, 1, 2, 3, 4, 5, 6, 7, 9 yang pemanfaatannya optional Instabillity of joint: [575] Perhatikan juga: see also note at the beginning .....

(Lanjutan) M24 Other specific joint derangements [See site code at the ..... ] Excl.: ... M24.0; M24.1; M24.2; M24.3; M24.4; M24.5; M24.6 dan M24.8 ada Excl.: ... M24.7 dan M24.9 M25 Other joint disorders, NEC M25.0 dan M25.3; M25.4 ada Excl.: ... M25.1; M25.2; M25.5 s/d M25.9

M30-M36 Systemic connective tissue disorders [577 – 580] (Gangguan jaringan ikat sistemik) Incl.: autoimmune disease NOS atau Systemic collagen disease NOS atau systemic Excl.: antiphospholipid syndrome (D68.6) autoimmune disease, single organ or single cell-type (code to relevant condition category)

(Lanjutan) Contoh: SLE (systemic lupus erythematosus) menyerang paru  M32.1 ! J99.1* Systemic sclerosis (Scleroderma) M34 Scleroderma neonatal (P83.8) Scleroderma circumscribed (L94.0) M30 Polyarteritis nodosa & related cond. M30.0; M30.1; M30.2; M30.3 dan M30.8 M31 Other necrotizing vasculopathies M31.0 s/d M31.6. Pada M31.7 ada Excl.: ... M31.8; M31.9

(Lanjutan) M32 Systemic lupus erythematosus Excl.: ... M32.0 ada Use additional .... M32.1 ; M32.8; M32.9 M33 Dermatopolymyositis M33.0; M33.1; M33.2 dan M33.9 M34 Systemic sclerosis Incl.: ... Excl.: ... M34.0; M34.1 dan M34.8; M34.9 Pada M34.2 ada Use additional ...

(Lanjutan) M35 Other systemic involvement of conn. tiss. Excl.: ... M35.0; M35.2; M35.4; M35.5 dan M35.8; M35.9 Pada M35.1; M35.3; M35.6; M35.7 ada Excl.: M36* Systemic disorders of connec. tissue in diseases cl. elsew. M36.0*; M36.1*; M36.2*; M36.4* dan M36.8* Pada M36.3* ada Excl.: ...

M40-M54 Dorsopathies [580 – 581] Dilengkapi dengan digit subklasifikasi suplementer untuk menunjukkan site (lokasi) sendi punggung yang terganggu. Khusus untuk M50-M51 tidak perlu subkla- sifikasi dimaksud. Perhatikan angka 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 [580-581] yang menjelaskan site ruas tulang vertebra yang terganggu.

M40-M43 Deforming dorsopathies [581] M40 Kyphosis and lordosis [See site code before M40] Excl.: ... M40.0 ada Excl.:... M40.1 s/d M40.5 M41 Scoliosis Incl.: ... M41.0 s/d M41.5 dan M41.8; M41.9

(Lanjutan) M42 Spinal osteochondrosis [See site code ... ] Excl.: ... M42.0 ada Excl.: ... M42.1 dan M42.9 M43 Other deforming dorsopathies M43.0; M43.1 dan M43.3; M43.4 dan M43.9 Pada M43.2; M43.5; M43.6 dan M43.8; ada Excl.: ...

M45-M49 Spondylopathies [583 – 585] M45 Ankylosing spondylitis [See side code ... ] Excl.: ... M46 Other inflammatory spondylitis [See site code .... ] M46.0; M46.1; M46.2 dan M46.4; M46.5 dan M46.8; M46.9 Pada M46.3 ada Use additional code [B95 - B98), if desired, to ....

(Lanjutan) M47 Spondylosis [See site code ... ] Incl.: ... M47.0 ; M47.2; dan M47.8; M47.9 Pada M47.1 ada Excl.: ... M48 Other spondylopathies [See site code .... ] M48.0; M48.1; M48.2; M48.3; M48.4 dan M48.8; M48,9 Pada M48.5 ada Excl.: ...

(Lanjutan) M49* Spondylopathies in diseases class. elsew. [ See site code .... ] Excl.: psoriasis and enteropathic arthropathies ( M07.-*, M09.-*) M49.0*; M49.1*; M49.2*; M49.4*; M49.5* dan M49.8* Pada M49.3* ada Excl.: ... Contoh: Tbc tulang punggung (Spondylitis Tbc) (Pott’s curvature) Thoracal 11-12  A18.0 M49.0* 4 Postural kyphosis Vert. Th 11-12  M40.0 4 Torticollis Vert C 5-6  M43.6 2 TBC tl. punggung Th-L  A18.0 M49.0* 5

(Lanjutan) M49* Penyakit penyebab (code ber !) ada di Bab lain bisa: - infeksi -> (Bab 1, A- B-) - saraf -> (Bab VI. G.-) - tumor ganas -> (Bab II. C-)

(lanjutan-4 ) Enthesis = gangguan akibat adanya implant metalic/material inorganik lain pengganti Jaringan yang hilang. Enthesopathy  baca definisi di [594] Vol. 1 Metastatic fracture of vertebra L1-2, dari Carcinoma payu dara  C79.5 M49.5* 6 M8010/6 Tumor ganas primernya  C50.9 M8010/3 Neuropathic-spondylopathy pd syringomyelia C7  G95.0 M49.4* 2

M50-M54 Other dorsopathies [585 – 567] Contoh: Gangguan Cervical disc dengan myelopathy  M50.0 G99.2* (tanpa digit suplementer) Cervicalgia ke 6  M54.2 2 Excl.: current injury – see injury of spine by body region discitis NOS (M46.4) M50 Cervical disc disorders Incl.: ... M50.0 ; pada M50.1 ada Excl.: ... M50.2; M50.3 dan M50.8; M50.9

(Lanjutan) M51 Other intervertebral disc disorders Incl.: ... M51.0 ; pada M51.1 ada Excl.: ... M51.2; M51.3; M51.4 dan M51.8; M51.9 M53 Other dorsopathies, NEC [See site code ... ] M53.0; M53.2; M53.3 dan M53.8; M53.9 M53.1 ada Excl.: ...

(Lanjutan) M54 Dorsalgia [See side code before M40] Excl.: psychogenic dorsalgia (F45.4) M45.0; M45,1; M45.2; M45.3: M45.4; M45.5 dan M45.6 semua ada Excl.: ... dan M45.8; M45.9

M60 – M79 Soft Tissue Disorders [587-596] M60-M63 Disorders of Muscle Excl.:- dermat–o–poly–my-os–itis  (M33.-) - muscular dys–trophies & my-o–pathies  (G71 – G72) - myopathy in: - amyloidosis  (E85.-) - polyarteritis nodosa  (M30.0) - rheumatoid arthritis  (M05.3) - scleroderma  (M34.-) - Sjogren’s syndrome  (M35.0) - SLE  (M32.-)

(Lanjutan) Amyloidosis = deposit amiloid (starchlike protein) yang luas pada berbagai organ tubuh, atau pada organ tertentu, bisa primer, bisa sekunder. Contoh: - pada ginjal, hati, lien, - sekunder pada penyakit tbc kronik ulceratif tulang, lepra, lues dsb.

(lanjutan - 6 ) M60 Myositis (688) [See site code ... ] M60.0 ada Use additional code (B95-B98).... M60.1 dan M60.8; M60.9 Pada M60.2 ada Excl.: ... M61 Calcification and ossification of muscle M61.0; M61.1; M61.2; M61.3; M61.5 dan M61.9 Pada M61.4 ada Excl.: ...

(Lanjutan M62 Other disorders of muscle [ See site code at the .... ] Excl.: ... M62.0 ; M62.1 ; M62.2 ; M62.4 dan M62.6 Semua disertai Excl.: ... M62.3 Immobility; M62.5 m. atrophy; dan M62.8 m. hernia ; M62.9 Disorder of muscle, uns. M63* Disorders of mus. in dis. class. elsew. M63.0*; M63.1*; M63.2*; M63.3* dan M63.8*

M65 – M68 Disorders of Synovium & Tendon [590 -591] M65 Synovitis & tenosynovitis [See site code .... ] Excl.: ... M65.0 Bila gangguan peradangan disertai Abses, bisa dilengkapi dengan additional code (B95-B96) untuk kuman penimbul abses terkait. M65.1; M65.3; M65.4 dan M65.8; M65.9 Pada M65.2 ada Excl.: ...

(Lanjutan) M66 Spontaneuos rupture of synovium & tend. [See site code .... ] Incl.: bila rupture timbul akibat tekanan berat di bawah kapasitas normal. Excl.: ... M66.0; M66.2; M66.3; M66.4 dan M66.5 Pada M66.1 ada Excl.: ... M67 Other dis. of synovium & tendon M67.0 dan M67.8; M67.9 Pada M67.1; M67.2; M67.3 dan M67.4 ada Excl.: ...

(Lanjutan) M68* Disorders of synovium and tendon in dis. class. elsew. M68.0* Synovitis and tensosynovitis .... Synovitis or tenosynovitis in: - GO - syphilis - TBC dan M68.8* Other disorders ...

Bab XIII, Blok: ( lanjutan -8 ) M70 – M79 Other Soft Tissue Disorders (Hal. 662 Vol.1) M70 Soft tissue disorders related to use, overuse and pressure. Termasuk: soft tissue disorders of occupational origin M71 Other bursopathies Kecuali: bunion -> (M20.1) bursitis yang terkelompk di M70.- enthesopathies (M76-M77)

Other soft tissue disorders (M70 – M79) [592 -596] M70 Soft t. Dis. Related to use, overuse & pres [See site code ..... ] Incl.: ... Excl.: ... M70.0 s/d M70.9 M71 Other bursopathies M71.0; M71.1 dan M71.8; M71.9 Pada M71.2; M71.3; M71.4; M71.5 ada Excl.:...

(Lanjutan) M72 Fibroblastic disorders [See site code .... ] Excl.: retroperitoneal fibromatosis M73* M72.0; M72.1; M72.2; dan M72.4; M72.9 Pada M72.6 ada Use additional .... M72.8 ada Excl.: ... M73* Soft tissue disorders in dis. Clas.elsew. M73.0*; M73.1* dan M73.8* M75 Shoulder lesions Excl.: shoulder-hand syndr. (M89.0) M75.0 s/d M75.5 dan M75.8; M75.9

(Lanjutan) M76 Enthesopathies of lower limb, excl. foot. [ See site code .... ] Note : .. Excl.: ... M76.0 s/d M76.9 M77 Other enthesopathies [See site code .... ] Excl.: … M77.0 s/d M77.3; M77.5 dan M77.8; M77.9 Pada M77.4 ada Excl.: ...

(Lanjutan) M79 Other soft tissue disorders, NEC [ See site code ..... ] Excl.: soft tissue pain, psychogenic [F45.4] M79.0; M79.1; M79.2; M79.3 dan M79.5 ada Excl.: ... M79.4; M79.6 dan M79.8; M79.9

M80-M94 Osteopathies & Chondropathies M80-M94 Osteopathies & Chondropathies (Gangguan tulang dan tulang rawan) [ 596 – 603] M80 – M85 Dis. of bone density & Structure M80 Osteoporosis with pathological fracture [See site code at the .. ... ] Incl.: … Excl.: … M80.0 s/d M81.3; M81.5 dan M81.8; M81.9 M80.4 ada Use additional cause code ....

(Lanjutan) M81 Osteoporosis without pathological frac. [See site code ... ] Excl.: … M81.0; M81.1; M81.3; M81.5 dan M81.8; M81.9 Pada M81.2; M81.4; M81.6 ada Excl.: ... M82* Osteoporosis in diseases classified M82.0*; M82.1* dan K82.8*

(Lanjutan) M83 Adult osteomalacia [See site code ... ] Excl.: osteomalacia: M83.0 s/d M83.4 dan M83.8; M83.9 Pada M83.5 ada Use additional .... M84 Disorders of continuity of bone M84.0; M84.2 dan M84.8; M84.9 Pada M84.1; M84.3; M84.4 ada Excl.: ...

(Lanjutan) M85 Other disorders of bone density & struc. [See site code ... ] Excl.: …(gangguan congenital. Q...) M85.0; M85.4; M85.5; M85.6 dan M85.8 ada Excl.: ... M85.1; M85.2; M85.3 dan M85.9

M86 – M90 Other Osteopathies [599 - 601] Excl.: postprocedural osteopathies (M96.-) M86 Osteomyelitis [See site code at ... ] Use additional code (B95-B96), if desired, to identify infectious agent Excl.; osteomyelitis (of) - due to salmonella  (A01-A02) - jaw  (K10.2) - vertebra (M46.2) M86.0 s/d M86.6 dan M86.8; M86.9

(Lanjutan) M87 Osteonecrosis [See site code …. ] Incl.: … Excl.: … M87.0; M87.2; M87.3 dan M867.8; M87.9 Pada M87.1 Osteonecrosis due to drugs Ada: Use add. external … to identify drug. M88 Paget’s dis. of bone [osteitis deformans] [See site code …. ] M88.0 dan M88.8; M88.9

Bab XIII, Blok: (lanjutan-11) M89 Other disorders of bone [See site code at the ... ] M89.1 s/d M89.5 dan M89.8; M89.9 Pada M89.6 ada Excl.: ... M90* Osteopathies in diseases classified elsewhere M90.0* ada Excl.: ... M90.1* s/d M90.8*

M91 – M94 Chondropathies [601 - 603] Excl.: post procedural chondropathies (M96.-) M91 Juvenil osteochondrosis of hip & pelvis [See site code .... ] Excl.: … M91.0 s/d M91.3 dan M91.8; M91.9 M92 Other juvenil osteochondrosis M92.0 s/d M92.9 (spec. as juvenile, of unspecified site)

(Lanjutan) M93 Other osteochondropathies Excl.: osteochondoris of spine (M42.-) M93.0, M93.1; M93.2 dan M93.8; M93.9 M94 Other disorders of cartilage [ See site code at .. .. ] M94.0; M94.1; M94.2; 94.3 dan M94.8; M94.9

M95 – M99 Other disorders of the muskuloskeletal system and connective tissue [604 – 606] M95 Other acquired deformities of M-Sk. System & conn. Tissue Excl.: ... M95.0; M95.1 dan M95.5 ada Excl.: ... M95.2; M95.3; M95.4 dan M95.8; 95.9 M96 Postproc. Musculo-Skel. dis, NEC M96.0 s/d M96.5 dan M96.8; M96.9 Pada M96.6 ada Excl.: ...

M99 Biomechanical lesions, not elsewhere classified [605 - 606] Note: This category should not be used if the condition can be classified elsewhere. Tersedia subklasifikasi suplementer (optional) untuk kategori M99.- ; baca juga Note: di halaman 628 0 Head region occipitocervical 1 Cervical region cervicothoracal 2 Thoracic region thoracolumbar 3 Lumbar region lumbosacral 4 Sacral region sacrococcygeal, sacroiliac 5 Pelvic region hip, pubic 6 Lower extremity 7 Upper extremity acromioclavicular, sternoclavicular 8 Rib cage ostochondral, costovertebral 9 Abdomen and other

(Lanjutan) M99.0 Segmental and .... M99.1 Subluxation complex .... M99.2 Subluxation stenosid .... M99.3 Osseus stenosis .... M99.4 Connective tissue .... M99.5 Intervertebral .... M99.6 Osseous and .... M99.7 Connective tissue .... M99.8 Other .... M99.9 Biomechanical lesion, unspec.