KLASIFIKASI PENYAKIT KULIT ICD 10 Bab 12 Pertemuan

KLASIFIKASI PENYAKIT KULIT (ICD 10 Bab 12) Pertemuan 4 Deasy Rosmala Dewi, SKM, MKes Prodi RMIK, Fakultas Ilmu-ilmu Kesehatan

KEMAMPUAN AKHIR YANG DIHARAPKAN • Memahami Bab ICD 10 dan ICD 9 CM Pancaindra (Kulit) • Menentukan nomor kode ICD 10 Pancaindra (Kulit) dengan presisi, benar dan tepat sesuai yang diderita pasien

KEKHUSUSAN BAB XII Diseases of the skin and subcutaneous tissue (L 00 L 99) Perhatikan Excl. : yang ada di bawah judul BAB ini [531] BAB ini terbagi dalam blok: L 00 – L 08 Infeksi kulit dan jaringan subcutaneous L 10 – L 14 Bullous disorders L 20 – L 30 Dermatitis dan eczema L 40 – L 45 Papulosquamous disorders L 50 – L 54 Urticaria & erythema L 55 – L 59 Radiation-related disord. of the skin. . . L 60 – L 75 Disord. of skin appendages L 80 – L 99 Other disord. of the skin & subcut. tissue

Ada enam (6) kategori bertanda * L 14* L 45* L 54* L 62* L 86* L 99* Gangguan Bullous pd penyakit di bagian lain Gangguan Papulosquamous pd peny. di bag. Erythema pada penyakit di bagian lain Gangguan Kuku pada penyakit di bagian lain Keratoderma pada penyakit di bagian lain Gangguan lain pada penyakit di bagian lain Bila kode tersebut di atas akan diterapkan harus cari partner kode yang bertanda dagger lain

Bab XII dibagi dalam Block (Blok): L 00 -L 08 Infections of the skin and subcutaneous tissue (Infeksi kulit dan jaringan di bawah kulit) Ada keterangan di [532] Use additional code (B 95 -B 97), bila dikehendaki, untuk mengidentifikasi agen infeksinya. Cari di antara nomor code B 95 -B 97 untuk menjelaskan nama kuman penyebab infeksi terkait sebagai code tambahan Perhatikan keterangan Note: di [161] berkaitan dengan aturan pemanfaatan nomor code B 95 -B 97

Contoh: Carbuncle di muka karena infeksi streptokokal A L 02. 0 B 95. 0 Paronychia akibat infeksi staphylococal L 03. 0 B 95. 8 Cellulitis organs genital eksternus pada wanita N 76. 4 pria N 48. 2 atau N 49. Pada N 76 ada: Use additional. . . (B 95 -B 98) Beda dengan: Lymphadenitis akut pada muka akibat TB A 18. 4

• L 00. X Staphylococcal scalded skin syndrome Incl. : . . Excl. : . . . • L 01 Impetigo (L, An acute inflammatory skin disease which may be circinate, bullous, gyrate, or furfuraceous in character) Excl. : . . . L 01. 0 Impetigo [any organism] [any site] L 01. 1 Impetiginizatiion of other dermatoses

• L 02 Cutaneous abscess, furuncle & carbuncle Incl. : . . Excl. : . . . L 02. 0, L 02. 2 dan L 02. 3 ada Excl. : . . . L 02. 1; L 02. 4 dan L 02. 8; L 02. 9 • L 03 Cellulitis Incl. : . . . Excl. : . . . L 03. 0; L 03. 1; L 03. 2 dan L 03. 8; L 03. 9. Pada L 03. 3 ada Excl. : . . . • L 04 Acute lymphadenitis Incl. : . . . Excl. : . . . L 04. 0; L 04. 1; L 04. 2; L 04. 3 dan L 04. 8; L 04. 9.

• L 05 Pilonidal cyst Incl. : . . . L 05. 0 dan L 05. 9. • L 08 Other local infections of skin & subcut. . L 08. 0 Pyoderma Dermatitis: - purulent - septic - suppurative Excl. : . . . L 08. 1 Erythrasma, dan L 08. 8; L 08. 9

L 10 - L 14 * Bullous disorders (Gangguan dengan UKK berbentuk bullous = pelepuh bulat besar bercairan) [536 -537] Excl. : . . L 10 Pemphigus (G, pemphix, pustule) Excl. : . . . L 10. 0; L 10. 1; L 10. 2; L 10. 3; L 10. 4 ; L 10. 8; L 10. 9 L 10. 5 Drug-induced pemphigus Use additional ext. cause code. . . L 11 Other acantholytic disorders (G, akantha, thorn) L 11. 0 ada Excl. : . . . L 11. 1; L 11. 8; L 11. 9

Contoh: L 10. 5 Drug-induced pemphigus Ada perintah: Use additional external cause code (Chapter XX), bila dikehendaki untuk identifikasi obat/zat penyebabnya). Bisa dicari di Bab XX, atau menelusuri langsung di Seksi III Indeks Alfabetik ICD-10 Vol. 3 bila nama generik/kimianya diketahui. Pemphigus akibat alergi penicilline dalam periode terapi rheumatik jantung: (802) Penicillin (any) L 10. 5 T 36. 0 Y 40. 0

• L 12 Pemphigoid Excl. : . . . L 12. 0; L 12. 1; L 12. 2; L 12. 8; L 12. 9 L 12. 3 ada Excl. : . . . • L 13 Other bullous disorders L 13. 0; L 13. 1; L 13. 8; L 13. 9 • L 14*. X Bullous disorders in diseases classified elsewhere.

Dermatitis and eczema L 20 -L 30 (Dermatitis dan eksim) Perhatikan Note: yang ada di bawah judul Blok ini 537 -542] yang menjelaskan: bahwa istilah dermatitis dan eksim digunakan secara sinonymous dan berganti-gantian. Contoh: Eksim infantile akut L 20. 8 Neurodermatitis diffuse L 20. 8 Dermatitis karena alergi salep anti-jamur L 23. 3 T 49. 0 X 44. - , bila kejadian di rumah X 44. 0 Eksim akibat iritasi detergents Eksim pada telinga luar L 24. 0 H 60. 5 [

• L 20 Atopic dermatitis Excl. : . . . L 20. 0 dan L 20. 8; L 20. 9. • L 21 Seborrhoeic dermatitis (L, sebum= greas/lemak) Excl. : . . . L 21. 0; L 21. 1 dan L 21. 8; L 21. 9. • L 22. X Diaper [napkin = popok] dermatitis Incl. : . . .

• L 23 Allergic contact dermatitis Incl. : . . . Excl. : . . . L 23. 0; L 23. 1; L 23. 2; L 23. 4; L 23. 5; L 23. 7 dan L 23. 8; L 23. 9. Pada L 23. 3 dan L 23. 6 ada Excl. : . . . • L 24 Irritant contact dermatitis Incl. : . . . Excl. : . . . L 24. 0; L 24. 1; L 24. 2; L 24. 3; L 24. 5; L 24. 7; dan L 24. 8; L 24. 9. Pada L 24. 4 dan L 24. 6 ada Excl. : . . .

• L 25 Unspecified contact dermatitis Incl. : . . . Excl. : . . . L 25. 0; L 25. 2; L 52. 3; L 25. 5 dan L 25. 8; L 52. 9. Pada L 25. 1 ada Use additional external. . Pada L 25. 1 dan L 25. 4, L 52. 3 ada Excl. : . . . • L 26. X Exfoliative dermatitis Incl. : . . . Excl. : . . .

• L 27 Dermatitis due to subst. taken intern. . . Excl. : . . . Pada L 27. 0, L 27. 1 ada Use additional. . . Pada L 27. 2 ada Excl. : . . . L 27. 8; L 27. 9. • L 28 Lichen simplex chronicus & prurigo (Lichen G, = lesion of the skin which consist solid papules with exaggerated skin markings) L 28. 0; L 28. 1 dan L 28. 2. of

L 40 -L 45 Papulosquamous disorders (Gangguan dengan papulosquamous) [ 542 -543] L 40 Psoriasis (G, reddish patches covered with silvery –white imbricated scales) L 40. 0; L 40. 1; L 40. 2; L 40. 3; L 40. 4; dan L 40. 8; L 40. 9 L 40. 5 Arthropathic psoriasis (M 07. 0 - M 07. 3*, M 09. 0*) L 41 Para psoriasis Excl. : . . . L 41. 0; L 41. 1; L 41. 2; L 41. 3; L 41. 4; L 41. 5 dan L 41. 8; L 41. 9

L 42. X L 43 Pityriasis rosea (G, branlike eruption) (bran = kulit padi) Lichen planus (G, lichen = solid papules) Excl. : . . . L 43. 0; L 43. 1; L 43. 3; dan L 43. 8; L 43. 9 L 43. 2 Lichenoid drug reaction Use additional external cause code …. (Chapter XX) if. . .

L 44 Other papulosquamoue disorders L 44. 0; L 44. 1; L 44. 2; L 44. 3; L 44. 4; dan L 44. 8; L 44. 9 L 45*. X Papulosquamous dis. in diseases classified elsewhere

L 50 -L 54 Urticaria and erythema [544 -545] Excl. : Lyme disease (A 69. 2) rosacea (L 71. -) L 50 Urticaria Excl. : …. L 50. 0; L 50. 1; L 50. 2; L 50. 3; L 50. 4; L 50. 5; L 50. 6 dan L 50. 8; L 50. 9 L 53. 0 Toxic erythema Use additional …. L 51 Erythema multiforme L 51. 0; L 51. 1; L 51. 2 dan L 51. 8; L 51. 9

L 52 L 53 Erythema nodusum Other erythematous conditions Excl. : . . . L 53. 0 Toxic erythema Use additional external cause code. . Excl. : . . L 53. 1; L 53. 2; L 53. 3 dan L 53. 8; L 53. 9 L 54* Erythema in diseases classified elsew. L 54. 0* (I 00 ) dan L 54. 8*

(L 55 - L 59) Radiation-related disorders of the skin and subcutaneous tissue [545 -546] (Gangguan kulit dan jaringan di bawah kulit terkait radiasi) L 55 Sunburn dirinci sesuai derajat sunburnnya. L 55. 0 derajat 1, L 55. 1 derajat 2 dan L 55. 2 derajat 3 dan L 55. 8, L 55. 9 Baca di ICD-10 Vol. 3 hal. 85: Tentang peraturan kode terkait derajat luka bakar!!!

L 56 Other acute skin changes due to ultraviolet radiation dirinci apa gangguan akibat: phototoxic atau photo allergic response, atau photocontact atau polymorphous light eruption, atau perubahan kulit akibat UV. L 56. 0 dan L 56. 1 ada Use additional. . . L 56. 2; L 56. 3; L 56. 4 dan L 56. 8; L 56. 9

L 59 Other disorders of skin and subcutaneous tissue related to radiation. L 59. 0 Erythema ab igne [dermatitis ab igne] L 59. 8 Other specified disorders of skin and subcutaneous tissue related to radiation L 59. 9 Disorder of skin and subcutaneous tissue related to radiation, unspecified.

L 60 - L 75 Disorders of skin appendages [547 -550] Excl. : congenital malforamation of integument (Q 84. -) L 60 Nail disorders (gangguan kuku) Excl. : . . . L 60. 0; L 60. 1; L 60. 2; L 60. 3; L 60. 4; L 60. 5 dan L 60. 8; L 60. 9 L 62* Nail disorders in diseases classified elsewhere (gangguan kuku akibat penyakit yang terklasifikasi di bagian lain) (nomor Code harus pakai tanda ) L 62. 0* dan L 62. 8*

L 63 Alopecia (botak) areata L 63. 0; L 63. 1; l 63. 8 dan L 63. 9 L 63. 2 Ophiasis (ophiosis) = alopecia areata (serpentine form about the hair margin (> children) L 64 Androgenic alopecia Incl. : . . . L 64. 0 Drug-induced androgenic alopecia Use additional external cause code. . L 64. 8 dan L 64. 9

L 67 Hair colour and hair abnormalities (Warna rambut dan abnormalitas rambut Excl. : monilethrix (Q 84. 1) pili annulati (Q 84. 1) telogen effluvium (L 65. 0) L 67. 0; L 67. 1 dan L 67. 8; L 67. 9 L 68 Hypertrichosis (Rambut terlalu lebat) Incl. : . . . Excl. : . . . L 68. 0 dan L 68. 1 ada Use addit. external …. L 68. 2; L 68. 3 dan L 68. 8; L 68. 9

L 70 Acne: Jerawat Excl. : acne keloid (L 73. 0) Masing digit ke 4 merinci tentang jenis jerawat. L 70. 0; L 70. 1; L 70. 2; L 70. 3; L 70. 4; L 70. 5 dan L 70. 8 Other acne dan L 08. 9 Acne unspec. L 71 Rosacea L 71. 0 Use additional external cause code (Chap. XX), if desired, to identify drug, if drug induced) L 71. 1 dan L 71. 8; L 71. 9

L 72 L 73 L 74 Follicular cysts of skin and subcutaneous t. L 72. 0; L 72. 1; L 72. 2 dan L 72. 8; L 72. 9 Other Follicuar disorders L 73. 0; L 73. 1; L 73. 2 dan L 73. 8; L 73. 9 Ecrine sweat disorders Excl. : hyperhydrosis (R 61. -) L 74. 0 Miliaria rubra (biang keringat) L 74. 1; L 74. 2; L 74. 3; L 74. 4; L 74. 8; L 74. 9

L 75 Apocrine sweat disorders Excl. : dyshidrosis [pompholyx] (L 30. 1) hidradenitis suppurative [L 73. 2] L 75. 0; L 75. 1; L 75. 2 dan L 75. 8; L 75. 9

L 80 -L 99 Other disorders of the skin and subcutaneous tissue (Gangguan lan pada kulit dan jaringan di bawah kulit) [551 -556] L 80. X Vitiligo ( Gangg. UKK bercak putih-putih) L 81 Gangguan terkait pigmentasi Excl: . . . L 81. 0; L 81. 1 s/d L 81. 9 L 82. X Seborrhoeic keratosis L 83. X Acanthosis nigricans Incl. : . . . L 84. X Corns and callosities Incl. : . . . (kulit menebal, kapalan)

L 85 Other epidermal thickening Excl. : . . . L 85. 0 dan L 85. 1 ada Excl. : . . L 85. 3 dan L 85. 8; L 85. 9 L 86*. X L 87 Keratoderma in diseases classified els. Incl. : follicular keratosis due to a vit. A xeroderma def. (E 50. 8 ) Transepidermal elimination disorders Excl. : . . . L 87. 0; L 87. 1; L 87. 2 dan L 87. 8; L 87. 9 L 88. X Pyoderma gangrenosum Incl. : . .

L 89 Decubitus ulcer Note: . . . Incl. : . . . Excl. : . . . L 89. 0 Stage I; L 89. 1 Stage II; L 89. 2 Stage III; L 89. 3 Stage IV dan L 89. 9 L 90 Atrophic disorders of skin L 90. 0 dan L 90. 5 ada Excl. : . . . L 90. 1; L 90. 2; L 90. 3; L 90. 4; L 90. 6; L 90. 8; L 90. 9

L 91 Hypertrophic disorders of skin L 91. 0 ada Excl. : . . L 91. 8 dan L 91. 9 L 92 Granulomatous disorders of skin and subcutaneous tissue Excl. : . . . L 92. 0; L 92. 2; L 92. 3 dan L 92. 8; L 92. 9 L 92. 1 ada Excl. : . . . L 93 Lupus erythematosus Use additional external cause. . Excl. : . . . L 93. 0; L 93. 1 dan L 93. 2

L 98 Other disorders of skin and subcut. tissue, NEC L 98. 0; L 98. 1; L 98. 2; L 98. 3 dan L 98. 8; L 98. 9 L 98. 4, L 98. 5 dan L 98. 6 ada Excl. : . . . L 99* Other disorders of skin and subcut. tissue pada penyakit terklasifikasi di bagian lain. (code pasangan harus bertanda ) L 99. 0* Amyloidosis of skin L 99. 8* Other spec. disor. Of skin. . .

Latihan Soal 1. Trichorrhexis invaginata 2. Acne Vulgaris 2. Botak androgen akibat obat 3. Dermatitis kontak akibat kosmetik 4. Psoriasis arthropathic 5. Granuloma annulare 6. Discoid lupus erythematosus 7. Focal oral mucinosis 8. Acute dermatitis sehabis makan fresh seafood 9. Jaringan parut keloid berat akibat jerawat 10. Penebalan dinding epidermal akibat gangguan kulit hipertrofi

OPERATIONS ON THE INTEGUMENTARY SYSTEM (85 -86) 85 Operations on the breast Includes: operations on the skin and subcutaneous tissue of: – breast female or male – previous mastectomy site female or male – revision of previous mastectomy site • 85. 0 Mastotomy Incision of breast (skin) Mammotomy Excludes: aspiration of breast (85. 91) removal of implant (85. 94)

• 85. 1 Diagnostic procedures on breast 85. 11 Closed [percutaneous] [needle] biopsy of breast 85. 12 Open biopsy of breast 85. 19 Other diagnostic procedures on breast Excludes: mammary ductogram (87. 35) mammography NEC (87. 37) manual examination (89. 36) microscopic examination of specimen (91. 61 -91. 69) thermography (88. 85) ultrasonography (88. 73) xerography (87. 36)

• 85. 2 Excision or destruction of breast tissue Excludes: mastectomy (85. 41 -85. 48) reduction mammoplasty (85. 31 -85. 32) 85. 20 Excision or destruction of breast tissue, not otherwise specified 85. 21 Local excision of lesion of breast Lumpectomy Removal of area of fibrosis from breast Excludes: biopsy of breast (85. 11 -85. 12)

85. 22 Resection of quadrant of breast 85. 23 Subtotal mastectomy Excludes: quadrant resection (85. 22) 85. 24 Excision of ectopic breast tissue Excision of accessory nipple 85. 25 Excision of nipple Excludes: excision of accessory nipple (85. 24)

• 85. 3 Reduction mammoplasty and subcutaneous mammectomy 85. 31 Unilateral reduction mammoplasty Unilateral: amputative mammoplasty size reduction mammoplasty 85. 32 Bilateral reduction mammoplasty Amputative mammoplasty Reduction mammoplasty (for gynecomastia) 85. 33 Unilateral subcutaneous mammectomy with synchronous implant Excludes: that without synchronous implan (85. 34)

85. 34 Other unilateral subcutaneous mammectomy Removal of breast tissue with preservation of skin and nipple Subcutaneous mammectomy NOS 85. 35 Bilateral subcutaneous mammectomy with synchronous implant Excludes: that without synchronous implan (85. 36) 85. 36 Other bilateral subcutaneous mammectomy

• 85. 4 Mastectomy 85. 41 Unilateral simple mastectomy Mastectomy: NOS complete 85. 42 Bilateral simple mastectomy Bilateral complete mastectomy 85. 43 Unilateral extended simple mastectomy Extended simple mastectomy NOS Modified radical mastectomy Simple mastectomy with excision of regional lymph nodes 85. 44 Bilateral extended simple mastectomy

85. 45 Unilateral radical mastectomy Excision of breast, pectoral muscles, and regional lymph nodes [axillary, clavicular, supraclavicular] Radical mastectomy NOS 85. 46 Bilateral radical mastectomy 85. 47 Unilateral extended radical mastectomy Excision of breast, muscles, and lymph nodes [axillary, clavicular, supraclavicular, internal mammary, and mediastinal] Extended radical mastectomy NOS 85. 48 Bilateral extended radical mastectomy

• 85. 5 Augmentation mammoplasty Excludes: that associated with subcutaneous mammectomy (85. 33, 85. 35) 85. 50 Augmentation mammoplasty, not otherwise specified 85. 51 Unilateral injection into breast for augmentation 85. 52 Bilateral injection into breast for augmentation Injection into breast for augmentation NOS 85. 53 Unilateral breast implant 85. 54 Bilateral breast implant Breast implant NOS • 85. 6 Mastopexy

• 85. 7 Total reconstruction of breast 85. 70 Total reconstruction of breast, not otherwise specified Perforator flap, free 85. 71 Latissimus dorsi myocutaneous flap 85. 72 Transverse rectus abdominis myocutaneous (TRAM) flap, pedicled Excludes: transverse rectus abdominis myocutaneous (TRAM) flap, free (85. 73) 85. 73 Transverse rectus abdominis myocutaneous (TRAM) flap, free Excludes: transverse rectus abdominis myocutaneous (TRAM) flap, pedicled (85. 72)

85. 74 Deep inferior epigastric artery perforator (DIEP) flap, free 85. 75 Superficial inferior epigastric artery (SIEA) flap, free 85. 76 Gluteal artery perforator (GAP) flap, free 85. 79 Other total reconstruction of breast Excludes: deep inferior epigastric artery perforator (DIEP) flap, free (85. 74) gluteal artery perforator flap, free (85. 76) lastissimus dorsi myocutaneous flap (85. 71) perforator flap, free (85. 70) superficial inferior epigastric artery (SIEA) flap, free (85. 75) total reconstruction of breast, not otherwise specified (85. 70) transverse rectus abdominis myocutaneous (TRAM) flap, free (85. 73) transverse rectus abdominis myocutaneous (TRAM) flap, pedicled (85. 72)

• 85. 8 Other repair and plastic operations on breast Excludes: that for: augmentation (85. 50 -85. 54) reconstruction (85. 70 -85. 76, 85. 79) reduction (85. 31 -85. 32) 85. 81 Suture of laceration of breast 85. 82 Split-thickness graft to breast 85. 83 Full-thickness graft to breast 85. 84 Pedicle graft to breast 85. 85 Muscle flap graft to breast 85. 86 Transposition of nipple 85. 87 Other repair or reconstruction of nipple 85. 89 Other mammoplasty

• 85. 9 Other operations on the breast 85. 91 Aspiration of breast Excludes: percutaneous biopsy of breast (85. 11) 85. 92 Injection of therapeutic agent into breast Excludes: that for augmentation of breast (85. 51 -85. 52) 85. 93 Revision of implant of breast 85. 94 Removal of implant of breast 85. 95 Insertion of breast tissue expander Insertion (soft tissue) of tissue expander (one or more) under muscle or platysma to develop skin flaps for donor use 85. 96 Removal of breast tissue expander 85. 99 Other

• 86 Operations on skin and subcutaneous tissue Includes: operations on: hair follicles male perineum nails sebaceous glands subcutaneous fat pads sudoriferous glands superficial fossae Excludes: those on skin of: anus (49. 01 -49. 99) breast (mastectomy site) (85. 0 -85. 99) ear (18. 01 -18. 9) eyebrow (08. 01 -08. 99) eyelid (08. 01 -08. 99) female perineum (71. 01 -71. 9) lips (27. 0 -27. 99) nose (21. 00 -21. 99) penis (64. 0 -64. 99) scrotum (61. 0 -61. 99) vulva (71. 01 -71. 9)

• 86. 0 Incision of skin and subcutaneous tissue 86. 01 Aspiration of skin and subcutaneous tissue Aspiration of: abscess of nail, skin, or subcutaneous tissue, hematoma of nail, skin, or subcutaneous tissue, seroma of nail, skin, or subcutaneous tissue 86. 02 Injection or tattooing of skin lesion or defect Injection of filling material Insertion of filling material Pigmenting of skin of filling material 86. 03 Incision of pilonidal sinus or cyst Excludes: marsupialization (86. 21)

86. 04 Other incision with drainage of skin and subcutaneous tissue Excludes: drainage of: fascial compartments of face and mouth (27. 0) palmar or thenar spac 82. 04), pilonidal sinus or cys 86. 03) 86. 05 Incision with removal of foreign body or device from skin and subcutaneous tissue Removal of carotid sinus baroreflex activation device Removal of loop recorder Removal of neurostimulator pulse generator (single array, dual array) Removal of tissue expander(s) from skin or soft tissue other than breast tissue Excludes: removal of foreign body without incision (98. 20 -98. 29)

86. 06 Insertion of totally implantable infusion pump Code also any associated catheterization Excludes: insertion of totally implantable vascular access device (86. 07) 86. 07 Insertion of totally implantable vascular access device [VAD] Totally implanted port Excludes: insertion of totally implantable infusion pump (86. 06)

86. 09 Other incision of skin and subcutaneous tissue Creation of thalamic stimulator pulse generator pocket, new site Escharotomy Exploration: sinus tract, skin, superficial fossa, Relocation of subcutaneous device pocket NEC, Reopening subcutaneous pocket for device revision without replacement, Undercutting of hair follicle Excludes: creation of loop recorder pocket, new site and insertion/relocation of device (37. 79) creation of pocket for implantable, patient-activated cardiac event recorder and insertion/relocation of device (37. 79) removal of catheter from cranial cavity (01. 27) that for drainage (86. 04)

• 86. 1 Diagnostic procedures on skin and subcutaneous tissue 86. 11 Biopsy of skin and subcutaneous tissue 86. 19 Other diagnostic procedures on skin and subcutaneous tissue Excludes: microscopic examination of specimen from skin and subcutaneous tissue (91. 61 -91. 79)

• 86. 2 Excision or destruction of lesion or tissue of skin and subcutaneous tissue 86. 21 Excision of pilonidal cyst or sinus Marsupialization of cyst Excludes: incision of pilonidal cyst or sinus (86. 03) 86. 22 Excisional debridement of wound, infection, or burn Removal by excision of: devitalized tissue necrosis slough Excludes: debridement of: abdominal wall (wound) (54. 3) bone (77. 60 -77. 69) muscle (83. 45)

86. 23 Removal of nail, nail bed, or nail fold 86. 24 Chemosurgery of skin Chemical peel of skin 86. 25 Dermabrasion That with laser Excludes: dermabrasion of wound to remove embedded debris (86. 28) 86. 26 Ligation of dermal appendage Excludes: excision of preauricula appendage (18. 29)

86. 27 Debridement of nail, nail bed, or nail fold Removal of: necrosis, slough Excludes: removal of nail, nail bed, or nail fold (86. 23) 86. 28 Nonexcisional debridement of wound, infection or burn Debridement NOS Maggot therapy Removal of devitalized tissue, necrosis and slough by such methods as: brushing, irrigation (under pressure), scrubbing, washing Water scalpel (jet)

• 86. 3 Other local excision or destruction of lesion or tissue of skin and subcutaneous tissue Destruction of skin by: cauterization cryosurgery, fulguration laser beam, That with Z-plasty Excludes: adipectomy (86. 83) biopsy of skin (86. 11) wide or radical excision of skin (86. 4) Z-plasty without excision (86. 84) • 86. 4 Radical excision of skin lesion Wide excision of skin lesion involving underlying or adjacent structure Code also any lymph node dissection (40. 3 -40. 5)

• 86. 5 Suture or other closure of skin and subcutaneous tissue 86. 51 Replantation of scalp 86. 59 Closure of skin and subcutaneous tissue of other sites Adhesives (surgical) (tissue) Staples Sutures Excludes: application of adhesive strips (butterfly) - omit code

• 86. 6 Free skin graft Includes: excision of skin for autogenous graft Excludes: construction or reconstruction of: penis (64. 43 -64. 44) trachea (31. 75) vagina (70. 61 -70. 64) 86. 60 Free skin graft, not otherwise specified 86. 61 Full-thickness skin graft to hand Excludes: heterograft (86. 65) homograft (86. 66)

86. 62 Other skin graft to hand Excludes: heterograft (86. 65), homograft (86. 66) 86. 63 Full-thickness skin graft to other sites Excludes: heterograft (86. 65), homograft (86. 66) 86. 64 Hair transplant Excludes: hair follicle transplant to eyebrow or eyelash (08. 63) 86. 65 Heterograft to skin Pigskin graft, Porcine graft Excludes: application of dressing only (93. 57) 86. 66 Homograft to skin Graft to skin of: amnionic membrane from donor skin from donor

86. 67 Dermal regenerative graft Artificial skin, NOS Creation of "neodermis" Decellularized allodermis Integumentary matrix implants Prosthetic implant of dermal layer of skin Regenerate dermal layer of skin Excludes: heterograft to skin (86. 65), homograft to skin (86. 66) 86. 69 Other skin graft to other sites Excludes: heterograft (86. 65), homograft (86. 66)

• 86. 7 Pedicle grafts or flaps Excludes: construction or reconstruction of: penis (64. 43 -64. 44) trachea (31. 75) vagina (70. 61 -70. 64) 86. 70 Pedicle or flap graft, not otherwise specified 86. 71 Cutting and preparation of pedicle grafts or flaps Elevation of pedicle from its bed Flap design and raising Partial cutting of pedicle or tube Pedicle delay Excludes: pollicization or digita transfer (82. 61, 82. 81) revision of pedicle (86. 75)

86. 72 Advancement of pedicle graft 86. 73 Attachment of pedicle or flap graft to hand Excludes: pollicization or digita transfer (82. 61, 82. 81) 86. 74 Attachment of pedicle or flap graft to other sites Attachment by: advanced flap, double pedicled flap, pedicle graft, rotating flap, sliding flap, tube graft 86. 75 Revision of pedicle or flap graft Debridement of pedicle or flap graft Defatting of pedicle or flap graft

• 86. 8 Other repair and reconstruction of skin and subcutaneous tissue 86. 81 Repair for facial weakness 86. 82 Facial rhytidectomy Face lift Excludes: rhytidectomy of eyelid (08. 86 -08. 87) 86. 83 Size reduction plastic operation Liposuction Reduction of adipose tissue of: abdominal wall (pendulous), arms (batwing), buttock thighs (trochanteric lipomatosis) Excludes: breast (85. 31 -85. 32)

86. 84 Relaxation of scar or web contracture of skin Z-plasty of skin Excludes: Z-plasty with excision of lesio (86. 3) 86. 85 Correction of syndactyly 86. 86 Onychoplasty 86. 89 Other repair and reconstruction of skin and subcutaneous tissue Excludes: mentoplasty (76. 67 -76. 68)

• 86. 9 Other operations on skin and subcutaneous tissue 86. 91 Excision of skin for graft Excision of skin with closure of donor site Excludes: that with graft at sam operative episode (86. 60 - 86. 69) 86. 92 Electrolysis and other epilation of skin Excludes: epilation of eyelid (08. 91 -08. 93) 86. 93 Insertion of tissue expander Insertion (subcutaneous) (soft tissue) of expander(one or more) in scalp (subgaleal space), face, neck, trunk except breast, and upper and lower extremities for development of skin flaps for donor use Excludes: flap graft preparation (86. 71), tissue expander, breast (85. 95)

86. 94 Insertion or replacement of single array neurostimulator pulse generator, not specified as rechargeable Pulse generator (single array, single channel) for intracranial, spinal, and peripheral neurostimulator Code also any associated lead implantation (02. 93, 03. 93, 04. 92) Excludes: insertion or replacement of single array rechargeable neurostimulator pulse generator (86. 97)

86. 95 Insertion or replacement of dual array neurostimulator pulse generator, not specified as rechargeable Pulse generator (dual array, dual channel) for intracranial, spinal, and peripheral neurostimulator Code also any associated lead implantation (02. 93, 03. 93, 04. 92) Excludes: insertion or replacement of dual array rechargeable neurostimulator pulse generator (86. 98) 86. 96 Insertion or replacement of other neurostimulator pulse generator Code also any associated lead implantation (02. 93, 03. 93, 04. 92) Excludes: insertion of dual array neurostimulator pulse generator (86. 95, 86. 98) insertion of single array neurostimulator pulse generator (86. 94, 86. 97)

86. 97 Insertion or replacement of single array rechargeable neurostimulator pulse generator Rechargeable pulse generator (single array, single channel) for intracranial, spinal, and peripheral neurostimulator Code also any associated lead implantation (02. 93, 03. 93, 04. 92) 86. 98 Insertion or replacement of dual array rechargeable neurostimulator pulse generator Rechargeable pulse generator (dual array, dual channel) for intracranial, spinal, and peripheral neurostimulator Code also any associated lead implantation (02. 93, 03. 93, 04. 92) 86. 99 Other Excludes: removal of sutures from: abdomen (97. 83), head and neck (97. 38), thorax (97. 43), trunk NEC (97. 84) wound catheter: irrigation (96. 58), replacement (97. 15)

Latihan mencari kode ICD 9 CM 1. Mastektomi Parsial 2. Pencabutan kuku 3. Onychoplasty 4. Rekonstruksi payudara total 5. Mammography 6. Rhytidectomy 7. Augmentation mammoplasty 8. Eksisi putting susu 9. Transplantasi rambut 10. Dermabration 11. Eskarotomi 12. Dermatoplasty