List ICD 10 tahun 2010 Indonesian Modification

List ICD 10 tahun 2010 Indonesian Modification

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List of Additional Code Diagnoses for ICD-10 2010 Version in Indonesia
LIST OF DIAGNOSIS
CODES -
INDONESIAN
MODIFICATION (IM)
Daftar Kode Diagnosis Indonesian Modification (IM) dalam ICD-10 2010
Indonesian Modification (IM)
Kementerian Kesehatan Republik Indonesia
Tahun 2025

2. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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1
Chapter I
Certain infectious and parasitic diseases
(A00-B99)
Tuberculosis
(A15-A19)
A15 Respiratory tuberculosis, bacteriologically and histologically confirmed
A15.0 Tuberculosis of lung, confirmed by sputum microscopy with or without culture
• Tuberculous:
• bronchiectasis
• fibrosis of lung
• pneumonia
• pneumothorax
confirmed by sputum microscopy with or without culture
A15.00 Tuberculosis of lung, with previously treated confirmation sputum microscopy
with or without culture
(IM)

A15.1 Tuberculosis of lung, confirmed by culture only
Conditions listed in A15.0, confirmed by culture only
A15.10 Tuberculosis of lung, with previously treated confirmation culture only
(IM)

A15.11 Tuberculosis of lung, confirmed by biomoleculer examination
(IM)

A15.12 Tuberculosis of lung, with previously treated confirmed by biomoleculer
examination
(IM)

A15.2 Tuberculosis of lung, confirmed histologically
Conditions listed in A15.0, confirmed histologically
A15.21 Tuberculosis of lung, with previously treated confirmed histologically
(IM)

A15.5 Tuberculosis of larynx, trachea and bronchus, confirmed bacteriologically and
histologically
• Tuberculosis of:
• bronchus
• glottis
• larynx
• trachea
confirmed bacteriologically and histologically
A15.50 Tuberculosis of larynx, trachea & bronchus confirmation by biomoleculer
examination
(IM)


A15.8 Other respiratory tuberculosis, confirmed bacteriologically and histologically
• Mediastinal tuberculosis
• Nasopharyngeal tuberculosis
• Tuberculosis of:
• nose
• sinus [any nasal]
confirmed bacteriologically and histologically
A15.80 Other respiratory tuberculosis, with previously treated with confirmation
bacteriology or histologically
(IM)

A15.81 Other respiratory tuberculosis confirmation by biomoleculer examination
(IM)

3. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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A16 Respiratory tuberculosis, not confirmed bacteriologically or histologically
A16.2 Tuberculosis of lung, without mention of bacteriological or histological confirmation
• Tuberculosis of lung
• Tuberculous:
• bronchiectasis
• fibrosis of lung
• pneumonia
• pneumothorax
NOS (without mention of bacteriological or histological
confirmation)
A16.20 Tuberculosis of lung, with previously treated without confirmation bacteriology
or histologically
(IM)


A16.8 Other respiratory tuberculosis, without mention of bacteriological or histological
confirmation
• Mediastinal tuberculosis
• Nasopharyngeal tuberculosis
• Tuberculosis of:
• nose
• sinus [any nasal]
NOS (without mention of bacteriological or histological
confirmation)

A16.80 Latent baccili tuberculosis infection
(IM)

A16.81 Other respiratory tuberculosis, with previously treated without confirmation
bacteriology or histologically
(IM)


Arthropod-borne viral fevers and viral haemorrhagic fevers
(A90-A99)
A91 Dengue haemorrhagic fever
A91.0 Dengue hemorrhagic fever, with shock
(IM)

A91.1 Dengue hemorrhagic fever, without shock
(IM)

A91.9 Dengue hemorrhagic fever, unspecified
(IM)

Viral hepatitis
(B15-B19)
Use additional code (Chapter XX), if desired, to identify drug, if post-transfusion hepatitis
Excl.:
cytomegaloviral hepatitis (B25.1)
herpesviral [herpes simplex] hepatitis (B00.8)
sequelae of viral hepatitis (B94.2)
B18 Chronic viral hepatitis
B18.1 Chronic viral hepatitis B without delta-agent
Chronic (viral) hepatitis B
B18.10 Chronic viral hepatitis B without delta-agent
(IM)

B18.19 Chronic hepatitis B, unspecified delta agent status
(IM)

4. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Mycoses
(B35-B49)
B35 Dermatophytosis
B35.0 Tinea barbae and tinea capitis
Beard ringworm
Kerion
Scalp ringworm
Sycosis, mycotic
B35.1 Tinea unguium
Dermatophytic onychia
Dermatophytosis of nail
Onychomycosis
Ringworm of nails
B35.2 Tinea manuum
Dermatophytosis of hand
Hand ringworm
B35.3 Tinea pedis
Athlete foot
Dermatophytosis of foot
Foot ringworm
B35.4 Tinea corporis
Ringworm of the body
B35.5 Tinea imbricata
Tokelau
B35.6 Tinea cruris
Dhobi itch
Groin ringworm
Jock itch
B35.7 Tinea faciei
(IM)

B35.8 Other dermatophytoses
Dermatophytosis:
disseminated
granulomatous
B35.9 Dermatophytosis, unspecified
Ringworm NOS
B37 Candidiasis
Incl.:
candidosis
moniliasis
Excl.:
neonatal candidiasis (P37.5)
B37.0 Candidal stomatitis
Oral thrush
B37.00 Acute pseudomembranous candidal stomatitis
(IM)

B37.01 Acute erythematous (atrophic) candidal stomatitis
(IM)

B37.02 Chronic hyperplastic candidal stomatitis
(IM)

B37.03 Chronic erythematous (atrophic) candidal stomatitis
(IM)

B37.04 Mucocutaneous candidiasis
(IM)

B37.05 Oral candidal granuloma
(IM)

B37.06 Angular cheilitis
(IM)

B37.08 Other specified candidal stomatitis
(IM)

5. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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B37.09 Candidal stomatitis, unspecified
(IM)

B39 Histoplasmosis
B39.6 Histoplasma limphadenopathy
(IM)

B44 Aspergillosis
Incl.:
Aspergilloma
B44.8 Other forms of aspergillosis
B44.81 Allergic Broncho Pulmonary Aspergillosis (ABPA)
(IM)

Helminthiases
(B65-B83)
B69 Cysticercosis
Incl.:
cysticerciasis infection due to larval form of Taenia solium
B69.2 Cysticercosis of skin
(IM)

B74 Filariasis
Excl.:
onchocerciasis (B73)
tropical (pulmonary) eosinophilia NOS (J82)
B74.8 Other filariases
Dirofilariasis
B74.80 Filaria limphadenopathy
(IM)

B78 Strongyloidiasis
Excl.:
trichostrongyliasis (B81.2)
B78.8 Other strongyloidiasis
(IM)

B83 Other helminthiases
B83.1 Gnathostomiasis
Wandering swelling
B83.10 Gnathostomiasis of central nervous system
(IM)

B83.11 Gnathostomiasis of eye
(IM)

B83.12 Gnathostomiasis of skin
(IM)

B83.18 Gnathostomiasis of other sites
(IM)

B83.19 Gnathostomiasis, unspecified
(IM)

6. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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5
Pediculosis, acariasis and other infestations
(B85-B89)
B86 Scabies
Incl.:
Sarcoptic itch
B86.0 Scabies due to Sarcoptes scabiei
(IM)

B86.8 Other scabies / norwegian scabies
(IM)

B86.9 Scabies, unspecified
(IM)

7. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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6
Chapter II
Neoplasms
(C00-D48)
Malignant neoplasms
(C00-C97)
C02 Malignant neoplasm of other and unspecified parts of tongue
C02.1 Border of tongue
Tip of tongue
C02.10 Malignant neoplasm of tip of tongue
(IM)

C02.11 Malignant neoplasm of lateral border of tongue
(IM)

C02.19 Malignant neoplasm of border of tongue, unspecified
(IM)

C06 Malignant neoplasm of other and unspecified parts of mouth
C06.1 Vestibule of mouth
Buccal sulcus (upper)(lower)
Labial sulcus (upper)(lower)
C06.10 Malignant neoplasm of vestibule mouth: upper labial sulcus
(IM)

C06.11 Malignant neoplasm of vestibule mouth: upper buccal sulcus
(IM)

C06.12 Malignant neoplasm of vestibule mouth: lower labial sulcus
(IM)

C06.13 Malignant neoplasm of vestibule mouth: lower buccal sulcus
(IM)

C06.14 Malignant neoplasm of vestibule mouth: upper sulcus, unspecified
(IM)

C06.15 Malignant neoplasm of vestibule mouth: lower sulcus, unspecified
(IM)

C06.19 Malignant neoplasm of vestibule mouth, unspecified
(IM)

C06.2 Retromolar area
C06.20 Malignant neoplasm of mouth: maxillary tuberosity
(IM)

C06.21 Malignant neoplasm of mouth: mandibular retromolar area
(IM)

C06.29 Malignant neoplasm of mouth: retromolar area, unspecified
(IM)

Malignant neoplasms of bone and articular cartilage
(C40-C41)
C41 Malignant neoplasm of bone and articular cartilage of other and unspecified sites
C41.0 Bones of skull and face
Maxilla (superior)
Orbital bone
Excl.:
carcinoma, any type except intraosseous or odontogenic of:
• maxillary sinus (C31.0)
• upper jaw (C03.0)
jaw bone (lower) (C41.1)

8. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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C41.00 Malignant neoplasm of maxilla, sarcoma
(IM)

C41.01 Malignant neoplasm of maxilla, malignant odontogenic tumour
(IM)

C41.02 Malignant neoplasm of maxilla, malignant intraosseous salivary gland tumour
(IM)

C41.08 Malignant neoplasm of other bone of skull and face
(IM)

C41.09 Malignant neoplasm of bone of skull and face, unspecified
(IM)

C41.1 Mandible
Lower jaw bone
Excl.:
carcinoma, any type except intraosseous or odontogenic of:
• jaw NOS (C03.9)
• jaw NOS
o lower (C03.1)
upper jaw bone (C41.0)
C41.10 Malignant neoplasm of mandible, sarcoma
(IM)

C41.11 Malignant neoplasm of mandible, malignant odontogenic tumour
(IM)

C41.19 Malignant neoplasm of mandible, unspecified
(IM)

Malignant neoplasms of urinary tract
(C64-C68)
C64 Malignant neoplasm of kidney, except renal pelvis
Excl.:
renal:
• calyces (C65)
• pelvis (C65)
C64.1 Malignant neoplasm of right kidney, except renal pelvis
(IM)

C64.2 Malignant neoplasm of left kidney, except renal pelvis
(IM)

C64.9 Malignant neoplasm of unspecified kidney, except renal pelvis
(IM)

C65 Malignant neoplasm of renal pelvis
Incl.:
Pelviureteric junction
Renal calyces
C65.1 Malignant neoplasm of right renal pelvis
(IM)

C65.2 Malignant neoplasm of left renal pelvis
(IM)

C65.9 Malignant neoplasm of unspecified renal pelvis
(IM)

C66 Malignant neoplasm of ureter
Excl.:
ureteric orifice of bladder (C67.6)
C66.1 Malignant neoplasm of right ureter
(IM)

C66.2 Malignant neoplasm of left ureter
(IM)

9. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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C66.9 Malignant neoplasm of unspecified ureter
(IM)

In situ neoplasms
(D00-D09)
Note:
Many in situ neoplasms are regarded as being located within a continuum of morphological change
between dysplasia and invasive cancer. For example, for cervical intraepithelial neoplasia
(CIN) three grades are recognized, the third of which (CIN III) includes both severe
dysplasia and carcinoma in situ. This system of grading has been extended to other organs,
such as vulva and vagina. Descriptions of grade III intraepithelial neoplasia, with or without
mention of severe dysplasia, are assigned to this section; grades I and II are classified as
dysplasia of the organ system involved and should be coded to the relevant body system
chapter.
Incl.:
Bowen disease
erythroplasia
morphology codes with behaviour code /2
Queyrat erythroplasia
D03 Melanoma in situ
Incl.:
morphology codes M872-M879 with behaviour code /2
D03.3 Melanoma in situ of other sites
D03.38 Melanoma in situ: other facial skin
(IM)

D03.39 Melanoma in situ: facial skin, unspecified
(IM)

Benign neoplasms
(D10-D36)
Incl.:
morphology codes with behaviour code /0

10. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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D10 Benign neoplasm of mouth and pharynx
D10.0 Lip
Lip (frenulum)(inner aspect)(mucosa)(vermilion border)
Excl.:
skin of lip (D22.0, D23.0)
D10.00 Benign neoplasm of upper lip, vermilion border
(IM)

D10.01 Benign neoplasm of upper lip, labial mucosa
(IM)

D10.02 Benign neoplasm of upper lip, vermilion border with mucosa
(IM)

D10.03 Benign neoplasm of lower lip, vermilion border
(IM)

D10.04 Benign neoplasm of lower lip, labial mucosa
(IM)

D10.05 Benign neoplasm of lower lip, vermilion border with mucosa
(IM)

D10.06 Benign neoplasm of both lips, vermilion border
(IM)

D10.07 Benign neoplasm of both lips, labial mucosa
(IM)

D10.08 Benign neoplasm of both lips, vermilion border with mucosa
(IM)

D10.09 Benign neoplasm of lip, unspecified
(IM)

D10.1 Tongue
Lingual tonsil
D10.10 Benign neoplasm of base of tongue (posterior to terminal sulcus)
(IM)

D10.11 Benign neoplasm of dorsal surface of tongue
(IM)

D10.12 Benign neoplasm of borders and tip of tongue
(IM)

D10.13 Benign neoplasm of ventral surface of tongue
(IM)

D10.14 Benign neoplasm of lingual tonsil
(IM)

D10.19 Benign neoplasm of tongue, unspecified
(IM)

D10.2 Floor of mouth

11. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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D10.3 Other and unspecified parts of mouth
Minor salivary gland NOS
Excl.:
benign odontogenic neoplasms (D16.4-D16.5)
mucosa of lip (D10.0)
nasopharyngeal surface of soft palate (D10.6)
D10.30 Benign neoplasm of mouth, buccal mucosa
(IM)

D10.31 Benign neoplasm of mouth, buccal mucosal commissure
(IM)

D10.32 Benign neoplasm of mouth, buccal sulcus
(IM)

D10.33 Benign neoplasm of mouth, gingiva and edentulous alveolar ridge
(IM)

D10.34 Benign neoplasm of mouth, hard palate
(IM)

D10.35 Benign neoplasm of mouth, soft palate
(IM)

D10.36 Benign neoplasm of mouth, vula
(IM)

D10.37 Benign neoplasm of mouth, retromolar area
(IM)

D10.38 Benign neoplasm of mouth, tuberosity benign
(IM)

D10.39 Benign neoplasm of mouth, unspecified
(IM)

D16 Benign neoplasm of bone and articular cartilage
Incl.:
Keratocystic odontogenic tumour
Excl.:
connective tissue of:
• ear (D21.0)
• eyelid (D21.0)
• larynx (D14.1)
• nose (D14.0)
synovia (D21.-)

12. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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D16.4 Bones of skull and face
Maxilla (superior)
Orbital bone
Excl.:
lower jaw bone (D16.5)
D16.40 Benign neoplasm of maxilla, bone and articular cartilage
(IM)

D16.41 Benign neoplasm of maxilla, odontogenic tissues
(IM)

D16.48 Benign neoplasm of other bones of skull and face
(IM)

D16.49 Benign neoplasm of maxilla, unspecified
(IM)

D16.5 Lower jaw bone
D16.50 Benign neoplasm of mandible, bone and cartilage
(IM)

D16.51 Benign neoplasm of mandible, odontogenic tissue
(IM)

D16.59 Benign neoplasm of mandible, unspecified
(IM)

D18 Haemangioma and lymphangioma, any site
Incl.:
morphology codes M912-M917 with behaviour code /0
Excl.:
blue or pigmented naevus (D22.-)
D18.0 Haemangioma, any site
Angioma NOS
D18.00 Haemangioma, skin and subcutaneous tissues
(IM)

D18.01 Haemangioma, intracranial structures
(IM)

D18.02 Haemangioma, liver
(IM)

D18.03 Haemangioma, intestine
(IM)

D18.04 Haemangioma, ear, nose, mouth and throat
(IM)

D18.07 Haemangioma, multiple sites
(IM)
D18.08 Haemangioma, other sites
(IM)

D18.09 Haemangioma, unspecified
(IM)

D25 Leiomyoma of uterus
Incl.:
benign neoplasms of uterus with morphology code M889 and behaviour code /0
fibromyoma of uterus
D25.7 Leiomyoma of uterus, multiple sites
(IM)

D29 Benign neoplasm of male genital organs
Incl.:
skin of male genital organs
D29.8 Beningn neolasm of other specified male genital organs
(IM)
Neoplasms of uncertain or unknown behaviour
(D37-D49)
Note:

13. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Categories D37-D48 classify by site neoplasms of uncertain or unknown behaviour, i.e., there is doubt
whether the neoplasm is malignant or benign. Such neoplasms are assigned behaviour
code /1 in the classification of the morphology of neoplasms.
D40 Neoplasm of uncertain or unknown behaviour of male genital organs
D40.8 Neoplasm of uncertain behavior of other specified male genital organs
(IM)

D48 Neoplasm of uncertain or unknown behaviour of other and unspecified sites

D49.5 Neoplasm of unspecified behavior of other genitourinary organs
(IM)

14. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter III
Diseases of the blood and blood-forming organs and
certain disorders involving the immune mechanism
(D50-D89)
Haemolytic anaemias
(D55-D59)
D59 Acquired haemolytic anaemia
D59.4 Other nonautoimmune haemolytic anaemias
Haemolytic anaemia:
• mechanical
• microangiopathic
• toxic
Use additional external cause code (Chapter XX), if desired, to identify cause.
D59.40 Other nonimmune hemolytic anemias, chemical
(IM)

D59.41 Other nonimmune hemolytic anemias, infectious
(IM)
D59.42 Other nonimmune hemolytic anemias, microangiopathic
(IM)
D59.43 Other nonimmune hemolytic anemias, physical
(IM)
D59.48 Other nonimmune hemolytic anemias, other
(IM)

Aplastic and other anaemias
(D60-D64)
D63* Anaemia in chronic diseases classified elsewhere
D63.1* Anaemia due to liver and endocrine disorders
(IM)

15. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter IV
Endocrine, nutritional and metabolic diseases
(E00-E90)
Disorders of thyroid gland
(E00-E07)
E03 Other hypothyroidism
Excl.:
iodine-deficiency-related hypothyroidism (E00-E02)
postprocedural hypothyroidism (E89.0)
E03.6 Hypothyroidism from Hashimoto's thyroiditis
(IM)
E06 Thyroiditis
Excl.:
postpartum thyroiditis (O90.5)
E06.6 Transient painless thyroiditis,sporadic
(IM)

Obesity and other hyperalimentation
(E65-E68)
E66 Obesity
E66.2 Extreme obesity with alveolar hypoventilation
Pickwickian syndrome
E66.20 Sleep related hypoventilation disorder
(IM)
E66.21 Sleep related hypoxemia disorder
(IM)

Metabolic disorders
(E70-E90)
E74 Other disorders of carbohydrate metabolism
E74.3 Other disorders of intestinal carbohydrate absorption
Glucose-galactose malabsorption
Sucrase deficiency
Excl.:
lactose intolerance (E73.-)
E74.30 Glucose malabsorption
(IM)
E74.38 Other disorders of intestinal carbohydrate metabolism
(IM)

16. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter V
Mental and behavioural disorders
(F00-F99)
Neurotic, stress-related and somatoform disorders
(F40-F48)
F44 Dissociative [conversion] disorders
F44.8 Other dissociative [conversion] disorders
Ganser syndrome
Multiple personality
Psychogenic:
• confusion
• twilight state
F44.88 Other specified dissociative [conversion] disorders
(IM)

F45 Somatoform disorders
F45.3 Somatoform autonomic dysfunction
Symptoms are presented by the patient as if they were due to a physical disorder of a system or
organ that is largely or completely under autonomic innervation and control, i.e. the
cardiovascular, gastrointestinal, respiratory and urogenital systems. The symptoms are
usually of two types, neither of which indicates a physical disorder of the organ or system
concerned. First, there are complaints based upon objective signs of autonomic arousal,
such as palpitations, sweating, flushing, tremor, and expression of fear and distress about
the possibility of a physical disorder. Second, there are subjective complaints of a
nonspecific or changing nature such as fleeting aches and pains, sensations of burning,
heaviness, tightness, and feelings of being bloated or distended, which are referred by the
patient to a specific organ or system.
Cardiac neurosis
Da Costa syndrome
Gastric neurosis
Neurocirculatory asthenia
Psychogenic forms of:
• aerophagy
• cough
• diarrhoea
• dyspepsia
• dysuria
• flatulence
• hiccough
• hyperventilation
• increased frequency of micturition
• irritable bowel syndrome
• pylorospasm
Excl.:
psychological and behavioural factors associated with disorders or diseases classified elsewhere
(F54)

17. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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F45.39 Somatoform autonomic dysfunction, unspecified organ or system
(IM)

F45.8 Other somatoform disorders
Any other disorders of sensation, function and behaviour, not due to physical disorders, which are not
mediated through the autonomic nervous system, which are limited to specific systems or
parts of the body, and which are closely associated in time with stressful events or
problems.
Psychogenic:
• dysmenorrhoea
• dysphagia, including "globus hystericus"
• pruritus
• torticollis
Teeth-grinding
F45.80 Other somatoform disorders: Dysphagia (psychogenic), including globus
hystericus
(IM)

F45.81 Other somatoform disorders: Torticollis (psychogenic)
(IM)
F45.82 Other somatoform disorders: Teeth-grinding [bruxism]
(IM)

F45.88 Other somatoform disorders: Other somatoform disorders
(IM)

Disorders of adult personality and behaviour
(F60-F69)
F60 Specific personality disorders
F60.3 Emotionally unstable personality disorder
Personality disorder characterized by a definite tendency to act impulsively and without consideration
of the consequences; the mood is unpredictable and capricious. There is a liability to
outbursts of emotion and an incapacity to control the behavioural explosions. There is a
tendency to quarrelsome behaviour and to conflicts with others, especially when impulsive
acts are thwarted or censored. Two types may be distinguished: the impulsive type,
characterized predominantly by emotional instability and lack of impulse control, and the
borderline type, characterized in addition by disturbances in self-image, aims, and internal
preferences, by chronic feelings of emptiness, by intense and unstable interpersonal
relationships, and by a tendency to self-destructive behaviour, including suicide gestures
and attempts.
Personality (disorder):
• aggressive
• borderline
• explosive
Excl.:
dissocial personality disorder (F60.2)
F60.38 Other emotionally unstable personality disorder
(IM)
F60.39 Emotionally unstable personality disorder, unspecified
(IM)

18. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter VI
Diseases of the nervous system
(G00-G99)
Inflammatory diseases of the central nervous system
(G00-G09)
G04 Encephalitis, myelitis and encephalomyelitis
G04.3 Viral transverse myelitis, unspecified
(IM)

Episodic and paroxysmal disorders
(G40-G47)
G47 Sleep disorders
G47.3 Sleep apnoea
Sleep apnoea:
• central
• obstructive
Excl.:
pickwickian syndrome (E66.2)
sleep apnoea of newborn (P28.3)
G47.31 Central sleep apnoea synddrome
(IM)

G47.32 Obstructive sleep apnoea syndrome
(IM)

19. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter VII
Diseases of the eye and adnexa
(H00-H59)

Use Additional Code to Identify Eye Anatomy
Note : Digunakan Untuk menentukan lateralisasi mata agar dokumentasi medis tergambar
dalam kodifikasi diagnosa penyakit (jika berada di mata kanan atau kiri maka
gunakan kodenya mata kanan dan kiri secara bersamaan)
HL00 Right Eye
(IM)

HL01 Left Eye
(IM)

20. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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19
Chapter VIII
Diseases of the ear and mastoid process
(H60-H95)
Diseases of external ear
(H60-H62)
H61 Other disorders of external ear
H61.4 Hematoma or seroma of external ear
(IM)

H61.5 Hematoma of middle ear or paranasal sinus
(IM)

Other disorders of ear
(H90-H95)
H90 Conductive and sensorineural hearing loss
Incl.:
congenital deafness
Excl.:
deaf mutism NEC (H91.3)
deafness NOS (H91.9)
hearing loss:
• NOS (H91.9)
• noise-induced (H83.3)
• ototoxic (H91.0)
• sudden (idiopathic) (H91.2)
H90.0 Conductive hearing loss, bilateral
H90.00 Conductive hearing loss, bilateral, moderate-severe
(IM)

H90.01 Conductive hearing loss, bilateral, mild
(IM)

H90.1 Conductive hearing loss, unilateral with unrestricted hearing on the contralateral side
H90.10 Conduct hearing loss, unilateral with unrestricted hearing on the contralateral
side, mild
(IM)

H90.11 Conduct hearing loss, unilateral with unrestricted hearing on the contralateral
side, mod-sev
(IM)

H90.2 Conductive hearing loss, unspecified
Conductive deafness NOS

21. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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H90.3 Sensorineural hearing loss, bilateral
H90.30 Sensorineural hearing loss, bilateral, mild
(IM)

H90.31 Sensorineural hearing loss, bilateral, mod-sev
(IM)

H90.32 Sensorineural hearing loss, bilateral, profound
(IM)

H90.4 Sensorineural hearing loss, unilateral with unrestricted hearing on the contralateral
side
H90.40 Sensorineural hear loss unilat unrestricted hearing contralateral side, mild
(IM)

H90.41 Sensorineural hear loss unilat unrestricted hearing contralateral side, mod-
sev
(IM)

H90.42 Sensorineural hear loss unilat unrestricted hearing contralateral side,
profound
(IM)

H90.5 Sensorineural hearing loss, unspecified
Congenital deafness NOS
• Hearing loss:
• central
• neural
• perceptive
• sensory
• NOS
Sensorineural deafness NOS
H90.6 Mixed conductive and sensorineural hearing loss, bilateral
H90.60 Mixed conductive and sensorineural hearing loss, bilateral, mild
(IM)

H90.61 Mixed conductive and sensorineural hearing loss, bilateral, mod-sev
(IM)

H90.62 Mixed conductive and sensorineural hearing loss, bilateral, profound
(IM)

H90.7 Mixed conductive and sensorineural hearing loss, unilateral with unrestricted hearing
on the contralateral side
H90.70 Mix conductive and sensorineural hearing loss, unilateral unrestricted hearing
on the contralateral side, mild
(IM)

H90.71 Mix conductive and sensorineural hearing loss, unilateral unrestricted hearing
on the contralateral side, mod-sev
(IM)

H90.72 Mix conductive and sensorineural hearing loss, unilateral unrestricted hearing
on the contralateral side, profound
(IM)
H91 Other hearing loss
Excl.:
abnormal auditory perception (H93.2)
hearing loss as classified in H90.-
impacted cerumen (H61.2)
noise-induced hearing loss (H83.3)
psychogenic deafness (F44.6)
transient ischaemic deafness (H93.0)
H91.4 Congenital hearing loss with inability to speak
(IM)

22. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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21
Chapter IX
Diseases of the circulatory system
(I00-I99)
Other forms of heart disease
(I30-I52)
I49 Other cardiac arrhythmias
Excl.:
bradycardia:
• NOS (R00.1)
• sinoatrial (R00.1)
• sinus (R00.1)
• vagal (R00.1)
complicating:
• abortion or ectopic or molar pregnancy (O00-O07, O08.8)
• obstetric surgery and procedures (O75.4)
neonatal cardiac dysrhythmia (P29.1)
I49.0 Ventricular fibrillation and flutter
I49.00 Ventricular fibrillation and flutter with structural heart diseases
(IM)
I49.01 Ventricular fibrillation and flutter without structural heart diseases
(idiopathic)(Bugrada sy
(IM)
I49.09 Ventricular fibrillation and flutter, unspecified
(IM)
Diseases of arteries, arterioles and capillaries
(I70-I79)
I70 Atherosclerosis
Incl.:
arteriolosclerosis
arteriosclerosis
arteriosclerotic vascular disease
atheroma
degeneration:
• arterial
• arteriovascular
• vascular
endarteritis deformans or obliterans
senile:
• arteritis
• endarteritis
Excl.:
cerebral (I67.2)
coronary (I25.1)
mesenteric (K55.1)
pulmonary (I27.0)

23. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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The following supplementary classification to indicate the presence or absence of gangrene is
provided for optional use.
.0 Without Gangrene
.1 With Gangrene
I70.1 Atherosclerosis of renal artery
Goldblatt kidney
Excl.:
atherosclerosis of renal arterioles (I12.-)
I70.10 Atherosclerosis of renal artery without gangrene
(IM)
I70.11 Atherosclerosis of renal artery with gangrene
(IM)
I70.2 Atherosclerosis of arteries of extremities
Atherosclerotic gangrene
Mönckeberg (medial) sclerosis
I70.3 Atherosclerosis of carotid arteries
(IM
)
Other and unspecified disorders of the circulatory system
(I95-I99)
I95 Hypotension
I95.3 Neural-mediated hypotension
(IM)

24. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter X
Diseases of the respiratory system
(J00-J99)
Influenza and pneumonia
(J09-J18)
J15 Bacterial pneumonia, not elsewhere classified
J15.8 Other bacterial pneumonia
J15.81 Pneumonia due to Rhodococcus equi
(IM)

J15.88 Other bacterial pneumonia
(IM)
Other diseases of upper respiratory tract
(J30-J39)
J37 Chronic laryngitis and laryngotracheitis
Use additional code (B95-B98), if desired, to identify infectious agent.
J37.2 Chronic laryngitis with gastric acid reflux
(IM)

Chronic lower respiratory diseases
(J40-J47)
J44 Other chronic obstructive pulmonary disease
J44.2 Wheezing ascociated respiratory illness
(IM)
J44.3 Obstruction syndrome post tuberculosis
(IM)

J44.9 Chronic obstructive pulmonary disease, unspecified
Chronic obstructive:
• airway disease NOS
• lung disease NOS
J44.90 Asthma COPD overlap syndrome (ACOS)
(IM)

25. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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J45 Asthma
J45.2 Bronchial hiperresponsiveness
(IM)
J45.3 Asthma with exacerbation
(IM)

J45.4 Cough variant asthma
(IM)
J45.5 Exercise induced bronchospasm
(IM)

J47 Bronchiectasis
Incl.:
Bronchiolectasis
Excl.:
congenital bronchiectasis (Q33.4)
tuberculous bronchiectasis (current disease) (A15-A16)
J47.0 Stable bronchiectasis
(IM)
J47.1 Bronchiectasis with exacerbation
(IM)

Other diseases of the respiratory system
(J95-J99)
J95 Postprocedural respiratory disorders, not elsewhere classified
J95.6 Postprocedural chylothorax
(IM)

J98 Other respiratory disorders
J98.7 Trapped lung
(IM)

26. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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25
Chapter XI
Diseases of the digestive system
(K00-K93)
Diseases of oral cavity, salivary glands and jaws
(K00-K14)
"Use additional code for the lateral side of the tooth”
For Code K00-K08 & S02.5 "Use additional code for the lateral side of the tooth”

For Permanent Teeth / Adult Teeth :
KG11 Upper Right Central Incisor
(IM)
KG12 Upper right lateral incisor
(IM)

KG13 Upper right canine
(IM)
KG14 Upper right first premolar
(IM)

KG15 Upper right second premolar
(IM)
KG16 Upper right first molar
(IM)
KG17 Upper right second molar
(IM)

KG18 Upper right third molar
(IM)

KG21 Upper left central incisor
(IM)

KG22 Upper left lateral incisor
(IM)

KG23 Upper left canine
(IM)

KG24 Upper left first premolar
(IM)

KG25 Upper left second premolar
(IM)

KG26 Upper left first molar
(IM)

KG27 Upper left second molar
(IM)
KG28 Upper left third molar
(IM)

KG31 Lower left central incisor
(IM)

KG32 Lower left lateral incisor
(IM)
KG33 Lower left canine
(IM)

KG34 Lower left first premolar
(IM)

KG35 Lower left second premolar
(IM)

KG36 Lower left first molar
(IM)

KG37 Lower left second molar
(IM)

KG38 Lower left third molar
(IM)

KG41 Lower right central incisor
(IM)

KG42 Lower right lateral incisor
(IM)

KG43 Lower right canine
(IM)

KG44 Lower right first premolar
(IM)

KG45 Lower right second premolar
(IM)

KG46 Lower right first molar
(IM)

KG47 Lower right second molar
(IM)

KG48 Lower right third molar
(IM)
For Deciduous Teeth / Primary Teeth :
KG51: Upper Right Central Incisor
(IM)

KG52: Upper Right Lateral Incisor
(IM)

KG53: Upper Right Canine
(IM)

KG54: Upper Right First Molar
(IM)

KG55: Upper Right Second Molar
(IM)

KG61: Upper Left Central Incisor
(IM)
KG62: Upper Left Lateral Incisor
(IM)

KG63: Upper Left Canine
(IM)

KG64: Upper Left First Molar
(IM)

KG65: Upper Left Second Molar
(IM)

KG71: Lower Left Central Incisor
(IM)

KG72: Lower Left Lateral Incisor
(IM)

KG73: Lower Left Canine
(IM)

KG74: Lower Left First Molar
(IM)

KG75: Lower Left Second Molar
(IM)

KG81: Lower Right Central Incisor
(IM)
KG82: Lower Right Lateral Incisor
(IM)
KG83: Lower Right Canine
(IM)

KG84: Lower Right First Molar
(IM)

KG85: Lower Right Second Molar
(IM)

K00 Disorders of tooth development and eruption
"Use additional code for the lateral side of the tooth”

Excl.:
embedded and impacted teeth (K01.-)
K00.0 Anodontia
Hypodontia (IM)
Oligodontia (IM)

K00.00 Partial anodontia [hypodontia] [oligodontia]
(IM)
K00.01 Total anodotia
(IM)
K00.09 Anodontia, unspecified
(IM)

27. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K00.1 Supernumerary teeth
Distomolar
Fourth molar
Mesiodens
Paramolar
Supplementary teeth
K00.10 Supernumerary teeth, Incisor and canine regions
(IM)
K00.11 Supernumerary teeth, Premolar region
(IM)

K00.12 Supernumerary teeth, Molar region
(IM)

K00.19 Supernumerary teeth, unspecified
(IM)

K00.2 Abnormalities of size and form of teeth
• Concrescence
• Fusion
• Gemination
• of teeth
Dens:
• evaginatus
• in dente
• invaginatus
Enamel pearls
Macrodontia
Microdontia
Peg-shaped [conical] teeth
Taurodontism
Tuberculum paramolare
Excl.:
tuberculum Carabelli, which is regarded as a normal variation and should not be coded
K00.20 Macrodontia
(IM)
K00.21 Microdontia
(IM)
K00.22 Concrescence
(IM)
K00.23 Fusion and gemination
(IM)

K00.24 Dens evaginatus, [occlusal tuberculum]
(IM)
K00.25 Dens invaginatus [dens in dente] [dilated odonoma] & incisor anomalies
(IM)

K00.26 Premolarization
(IM)
K00.27 Abnormal tubercula & enamel pearls [enameloma]
(IM)

K00.28 Taurodontism
(IM)
K00.29 Other & unspecified abnormalities of size & form of teeth
(IM)

K00.3 Mottled teeth
Dental fluorosis
Mottling of enamel
Nonfluoride enamel opacities
Excl.:
deposits [accretions] on teeth (K03.6)
K00.30 Endemic (fluoride) mottling of enamel [dental fluorosis]
(IM)

K00.31 Non-endemic mottling of enamel [non-fluoride enamel opacities]
(IM)
K00.39 Mottled teeth, unspecified
(IM)

K00.4 Disturbances in tooth formation
Aplasia and hypoplasia of cementum

28. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Dilaceration of tooth
Enamel hypoplasia (neonatal)(postnatal)(prenatal)
Regional odontodysplasia
Turner tooth
Excl.:
Hutchinson teeth and mulberry molars in congenital syphilis (A50.5)
mottled teeth (K00.3)
K00.40 Enamel hypoplasia
(IM)

K00.41 Prenatal enamel hypoplasia
(IM)
K00.42 Neonatal enamel hypoplasia
(IM)

K00.43 Aplasia and hypoplasia of cementum
(IM)
K00.44 Dilaceration
(IM)
K00.45 Odontodysplasia [regional odontodysplasia]
(IM)
K00.46 Turner's tooth
(IM)

K00.48 Other specified disturbances in tooth formation
(IM)
K00.49 Disturbances in tooth formation, unspecified
(IM)
K00.5 Hereditary disturbances in tooth structure, not elsewhere classified
• Amelogenesis
• Dentinogenesis
• Odontogenesis
• imperfecta
Dentinal dysplasia
Shell teeth
K00.50 Amelogenesis imperfecta
(IM)

K00.51 Dentinogenesis imperfecta
(IM)
K00.52 Odontogenesis imperfecta
(IM)
K00.58 Other hereditary disturbances in tooth structure
(IM)
K00.59 Hereditary disturbances in tooth structure, unspecified
(IM)
K00.6 Disturbances in tooth eruption
Dentia praecox
• Natal
• Neonatal
• tooth
Premature:
• eruption of tooth
• shedding of primary [deciduous] tooth
Retained [persistent] primary tooth

29. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

Indonesian Modification Version_01 2025
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K00.60 Natal teeth
(IM)
K00.61 Neonatal teeth
(IM)
K00.62 Premature eruption [dentia praecox]
(IM)
K00.63 Retained [persistent] primary [deciduous] teeth
(IM)

K00.64 Late eruption
(IM)
K00.65 Premature shedding of primary [deciduous] teeth
(IM)
K00.68 Other specified disturbances in tooth eruption
(IM)
K00.69 Disturbances in tooth eruption, unspecified
(IM)
K00.7 Teething syndrome
K00.8 Other disorders of tooth development
Colour changes during tooth formation
Intrinsic staining of teeth NOS
K00.80 Colour changes during tooth formation due to blood type incompatibility
(IM)
K00.81 Colour changes during tooth formation due to malformation of biliary system
(IM)

K00.82 Colour changes during tooth formation due to porphyria
(IM)
K00.83 Colour changes during tooth formation due to tetracyclines
(IM)
K00.88 Other specified disorders of tooth development
(IM)
K00.9 Disorder of tooth development, unspecified
Disorder of odontogenesis NOS
K01 Embedded and impacted teeth
"Use additional code for the lateral side of the tooth”
Excl.:
embedded and impacted teeth with abnormal position of such teeth or adjacent teeth (K07.3)
K01.0 Embedded teeth
An embedded tooth is a tooth that has failed to erupt without obstruction by another tooth.
K01.1 Impacted teeth
An impacted tooth is a tooth that has failed to erupt because of obstruction by another tooth.
K01.10 Impacted teeth, Maxillary incisor
(IM)

K01.11 Impacted teeth, Mandibular incisor
(IM)

K01.12 Impacted teeth, Maxillary canine
(IM)
K01.13 Impacted teeth, Mandibular canine
(IM)
K01.14 Impacted teeth, Maxillary premolar
(IM)
K01.15 Impacted teeth, Mandibular premolar
(IM)
K01.16 Impacted teeth, Maxillary molar
(IM)
K01.17 Impacted teeth, Mandibular molar
(IM)

K01.18 Impacted teeth, Supernumerary tooth
(IM)

K01.19 Impacted tooth, unspecified
(IM)

30. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

Indonesian Modification Version_01 2025
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K03 Other diseases of hard tissues of teeth
"Use additional code for the lateral side of the tooth”
Excl.:
bruxism (F45.8)
dental caries (K02.-)
teeth-grinding NOS (F45.8)
K03.0 Excessive attrition of teeth
• Wear:
• approximal
• occlusal
• of teeth
K03.00 Excessive attrition of teeth Occlusal
(IM)
K03.01 Excessive attrition of teeth Approximal
(IM)

K03.08 Other specified attrition of teeth
(IM)

K03.09 Attrition of teeth, unspecified
(IM)

K03.1 Abrasion of teeth
• Abrasion:
• dentifrice
• habitual
• occupational
• ritual
• traditional
• Wedge defect NOS
• of teeth
K03.10 Dentrifice
(IM)
K03.11 Habitual abrasion of teeth
(IM)

K03.12 Occupational abrasion of teeth
(IM)
K03.13 Traditioanal abrasion of teeth
(IM)
K03.18 Other specified abrasion of teeth
(IM)

K03.19 Abrasion of teeth, unspecified
(IM)
K03.2 Erosion of teeth
Erosion of teeth:
• NOS
• due to:
o diet
o drugs and medicaments
o persistent vomiting
• idiopathic
• occupational

31. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K03.20 Occupational erosion of teeth
(IM)
K03.21 Erosion of teeth due to persistent regurgitating or vomiting
(IM)
K03.22 Erosion of teeth due to diet
(IM)

K03.23 Erosion of teeth due to drugs and medicaments
(IM)
K03.24 Idiopathic erosion of teeth
(IM)
K03.28 Other specified erosion of teeth
(IM)
K03.29 Erosion of teeth, unspecified
(IM)

K03.3 Pathological resorption of teeth
Internal granuloma of pulp
Resorption of teeth (external)
K03.30 External resorption of teeth
(IM)
K03.31 Internal [internal granuloma] [pink spot] resorption of teeth
(IM)
K03.39 Pathological resorption of teeth, unspecified
(IM)

K03.4 Hypercementosis
Cementation hyperplasia
K03.5 Ankylosis of teeth
K03.6 Deposits [accretions] on teeth
Dental calculus:
• subgingival
• supragingival
Deposits [accretions] on teeth:
• betel
• black
• green
• materia alba
• orange
• tobacco
Staining of teeth:
• NOS
• extrinsic NOS
K03.60 Pigmented film
(IM)

K03.61 Deposits on teeth due to tobacco habit
(IM)
K03.62 Deposits on teeth due to betel-chewing habit
(IM)

K03.63 Other gross soft deposits
(IM)

K03.64 Supragingival calculus
(IM)

K03.65 Subgingival caluculus
(IM)

K03.66 Dental plaque
(IM)

K03.68 Other specified deposits on teeth
(IM)

K03.69 Deposit [accretions] on teeth, unspecified
(IM)
K03.7 Posteruptive colour changes of dental hard tissues
Excl.:
deposits [accretions] on teeth (K03.6)

32. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K03.70 Posterupt col chng of dent hard tiss due to metats & met comp
(IM)

K03.71 Posterupt col chng of dent hard tiss due to pulpal bleeding
(IM)

K03.72 Posterupt col chng of dent hard tiss due to chewing habit
(IM)

K03.78 Other spec posterupt col chng of dent hard tiss
(IM)

K03.79 Posterupt col chng of dent hard tiss, unspecified
(IM)

K03.8 Other specified diseases of hard tissues of teeth
Irradiated enamel
(IM)

Sensitive dentine
(IM)

K03.80 Sensitive dentine
(IM)

K03.81 Changes of enamel due to irradiation
(IM)

K03.88 Other specified diseases of hard tissues of teeth
(IM)

Use additional external cause code (Chapter XX), if desired, to identify radiation, if radiation-induced.
K03.9 Disease of hard tissues of teeth, unspecified
K04 Diseases of pulp and periapical tissues
"Use additional code for the lateral side of the tooth”
K04.8 Radicular cyst
Cyst:
• apical (periodontal)
• periapical
• residual radicular
Excl.:
lateral periodontal cyst (K09.0)
K04.80 Apical and lateral radicular cyst
(IM)

K04.81 Residual radicular cyst
(IM)

K04.82 Inflammatory paradental radicular cyst
(IM)

K04.89 Radicular cyst, unspecified
(IM)

K04.9 Other and unspecified diseases of pulp and periapical tissues
K05 Gingivitis and periodontal diseases
"Use additional code for the lateral side of the tooth”
K05.0 Acute gingivitis
Excl.:
acute necrotizing ulcerative gingivitis (A69.1)
herpesviral [herpes simplex] gingivostomatitis (B00.2)
K05.00 Acute streoptococcal gingivostomatitis
(IM)

K05.08 Other specified acute gingivitis
(IM)

K05.09 Acute gingivitis, unspecified
(IM)

33. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K05.1 Chronic gingivitis
Gingivitis (chronic):
• NOS
• desquamative
• hyperplastic
• simple marginal
• ulcerative
K05.10 Chronic gingivitis, Simple marginal
(IM)

K05.11 Chronic gingivitis, Hyperplastic
(IM)

K05.12 Chronic gingivitis, Ulcerative
(IM)

K05.13 Chronic gingivitis, Desquamative
(IM)

K05.18 Other specified chronic gingivitis
(IM)

K05.19 Chronic gingivitis, unspecified
(IM)

K05.2 Acute periodontitis
Acute pericoronitis
Parodontal abscess
Periodontal abscess
Excl.:
acute apical periodontitis (K04.4)
periapical abscess (K04.7)
periapical abscess with sinus (K04.6)
K05.20 Periodontal abscess of gingival origin wo sinus
(IM)
K05.21 Periodontal abscess of gingival origin w sinus
(IM)
K05.22 Acute pericoronitis
(IM)

K05.28 Other specified acute periodontitis
(IM)

K05.29 Acute periodontitis, unspecified
(IM)

K05.3 Chronic periodontitis
Chronic pericoronitis
Periodontitis:
• NOS
• complex
• simplex
K05.30 Chronic periodontitis, Simplex
(IM)

K05.31 Chronic periodontitis, Complex
(IM)

K05.32 Chronic periodontitis, Chronic pericoronitis
(IM)

K05.33 Chronic periodontitis, Thickened follicle
(IM)
K05.38 Other specified chronic periodontitis
(IM)
K05.39 Chronic periodontitis,unspecified
(IM)

K06 Other disorders of gingiva and edentulous alveolar ridge
"Use additional code for the lateral side of the tooth”
Excl.:
atrophy of edentulous alveolar ridge (K08.2)
gingivitis:

34. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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• NOS (K05.1)
• acute (K05.0)
• chronic (K05.1)
K06.0 Gingival recession
Gingival recession (generalized
(IM)
(localized
(IM)
(postinfective)(post-operative)
K06.00 Localized gingival recession
(IM)

K06.01 Generalized gingival recession
(IM)

K06.09 Gingival recession, unspecified
(IM)
K06.1 Gingival enlargement
Gingival fibromatosis
(IM)

K06.10 Gingival fibromatosis
(IM)

K06.18 Other specified gingival enlargement
(IM)

K06.19 Gingival enlargement, unspecified
(IM)

K06.2 Gingival and edentulous alveolar ridge lesions associated with trauma
Irritative hyperplasia of edentulous ridge [denture hyperplasia]
K06.20 Gingival and edentulous alveolar ridgelesions associated with trauma, Due to
traumatic occlusion
(IM)

K06.21 Gingival and edentulous alveolar ridgelesions associated with trauma, Due to
toothbrushing
(IM)

K06.22 Gingival and edentulous alveolar ridgelesions associated with trauma,
Frictional [functional] keratosis
(IM)

K06.28 Gingival and edentulous alveolar ridgelesions associated with trauma, Other
specified gingival & edentulous alveolar ridge lesions associated with trauma
(IM)

K06.29 Gingival & edentulous alveolar ridge lesions ass w trauma, unspecified
(IM)

Use additional external cause code (Chapter XX), if desired, to identify cause.
K06.8 Other specified disorders of gingiva and edentulous alveolar ridge
Fibrous epulis
(IM)
Flabby ridge
(IM)

Giant cell epulis
(IM)

Peripheral giant cell granuloma
(IM)
Pyogenic granuloma of gingiva
(IM)

35. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K06.80 Gingival cyst of adult
(IM)
K06.81 Peripheral giant cell granuloma [giant cell epulis]
(IM)

K06.82 Fibrous epulis
(IM)
K06.83 Pyogenic granuloma
(IM)

K06.84 Flabby ridge
(IM)

K06.85 Other specified disorders of gingival
(IM)
K06.86 Other specified disorders of edentulous alveolar ridge
(IM)
K06.9 Disorder of gingiva and edentulous alveolar ridge, unspecified
K07 Dentofacial anomalies [including malocclusion]
"Use additional code for the lateral side of the tooth”
Excl.:
hemifacial atrophy or hypertrophy (Q67.4)
unilateral condylar hyperplasia or hypoplasia (K10.8)
K07.0 Major anomalies of jaw size
Hyperplasia, hypoplasia:
(IM)

•
mandibular
(IM)
•
maxillary
(IM)
Macrognathism (mandibular)(maxillary)
(IM)
Micrognathism (mandibular)(maxillary)
(IM)
Excl.:
acromegaly (E22.0)
Robin syndrome (Q87.0)

36. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K07.00 Maxillary macrognthism [maxillary hyperplasia]
(IM)

K07.01 Mandibular macrognathism [mandibular hyperplasia]
(IM)
K07.02 Macrognathism, both jaws
(IM)

K07.03 Maxillary micrognathism [maxiliary hypoplasia]
(IM)
K07.04 Mandibular micrognathism [mandibular hypoplasia]
(IM)
K07.05 Micrognathism, both jaws
(IM)
K07.08 Other specified major anomalies of jaw size
(IM)
K07.09 Anomaly of jaw size, unspecified
(IM)
K07.1 Anomalies of jaw-cranial base relationship
Asymmetry of jaw
(IM)
Prognathism (mandibular)(maxillary)
(IM)
Retrognathism (mandibular)(maxillary)
(IM)
K07.10 Asymmetry of jaw
(IM)
K07.11 Mandibular prognathism
(IM)
K07.12 Maxillary prognathism
(IM)
K07.13 Mandibular retrognathism
(IM)
K07.14 Maxillary retrognathism
(IM)
K07.18 Other specified anomalies of jaw-cranial base relationship
(IM)
K07.19 Anomaly of jaw-cranial base relationship, unspecified
(IM)
K07.2 Anomalies of dental arch relationship
Crossbite (anterior)(posterior)
(IM)
Disto-occlusion
(IM)
Mesio-occlusion
(IM)
Midline deviation of dental arch
(IM)
Openbite (anterior)(posterior)
(IM)
Overbite (excessive):
(IM)

•
deep
(IM)
• horizontal
(IM)

• vertical
(IM)

Overjet
(IM)
Posterior lingual occlusion of mandibular teeth
(IM)

37. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K07.20 Disto-occlusion
(IM)
K07.21 Mesio-occlusion
(IM)
K07.22 Excessive overjet [horizontal overbite]
(IM)

K07.23 Excessive overbite [vertical overbite]
(IM)

K07.24 Openbite
(IM)

K07.25 Crossbite (anterior, posterior)
(IM)
K07.26 Midline deviation
(IM)
K07.27 Posterior lingual occlusion of mandibular arch
(IM)
K07.28 Other specified anomalies of dental arch relationship (IM)
K07.29 Anomaly of dental arch relationship, unspecified
(IM)
K07.3 Anomalies of tooth position
• Crowding
• Diastema
• Displacement
• Rotation
• Spacing, abnormal
• Transposition
• of tooth or teeth
Impacted or embedded teeth with abnormal position of such teeth or adjacent teeth
Excl.:
embedded and impacted teeth without abnormal position (K01.-)
K07.30 Crowding
(IM)
K07.31 Displacement
(IM)
K07.32 Rotation
(IM)

K07.33 Spacing
(IM)
K07.34 Transposition
(IM)
K07.38 Other specified anomalies of tooth position
(IM)

K07.39 Anomaly of tooth position, unspecified
(IM)
K07.4 Malocclusion, unspecified
K07.5 Dentofacial functional abnormalities
Abnormal jaw closure
Malocclusion due to:
• abnormal swallowing
• mouth breathing
• tongue, lip or finger habits
Excl.:
bruxism (F45.8)
teeth-grinding NOS (F45.8)
K07.50 Abnormal law closure
(IM)

K07.51 Maloclusion due to abnormal swallowing
(IM)

K07.54 Malocclusion due to mouth breathing
(IM)
K07.55 Malocclusion due to tongue, lip or finger habits
(IM)

K07.58 Other specified dentofacial functional abnormalities
(IM)

K07.59 Dentofacial functional abnormality, unspecified
(IM)
K07.6 Temporomandibular joint disorders
Costen complex or syndrome

38. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Derangement of temporomandibular joint
Snapping jaw
Temporomandibular joint-pain-dysfunction syndrome
Excl.:
current temporomandibular joint:
• dislocation (S03.0)
• strain (S03.4)
K07.60 TM joint-pain-dysfunction [Costen's] syndrome
(IM)
K07.61 Clicking (snapping) jaws
(IM)

K07.62 Recurrent dislocation & subluxation of TM joint
(IM)

K07.63 Pain in TM joint, not elsewhere classified
(IM)
K07.64 Stiffness of TM joint, not elsewhere classified
(IM)
K07.65 Osteophyte of temporomandibular joint
(IM)
K07.68 Other specified temporomandibular joint disorders
(IM)
K07.69 Temporomandibular joint disorder, unspecified
(IM)

K07.8 Other dentofacial anomalies
K07.9 Dentofacial anomaly, unspecified
K08 Other disorders of teeth and supporting structures
"Use additional code for the lateral side of the tooth”
K08.8 Other specified disorders of teeth and supporting structures
Enlargement of alveolar ridge NOS
(IM)

Irregular alveolar process
(IM)

Toothache NOS
(IM)

K08.80 Toothache NOS
(IM)

K08.81 Irregular alveolar process
(IM)
K08.82 Enlargement of alveolar ridge NOS
(IM)

K08.88 Other spec disorders of teeth & supporting structures
(IM)

K09 Cysts of oral region, not elsewhere classified
Incl.:
lesions showing histological features both of aneurysmal cyst and of another fibro-osseous lesion
Excl.:
radicular cyst (K04.8)
K09.0 Developmental odontogenic cysts
Cyst:
• dentigerous
• eruption
• follicular
• gingival
• lateral periodontal
• primordial

39. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K09.00 Developmental odontogenic cysts, eruption
(IM)

K09.01 Developmental odontogenic cysts, gingival
(IM)
K09.02 Dev odontogen cysts, keratocyst [primordial]
(IM)

K09.03 Dev odontogen cysts, follicular [dentigerous]
(IM)

K09.04 Dev odontogen cysts, lateral periodontal
(IM)

K09.08 Other specified developmental odontogenic cysts
(IM)

K09.09 Developmental odontogenic cyst, unspecified
(IM)

K09.1 Developmental (nonodontogenic) cysts of oral region
Cyst (of):
• globulomaxillary
• incisive canal
• median palatal
• nasopalatine
• palatine papilla
K09.10 Dev (nonodontogen) cysts of oral region globulomaxillary
(IM)

K09.11 Dev (nonodontogen) cysts of oral region median palatal
(IM)

K09.12 Dev (nonodontogen) cysts of oral region, nasopalatine [incisive canal]
(IM)

K09.13 Dev (nonodontogen) cysts of oral region, palatine papilla
(IM)

K09.18 Other specified dev (nonodontogen) cysts of oral origin
(IM)

K09.19 Developmental cyst of oral region, unspecified
(IM)

K09.2 Other cysts of jaw
Cyst of jaw:
• NOS
• aneurysmal
• haemorrhagic
• traumatic
Excl.:
latent bone cyst of jaw (K10.0)
Stafne cyst (K10.0)
K09.20 Aneurysmal bone cyst
(IM)

K09.21 Solitary bone [traumatic] [haemorrhagic] cyst of jaw
(IM)

K09.22 Epithelial jaw cyst not idenifiable as odontogenic or nonodontogenic
(IM)

K09.28 Other specified cysts of jaw (
IM)
K09.29 Cyst of jaw, unspecified
(IM)

K09.8 Other cysts of oral region, not elsewhere classified
• Dermoid cyst
• Epidermoid cyst
• Lymphoepithelial cyst
• of mouth
Epstein pearl
Nasoalveolar cyst
Nasolabial cyst

40. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K09.80 Dermoid cyst
(IM)

K09.81 Epidermoid cyst
(IM)

K09.82 Gingival cyst of newborn
(IM)

K09.83 Palatal cyst of newborn
(IM)
K09.84 Nasoalveolar [nasolabial] cyst
(IM)

K09.85 Lymphoepidermoid cyst
(IM)

K09.88 Other specified cysts of oral region
(IM)

K09.9 Cyst of oral region, unspecified
K10 Other diseases of jaws
K10.0 Developmental disorders of jaws
Latent bone cyst of jaw
Stafne cyst
Torus:
• mandibularis
• palatinus
K10.00 Torus mandibularis
(IM)

K10.01 Torus palatinus
(IM)

K10.02 Latent bone cyst
(IM)

K10.08 Other specified developmental disorders of jaws
(IM)
K10.09 Developmental disorder of jaws, unspecified
(IM)

K10.1 Giant cell granuloma, central
Giant cell granuloma NOS
Excl.:
peripheral giant cell granuloma (K06.8)
K10.2 Inflammatory conditions of jaws
• Osteitis
• Osteomyelitis (neonatal)
• Osteoradionecrosis
• Periostitis
• of jaw (acute)(chronic)(suppurative)
Sequestrum of jaw bone (IM)
K10.20 Osteitis of jaw
(IM)

K10.21 Osteomyelitis of jaw
(IM)

K10.22 Periostitis of jaw
(IM)

K10.23 Chronic periostitis of jaw
(IM)

K10.24 Neonatal osteomyelitis of maxilla [neonatal maxillitis]
(IM)

K10.25 Sequestrum
(IM)

K10.26 Osteoradionecrosis
(IM)

K10.28 Other specified inflammatory conditions of jaws
(IM)

K10.29 Inflammatory conditions of jaws, unspecified
(IM)

Use additional external cause code (Chapter XX), if desired, to identify radiation, if radiation-induced.
K10.3 Alveolitis of jaws
Alveolar osteitis

41. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Dry socket
K10.8 Other specified diseases of jaws
Cherubism
• Exostosis
• Fibrous dysplasia
• of jaw
Unilateral condylar:
• hyperplasia
• hypoplasia
K10.80 Cherubism
(IM)

K10.81 Unilateral condylar hyperplasia of mandible
(IM)

K10.82 Unilateral condylar hypoplasia of mandible
(IM)

K10.83 Fibrous dysplasia of jaw
(IM)

K10.88 Other specified disease of jaws
(IM)
K10.9 Disease of jaws, unspecified
K11 Diseases of salivary glands
K11.6 Mucocele of salivary gland
• Mucous:
• extravasation cyst
• retention cyst
• of salivary gland
Ranula
K11.60 Mucous retention cyst
(IM)

K11.61 Mucous extravasation cyst
(IM)

K11.69 Mucocele of salivary gland, unspecified
(IM)

Ranula
K11.7 Disturbances of salivary secretion
Hypoptyalism
Ptyalism
Xerostomia
Excl.:
dry mouth NOS (R68.2)
K11.70 Hyposecretion
(IM)

K11.71 Xerostomia
(IM)

K11.72 Hypersecretion [ptyalism]
(IM)

K11.78 Other specified disturbances of salivary secretion
(IM)

K11.79 Disturbance of salivary secretion, unspecified
(IM)

42. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K11.8 Other diseases of salivary glands
Benign lymphoepithelial lesion of salivary gland
Mikulicz disease
Necrotizing sialometaplasia
Sialectasia
• Stenosis
• Stricture
• of salivary duct
Excl.:
sicca syndrome [Sjögren] (M35.0)
K11.80 Benign lymphoepithelial lesion of salivary gland
(IM)
K11.81 Mikulicz, disease
(IM)

K11.82 Stenosis [stricture] of salivary duct
(IM)
K11.83 Sialectasia
(IM)

K11.85 Necrotizing sialometaplasia
(IM)
K11.88 Other specified disease of salivary glands
(IM)

K11.9 Disease of salivary gland, unspecified
Sialoadenopathy NOS
K12 Stomatitis and related lesions
K12.0 Recurrent oral aphthae
Aphthous stomatitis (major)(minor)
Bednar aphthae
Periadenitis mucosa necrotica recurrens
Recurrent aphthous ulcer
Stomatitis herpetiformis
K12.00 Recurrent (minor) aphthae
(IM)

K12.01 Periadenitis mucosa necrotica recurrens
(IM)

K12.02 Stomatis herpetiformis [herpetiform eruption]
(IM)

K12.03 Bednar's aphthae
(IM)

K12.04 Traumatic ulcer
(IM)

K12.08 Other specified recurrent oral aphthae
(IM)

K12.09 Recurrent oral aphthae, unspecified
(IM)
K12.1 Other forms of stomatitis
Stomatitis:
• NOS
• denture
• ulcerative
• vesicular

43. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K12.10 Stomatitis artifacta
(IM)

K12.11 Geographic stomatitis
(IM)

K12.12 Denture stomatitis
(IM)

K12.13 Papillary hyperplasia of palate
(IM)

K12.14 Contact stomatitis
(IM)

K12.18 Other specified forms of stomatitis
(IM)

K12.19 Stomatitis, unspecified
(IM)

▪ NOS
▪ ulcerative
▪ vesicular
K12.2 Cellulitis and abscess of mouth
Cellulitis of mouth (floor)
Submandibular abscess
Excl.:
abscess (of):
• periapical (K04.6-K04.7)
• periodontal (K05.2)
• peritonsillar (J36)
• salivary gland (K11.3)
• tongue (K14.0)
K12.20 Buccal abscess
(IM)

K12.21 Submandibular abscess
(IM)
K12.22 Anterior-visceral abscess
(IM)

K13 Other diseases of lip and oral mucosa
Incl.:
epithelial disturbances of tongue
Excl.:
certain disorders of gingiva and edentulous alveolar ridge (K05-K06)
cysts of oral region (K09.-)
diseases of tongue (K14.-)
stomatitis and related lesions (K12.-)
K13.0 Diseases of lips
Cheilitis:
• NOS
• angular
• exfoliative
• glandular
Cheilodynia
Cheilosis
Perlèche NEC
Excl.:
ariboflavinosis (E53.0)
cheilitis due to radiation-related disorders (L55-L59)
perlèche due to:
• candidiasis (B37.8)
• riboflavin deficiency (E53.0)

44. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K13.00 Angular cheilitis
(IM)

K13.01 Cheilitis glandularis apostematosa
(IM)

K13.02 Cheilitis, exfoliative
(IM)

K13.03 Cheilitis NOS
(IM)

K13.04 Cheilodynia
(IM)

K13.08 Other specified disease of lips
(IM)
K13.09 Disease of lips, unspecified
(IM)

K13.1 Cheek and lip biting
K13.2 Leukoplakia and other disturbances of oral epithelium, including tongue
• Erythroplakia
• Leukoedema
• of oral epithelium, including tongue
Leukokeratosis nicotina palati
Smoker palate
Excl.:
hairy leukoplakia (K13.3)
K13.20 Leukoplakia, idiopathic
(IM)
K13.21 Leukoplakia, tobacco-associated
(IM)

K13.22 Erythroplakia
(IM)

K13.23 Leukoedema
(IM)

K13.24 Smoker's palate [leukokeratosis nicotina palati] [nicotina palati]
(IM)

K13.28 Other spec leukoplakia & disturbances of oral epith,including tongue
(IM)

K13.29 Leukoplakia & disturbances of oral epithelium,unspec
(IM)

K13.3 Hairy leukoplakia
K13.4 Granuloma and granuloma-like lesions of oral mucosa
• Eosinophilic granuloma
• Granuloma pyogenicum
• Verrucous xanthoma
• of oral mucosa
K13.40 Pyogenic granuloma
(IM)

K13.41 Eosinophilic granuloma of oral mucosa
(IM)

K13.42 Verrucous xanthoma [histiocytosis Y]
(IM)

K13.48 Other specified granuloma & granuloma-like lesions of oral mucosa
(IM)

K13.49 Granuloma & granuloma-like lesions of oral mucosa, unspecified
(IM)

K13.5 Oral submucous fibrosis
Submucous fibrosis of tongue
K13.6 Irritative hyperplasia of oral mucosa
Excl.:
irritative hyperplasia of edentulous ridge [denture hyperplasia] (K06.2)
K13.7 Other and unspecified lesions of oral mucosa
Focal oral mucinosis
K13.70 Excessive melanin pigmentation
(IM)

K13.71 Oral fistula
(IM)

K13.72 Deliberate tattoo
(IM)

K13.73 Focal oral mucinosis
(IM)

K13.78 Other specified lesions of oral mucosa
(IM)

45. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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K13.79 Lesion of oral mucosa, unspecified
(IM)

K14 Diseases of tongue
Excl.:
• erythroplakia
• focal epithelial hyperplasia
• leukoedema
• leukoplakia
• of tongue (K13.2)
hairy leukoplakia (K13.3)
macroglossia (congenital) (Q38.2)
submucous fibrosis of tongue (K13.5)
K14.0 Glossitis
• Abscess
• Ulceration (traumatic)
• of tongue
K14.00 Abscess of tongue
(IM)

K14.01 Traumatic ulceration of tongue
(IM)

K14.08 Other specified glossitis
(IM)

K14.09 Glossitis, unspecified
(IM)

Excl.:
atrophic glossitis (K14.4)
K14.1 Geographic tongue
Benign migratory glossitis
Glossitis areata exfoliativa
K14.2 Median rhomboid glossitis
K14.3 Hypertrophy of tongue papillae
Black hairy tongue
Coated tongue
Hypertrophy of foliate papillae
Lingua villosa nigra
K14.30 Coated tongue
(IM)

K14.31 Hairy tongue
(IM)

K14.32 Hypertrophy of foliate papillae
(IM)

Lingua villosa nigra
K14.38 Other specified hypertrophy of tongue papillae
(IM)

K14.39 Hypertrophy of tongue papillae, unspecified
(IM)

K14.4 Atrophy of tongue papillae
Atrophic glossitis
K14.40 Atrophy of tongue papillae due to tongue cleaning habit
(IM)

K14.41 Atrophy of tongue papillae due to systemic disorder
(IM)

K14.42 Atrophic glossitis NOS
(IM)

K14.48 Other specified atrophy of tongue papillae
(IM)

K14.49 Atrophy of tongue papillae, unspecified
(IM)

K14.5 Plicated tongue
• Fissured
• Furrowed
• Scrotal
• tongue

46. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Excl.:
fissured tongue, congenital (Q38.3)
K14.6 Glossodynia
Glossopyrosis
Painful tongue
K14.60 Glossopyrosis [burning tongue]
(IM)

K14.61 Glossodynia [painful tongue]
(IM)

K14.68 Other specified glossodynia
(IM)

K14.69 Glossodynia, unspecified
(IM)

K14.8 Other diseases of tongue
• Atrophy
• Crenated
• Enlargement
• Hypertrophy
• (of) tongue
K14.80 Crenated tongue [lingua indentata]
(IM)
K14.81 Hypertrophy of tongue
(IM)

K14.82 Atrophy of tongue
(IM)

K14.88 Other specified diesease of tongue
(IM)

K14.9 Disease of tongue, unspecified
Glossopathy NOS
Noninfective enteritis and colitis
(K50-K52)
K52 Other noninfective gastroenteritis and colitis
K52.2 Allergic and dietetic gastroenteritis and colitis
Food hypersensitivity gastroenteritis or colitis
K52.20 Allergic and dietetic gastroenteritis and colitis due to cow's milk protein
(IM)

K52.28 Other allergic and dietetic gastroenteritis and colitis
(IM)

K52.29 Allergic and dietetic gastroenteritis and colitis, unspecified
(IM)

Diseases of peritoneum
(K65-K67)
K65 Peritonitis
Excl.:
peritonitis:
• aseptic (T81.6)
• benign paroxysmal (E85.0)
• chemical (T81.6)
• due to talc or other foreign substance (T81.6)
• neonatal (P78.0-P78.1)
• pelvic, female (N73.3-N73.5)
• periodic familial (E85.0)

47. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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• puerperal (O85)
• with or following:
o abortion or ectopic or molar pregnancy (O00-O07, O08.0)
o appendicitis (K35.-)
o diverticular disease of intestine (K57.-)
K65.0 Acute peritonitis
Abscess (of):
• abdominopelvic
• mesenteric
• omentum
• peritoneum
• retrocaecal
• retroperitoneal
• subdiaphragmatic
• subhepatic
• subphrenic
Peritonitis (acute):
• generalized
• pelvic, male
• subphrenic
• suppurative
K65.00 Primary peritonitis
(IM)

K65.01 Secondary bacterial peritonitis
(IM)

Use additional code (B95-B98), if desired, to identify infectious agent.
Disorders of gallbladder, biliary tract and pancreas
(K80-K87)
K83 Other diseases of biliary tract
K83.6 Stenosis of sphincter of Oddi
(IM)

Other diseases of the digestive system
(K90-K93)
K91 Postprocedural disorders of digestive system, not elsewhere classified
K91.2 Postsurgical malabsorption, not elsewhere classified
Postsurgical blind loop syndrome
K91.20 Post surgical malabsorption, post massive bowel resection
(IM)

K91.28 Other postsurgical malabsorption
(IM)

K91.29 Postsurgical malabsorption, unspecified
(IM)

48. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter XII
Diseases of the skin and subcutaneous tissue
(L00-L99)
Dermatitis and eczema
(L20-L30)
L24 Irritant contact dermatitis
L24.8 Irritant contact dermatitis due to other agents
Dyes (IM)
L24.80 Irritant contact dermatitis due to dyes
(IM)

L24.81 Paederus dermatitis
(IM)

L24.88 Irritant contact dermatitis due to other agents
(IM)

L27 Dermatitis due to substances taken internally
L27.1 Localized skin eruption due to drugs and medicaments
L27.10 Fixed drug eruption
(IM)

L27.18 Other specified localized skin eruption due to drugs and medicaments
(IM)

L27.19 Localized skin eruption due to drugs and medicaments, unspecified
(IM)

Use additional external cause code (Chapter XX), if desired, to identify drug.
Disorders of skin appendages
(L60-L75)
L70 Acne
L70.8 Other acne
L70.80 Acne cosmetica
(IM)

L70.81 Acne scar
(IM)

L70.82 Steroid acne
(IM)

L70.83 Acne fulminans
(IM)

L70.88 Other acne
(IM)

Other disorders of the skin and subcutaneous tissue
(L80-L99)
L81 Other disorders of pigmentation
L81.8 Other specified disorders of pigmentation
Iron pigmentation
(IM)

Tattoo pigmentation
(IM)

L81.80 Nevus fuscocaeruleus (Nevus of Hori)
(IM)

49. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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L81.81 Ochronosis, pigmented colloid milium
(IM)

L81.82 Cosmetic tattoo
(IM)

L81.83 Traumatic tattoo
(IM)

L81.88 Other specified disorders of pigmentation
(IM)

Iron pigmentation
(IM)

Tattoo pigmentation
(IM)

50. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter XIII
Diseases of the musculoskeletal system and connective tissue
(M00-M99)

No Additional Code for Indonesian Modification (IM)

51. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter XIV
Diseases of the genitourinary system
(N00-N99)
lateralization of urinary anatomy code:
NL11 Right kidney
(IM)

NL12 Left kidney
(IM)

NL13 Right ureter
(IM)

NL14 Left ureter
(IM)

NL15 Bladder
(IM)

Renal failure
(N17-N19)
N17 Acute renal failure
N17.9 Acute renal failure, unspecified
N17.91 Acute kidney injury stage 1
(IM)

N17.92 Acute kidney injury stage 2
(IM)

N17.93 Acute kidney injury stage 3 needed renal support
(IM)

N17.94 Acute kidney injury superimposed on chronic kidney disease
(IM)

N17.95 Acute kidney injury superimposed on chronic kidney disease needed renal
support
(IM)

N18 Chronic kidney disease
N18.6 End stage renal disease
(IM)
Other disorders of kidney and ureter
(N25-N29)
N26 Unspecified contracted kidney
Incl.:
Atrophy of kidney (terminal)
Renal sclerosis NOS
Excl.:
contracted kidney with hypertension (I12.-)
diffuse sclerosing glomerulonephritis (N18.-)
hypertensive nephrosclerosis (arteriolar)(arteriosclerotic) (I12.-)
small kidney of unknown cause (N27.-)

N26.2 Page kidney
(IM)
Other diseases of urinary system
(N30-N39)
N36 Other disorders of urethra

52. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
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N36.4 Urethral functional and muscular disorders
(IM)

N36.5 Urethral false passage
(IM)

Diseases of male genital organs
(N40-N51)
N40 Hyperplasia of prostate
Incl.:
• Adenofibromatous hypertrophy
• Enlargement (benign)
• Hypertrophy (benign)
• of prostate
Median bar (prostate)
Prostatic obstruction NOS
Excl.:
benign neoplasms, of prostate (D29.1)

N40.0 Benign prostatic hyperplasia without lower urinary tract symptoms
(IM)

N40.1 Benign prostatic hyperplasia with lower urinary tract symptoms
(IM)

N40.2 Nodular prostate without lower urinary tract symptoms
(IM)

N40.3 Nodular prostate with lower urinary tract symptoms
(IM)

N41 Inflammatory diseases of prostate
N41.4 Granulomatous prostatitis
(IM)

N44 Torsion of testis
Incl.:
Torsion of:
• epididymis
• spermatic cord
• testicle
N44.0 Torsion of testis
(IM)

N44.1 Cyst of tunica albuginea testis
(IM)

N44.2 Benign cyst of testis
(IM)

N44.8 Other noninflammatory disorders of the testis
(IM)

N45 Orchitis and epididymitis
Use additional code (B95-B98), if desired, to identify infectious agent.

N45.1 Epididymitis
(IM)

N45.2 Orchitis
(IM)

N45.3 Epididymoorchitis
(IM)

N45.4 Abscess of epididymis or testis
(IM)
N46 Male infertility

53. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
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Incl.:
Azoospermia NOS
Oligospermia NOS

N46.0 Azoospermia
(IM)

N46.1 Oligospermia
(IM)

N46.8 Other male infertility
(IM)

N46.9 Male infertility, unspecified
(IM)

N47 Redundant prepuce, phimosis and paraphimosis
Incl.:
Adherent prepuce
Tight foreskin

N47.0 Adherent prepuce, newborn
(IM)

N47.1 Phimosis
(IM)

N47.2 Paraphimosis
(IM)

N47.3 Deficient foreskin
(IM)

N47.4 Benign cyst of prepuce
(IM)

N47.5 Adhesions of prepuce and glans penis
(IM)

N47.7 Other inflammatory diseases of prepuce
(IM)

N47.8 Other disorders of prepuce
(IM)

N49 Inflammatory disorders of male genital organs, not elsewhere classified
N49.3 Fournier gangrene
(IM)

N50 Other disorders of male genital organs

N50.00 Cyst of epididymis
(IM)

N50.10 Vasculogenic erectile dysfunction
(IM)
N50.2 Erectile dysfunction due to diseases classified elsewhere
(IM)
N50.3 Drug-induced erectile dysfuntion
(IM)

N50.4 Postprocedural erectile dysfunction
(IM)
N50.5 Other male erectile dysfunction
(IM)
N50.6 Male erectile dysfunction, unspecified
(IM)
N50.7 Ejaculatory dysfunction
(IM)
N50.80 Other male sexual dysfunction
(IM)
N50.90 Unspecified male sexual dysfunction
(IM)
Inflammatory diseases of female pelvic organs
(N70-N77)
N70 Salpingitis and oophoritis

54. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
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N70.2 Tubo-ovarian abscess
(IM)
disorders of female genital tract
(N80-N98)
N80 Endometriosis
N80.7 Pelvic endometriosis
(IM)

N81 Female genital prolapse

N81.7 Cystorectocele
(IM)
N93 Other abnormal uterine and vaginal bleeding
Excl.:
neonatal vaginal haemorrhage (P54.6)
pseudomenses (P54.6)
N93.0 Postcoital and contact bleeding
N93.00 Contact bleeding
(IM)

N93.01 Postcoital bleeding
(IM)

N97 Female infertility
N97.5 Female infertility associated with peritoneal factors
(IM)

55. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter XV
Pregnancy, childbirth and the puerperium
(O00-O99)
No Additional Code Of Indonesian Modification
(IM)

56. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter XVI
Certain conditions originating in the perinatal period
(P00-P96)
No Additional Code Of Indonesian Modification
(IM)

57. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter XVII
Congenital malformations, deformations and chromosomal abnormalities
(Q00-Q99)
Other congenital malformations of the digestive system
(Q38-Q45)
Q38 Other congenital malformations of tongue, mouth and pharynx
Q38.3 Other congenital malformations of tongue
Aglossia
Bifid tongue
• Congenital:
• adhesion
• fissure
• malformation NOS
• of tongue
Hypoglossia
Hypoplasia of tongue
Microglossia
Q38.30 Aglossia
(IM)

Q38.31 Bifid tongue
(IM)

Q38.32 Adhesion of tongue, congenital
(IM)

Q38.33 Fissure of tongue, congenital
(IM)

Q38.34 Microglossia
(IM)

Q38.38 Other specified congenital malformations of tongue
(IM)

Q38.39 Congenital malformation of tongue, unspecified
(IM)

Q38.4 Congenital malformations of salivary glands and ducts
• Absence
• Accessory
• Atresia
• (of) salivary gland or duct
Congenital fistula of salivary gland
Q38.40 Absence of salivary gland or duct
(IM)

Q38.41 Accessory salivary gland or duct
(IM)

Q38.42 Atresia of salivary gland or duct
(IM)

Q38.43 Congenital fistula of salivary gland
(IM)

Q38.48 Other specified congenital malformations of salivary glands and ducts
(IM)

Q38.49 Congenital malformation of salivary glands and ducts, unspecified
(IM)

Q38.5 Congenital malformations of palate, not elsewhere classified
Absence of uvula
Congenital malformation of palate NOS
High arched palate
Excl.:
cleft palate (Q35.-)
cleft palate
• with cleft lip (Q37.-)
Q38.59 Congenital malformation of palate, unspecified
(IM)

58. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Q40 Other congenital malformations of upper alimentary tract
Q40.4 Congenital microvillous atrophy
(IM)

Q41 Congenital absence, atresia and stenosis of small intestine
Incl.:
congenital obstruction, occlusion and stricture of small intestine or intestine NOS
Excl.:
meconium ileus (E84.1)
Q41.0 Congenital absence, atresia and stenosis of duodenum
Q41.00 Duodenal web
(IM)

Q41.08 Other congenital absence, atresia and stenosis of duodenum
(IM)

Q41.09 Congenital absence, atresia and stenosis of duodenum, unspecified
(IM)

Q44 Congenital malformations of gallbladder, bile ducts and liver
Q44.7 Other congenital malformations of liver
Accessory liver
Alagille syndrome
Congenital:
• absence of liver
• hepatomegaly
• malformation of liver NOS
Q44.70 Alagille Syndrome
(IM)

Q44.71 Progressive familial intrahepatic cholestasis
(IM)

Q44.78 Other congenital malformations of liver
(IM)

Q44.79 Congenital malformations of liver, unspecified
(IM)

Congenital malformations and deformations of the musculoskeletal system
(Q65-Q79)
Q67 Congenital musculoskeletal deformities of head, face, spine and chest
Q67.4 Other congenital deformities of skull, face and jaw
Depressions in skull
Deviation of nasal septum, congenital
Hemifacial atrophy or hypertrophy
Squashed or bent nose, congenital
Excl.:
dentofacial anomalies [including malocclusion] (K07.-)
syphilitic saddle nose (A50.5)

Q67.40 Hemifacial atrophy
(IM)

Q67.41 Hemifacial hypertrophy
(IM)

Q67.48 Other specified congenital deformities of skull, face and jaw
(IM)

Depressions in skull
Deviation of nasal septum, congenital
Squashed or bent nose, congenital

59. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
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Q67.49 Congenital deformity of skull, face or jaw, unspecified (IM)
Q68 Other congenital musculoskeletal deformities
Q68.8 Other specified congenital musculoskeletal deformities
Congenital:
• deformity of:
o clavicle
o elbow
o forearm
o scapula
• dislocation of:
o elbow
o shoulder
Q68.80 Congenital deformity of clavicle
(IM)

Q68.81 Congenital deformity of elbow
(IM)

Q68.82 Congenital deformity of forearm
(IM)

Q68.83 Congenital deformity of scapula
(IM)

Q68.84 Congenital dislocation of elbow
(IM)

Q68.85 Congenital dislocation of shoulder
(IM)

Q68.88 Other specified congenital musculoskeletal deformities
(IM)

Q71 Reduction defects of upper limb
Q71.3 Congenital absence of hand and finger(s)
Q71.30 Congenital absence of hand
(IM)

Q71.31 Congenital absence of finger(s)
(IM)

Q71.32 Congenital absence of thumb
(IM)

Q71.33 Congenital hypoplastic thumb
(IM)

Q71.38 Other congenital absence of hand and finger(s)
(IM)

Q72 Reduction defects of lower limb
Q72.3 Congenital absence of foot and toe(s)
Q72.30 Congenital absence of foot
(IM)

Q72.31 Congenital absence of toe(s)
(IM)

Q75 Other congenital malformations of skull and face bones
Q75.0 Craniosynostosis
Acrocephaly
Imperfect fusion of skull
Oxycephaly
Trigonocephaly

Q75.00 Acrocephaly
(IM)

Q75.01 Imperfect fusion of skull
(IM)

60. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
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Q75.02 Oxycephaly
(IM)

Q75.03 Trigonocephaly
(IM)

Q76 Congenital malformations of spine and bony thorax
Q76.2 Congenital spondylolisthesis
Congenital spondylolysis
Excl.:
spondylolisthesis (acquired) (M43.1)
spondylolysis (acquired) (M43.0)

Q76.20 Congenital spondylolisthesis
(IM)

Q76.21 Congenital spondylolysis
(IM)

Other congenital malformations
(Q80-Q89)
Q87 Other specified congenital malformation syndromes affecting multiple systems
Q87.0 Congenital malformation syndromes predominantly affecting facial appearance
Acrocephalopolysyndactyly
Acrocephalosyndactyly [Apert]
Cryptophthalmos syndrome
Cyclopia
Syndrome:
• Goldenhar
• Moebius
• oro-facial-digital
• Robin
Whistling face
Q87.00 Acrocephalosyndactyly [Apert]
(IM)

Q87.01 Golddnhar's syndrome
(IM)

Q87.02 Moebius' syndrome
(IM)

Q87.03 Oro-facial-digital syndrome
(IM)

Q87.05 Robin's syndrome
(IM)

Q87.08 Other congenital malformation syndrome predominantly affecting facial
appearance
(IM)

Cryptophthalmos syndrome
Cyclopia
Whistling face
Q89 Other congenital malformations, not elsewhere classified
Q89.2 Congenital malformations of other endocrine glands
Congenital malformation of parathyroid or thyroid gland
Persistent thyroglossal duct
Thyroglossal cyst

Q89.20 Persistent thyroglossal or thyrolingual duct
(IM)

61. List Code ICD 10 2010 Indonesian Modification (IM)
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Q89.21 Thyroglossal cyst
(IM)

Q89.22 Thyroglossal fistula
(IM)

Q89.23 Lingual thyroid
(IM)

Q89.28 Congenital malformations of other endocrine glands
(IM)

62. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
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Chapter XVIII
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere
classified
(R00-R99)
Symptoms and signs involving the circulatory and respiratory systems
(R00-R09)
R04 Haemorrhage from respiratory passages
R04.2 Haemoptysis
Blood-stained sputum
Cough with haemorrhage

R04.20 Massive hemoptysis
(IM)

Symptoms and signs involving the digestive system and abdomen
(R10-R19)
R10 Abdominal and pelvic pain
R10.4 Other and unspecified abdominal pain
Abdominal tenderness NOS
Colic:
• NOS
• Infantile
R10.40 Idiopathic recurrent abdominal pain of childhood
(IM)

• Colic Infantile
R10.48 Other abdominal pain
(IM)

R10.49 Abdominal pain, unspecified
(IM)

Abdominal tenderness NOS
R11 Nausea and vomiting
Excl.:
haematemesis (K92.0)
haematemesis
• neonatal (P54.0)
vomiting (of):
• excessive, in pregnancy (O21.-)
• following gastrointestinal surgery (K91.0)
• newborn (P92.0)
• psychogenic (F50.5)
R11.0 Cyclic vomiting
(IM)

R11.9 Nausea and vomiting, unspecified
(IM)

63. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
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R17 Unspecified jaundice
Excl.:
neonatal jaundice (P55.-, P57-P59)

R17.0 Cholestatic jaundice
(IM)

R17.1 Obstructive jaundice
(IM)

R17.8 Other jaundice
(IM)

R17.9 Jaundice, unspecified
(IM)

Symptoms and signs involving the urinary system
(R30-R39)
R31 Unspecified haematuria
Excl.:
recurrent or persistent haematuria (N02.-)
R31.0 Gross hematuria
(IM)

R31.1 Benign essential microscopic hematuria
(IM)

R31.2 Other microscopic hematuria
(IM)

R33 Retention of urine
R33.0 Drug induced retention of urine
(IM)

R36 Urethral discharge
Incl.:
Penile discharge
Urethrorrhoea

R36.0 Urethral discharge without blood
(IM)

R36.1 Hematospermia
(IM)

R37 Sexual dysfunction, unspecified
(IM)

Symptoms and signs involving cognition, perception, emotional state and behaviour
(R40-R46)
R40 Somnolence, stupor and coma

R40.9 Alteration of consciousness, unspecified
(IM)

General symptoms and signs
(R50-R69)
R51 Headache
Incl.:
Facial pain NOS
Excl.:

64. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
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BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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atypical facial pain (G50.1)
migraine and other headache syndromes (G43-G44)
trigeminal neuralgia (G50.0)

R51.0 Headache, unspecified
(IM)

R51.1 Facial pain, unspecified
(IM)

Abnormal findings on examination of blood, without diagnosis
(R70-R79)
R73 Elevated blood glucose level

R73.1 Impaired fasting glucose
(IM)



Abnormal findings on examination of other body fluids, substances and tissues, without
diagnosis
(R83-R89)
diagnostic abnormal findings classified elsewhere - see Alphabetical Index
The following fourth-character subdivisions are for use with categories R83-R89:
.0 Abnormal level of enzymes
.1 Abnormal level of hormones
.2 Abnormal level of other drugs, medicaments and biological substances
.3 Abnormal level of substances chiefly nonmedicinal as to source
.4 Abnormal immunological findings
.5 Abnormal microbiological findings
Positive culture findings
.6 Abnormal cytological findings
Abnormal Papanicolaou smear
.60 Atypical squamous cells [ASC]
(IM)

.61 Low-grade squamous intraepithelial lesion [LSIL]
(IM)

.62 High-grade squamous intraepithelial lesion [HSIL]
(IM)

.63 Atypical glandular cells [AGC]
(IM)

.68 Other abnormal cytologic finding in specimens from female genital organs
(IM)

.69 Unspecified Abnormal Cytological Finding
(IM)

.7 Abnormal histological findings
.8 Other abnormal findings
Abnormal chromosomal findings
.9 Unspecified abnormal finding
R87 Abnormal findings in specimens from female genital organs
[See before R83 for subdivisions]
Incl.:
Abnormal findings in secretions and smears from:
• cervix uteri
• vagina
• vulva

65. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Excl.:
carcinoma in situ (D05-D07.3)
dysplasia of:
• cervix uteri (N87.-)
• vagina (N89.0-N89.3)
• vulva (N90.0-N90.3)
R87.60 Atypical squamous cells [ASC]
(IM)

R87.61 Low-grade squamous intraepithelial lesion [LSIL]
(IM)

R87.62 High-grade squamous intraepithelial lesion [HSIL]
(IM)

R87.63 Atypical glandular cells [AGC]
(IM)

R87.68 Other abnormal cytologic finding in specimens from female genital organs
(IM)

R87.69 Abnormal cytologic finding in specimens from female genital organs,
unspecified
(IM)

66. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter XIX
Injury, poisoning and certain other consequences of external
causes
(S00-T98)
Injuries to the head
(S00-S09)
S00 Superficial injury of head
S00.5 Superficial injury of lip and oral cavity
S00.50 Superficial injury of internal cheek
(IM)

S00.51 Superficial injury of other parts of mouth ,including tongue
(IM)

S00.52 Superficial injury of lip
(IM)

S00.59 Superficial injury of lip and oral cavity, unspecified
(IM)

S01 Open wound of head
S01.4 Open wound of cheek and temporomandibular area
S01.40 Open wound of cheek
(IM)

S01.41 Open wound of temporomandibular area
(IM)

S01.47 Open wound of cheek with open wound of temporomandibular area
(IM)

S01.5 Open wound of lip and oral cavity
Excl.:
tooth:
• dislocation (S03.2)
• fracture (S02.5)
S01.50 Open wound of oral cavity
(IM)
S01.51 Open wound of lip
(IM)

S01.57 Open wound of oral cavity with open wound of lip
(IM)

67. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S02 Fracture of skull and facial bones
Note:
For primary coding of fracture of skull and facial bones with associated intracranial
injury, reference should be made to the morbidity or mortality coding rules and
guidelines in Volume 2.
The following subdivisions are provided for optional use in a supplementary character
position where it is not possible or not desired to use multiple coding to identify
fracture and open wound; a fracture not indicated as closed or open should be
classified as closed.
0 closed
1 open
S02.4 Fracture of malar and maxillary bones
Superior maxilla
Upper jaw (bone)
Zygoma

S02.40 Fracture of maxillary alveolar process
(IM)

S02.41 Fracture of malar bone [zygoma]
(IM)

S02.42 Fracture of maxillary bones
(IM)

S02.47 Multiple fracture of malar and maxillary bones
(IM)

S02.6 Fracture of mandible
Lower jaw (bone)

S02.61 Fracture of body of mandible
(IM)

S02.62 Fracture of condyle
(IM)

S02.63 Fracture of coronoid process
(IM)

S02.64 Fracture of ramus
(IM)

S02.65 Fracture of symphysis
(IM)

S02.66 Fracture of angle
(IM)

S02.67 Multiple fractures of mandible
(IM)

S02.69 Fracture of mandible, part unspecified
(IM)

68. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S03 Dislocation, sprain and strain of joints and ligaments of head
S03.2 Dislocation of tooth
S03.20 Luxation of tooth
(IM)

S03.21 Intrusion or extrusion of tooth
(IM)

S03.22 Avulsion of tooth [exarticulation]
(IM)

S03.29 Dislocation of tooth, unspecified
(IM)

S04 Injury of cranial nerves
S04.8 Injury of other cranial nerves
Glossopharyngeal [9th] nerve
Hypoglossal [12th] nerve
Olfactory [1st] nerve
Vagus [10th] nerve

S04.80 Injury of olfactory nerve
(IM)

S04.81 Injury of glossopharyngeal nerve
(IM)

S04.82 Injury of vagus nerve
(IM)

S04.83 Injury of hypoglossal nerve
(IM)

S09 Other and unspecified injuries of head
S09.0 Injury of blood vessels of head, not elsewhere classified
Excl.:
injury of:
• cerebral blood vessels (S06.-)
• precerebral blood vessels (S15.-)
S09.00 Injury of anterior nasal arteries
(IM)

S09.01 Injury of posterior nasal arteries
(IM)

69. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Injuries to the neck
(S10-S19)
S12 Fracture of neck
Incl.:
cervical:
• neural arch
• spine
• spinous process
• transverse process
• vertebra
• vertebral arch
The following subdivisions are provided for optional use in a supplementary character
position where it is not possible or not desired to use multiple coding to identify
fracture and open wound; a fracture not indicated as closed or open should be
classified as closed.
0 closed
1 open
S12.2 Fracture of other specified cervical vertebra
Excl.:
multiple fractures of cervical spine (S12.7)

S12.20 Fracture of 3rd cervical vertebra
(IM)

S12.21 Fracture of 4th cervical vertebra
(IM)

S12.22 Fracture of 5th cervical vertebra
(IM)

S12.23 Fracture of 6th cervical vertebra
(IM)

S12.24 Closed Fracture of 7th cervical vertebra
(IM)

S12.28 Closed Fracture of other cervical vertebra
(IM)

S13 Dislocation, sprain and strain of joints and ligaments at neck level
S13.1 Dislocation of cervical vertebra
Cervical spine NOS

S13.10 Dislocation of C1/C2 vertebra
(IM)

S13.11 Dislocation of C2/C3 vertebra
(IM)

S13.12 Dislocation of C3/C4 vertebra
(IM)

S13.13 Dislocation of C4/C5 vertebra
(IM)

S13.14 Dislocation of C5/C6 vertebra
(IM)

S13.15 Dislocation of C6/C7 vertebra
(IM)

S13.16 Dislocation of C7/T1 vertebra
(IM)

S13.18 Dislocation of other,cervical vertebra
(IM)

S13.19 Dislocation of cervical vertebra, part unspecified
(IM)

70. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Injuries to the thorax
(S20-S29)
S22 Fracture of rib(s), sternum and thoracic spine
Incl.:
thoracic:
• neural arch
• spinous process
• transverse process
• vertebra
• vertebral arch
Excl.:
fracture of:
• clavicle (S42.0)
• scapula (S42.1)
The following subdivisions are provided for optional use in a supplementary character
position where it is not possible or not desired to use multiple coding to identify
fracture and open wound; a fracture not indicated as closed or open should be
classified as closed.
0 closed
1 open
S22.0 Fracture of thoracic vertebra
Fracture of thoracic spine NOS

S22.00 Fracture of thoracic vertebra, compression type
(IM)

S22.01 Fracture of thoracic vertebra, burst type
(IM)

S22.02 Fracture of thoracic vertebra, seat-belt type
(IM)

S22.03 Fracture of thoracic vertebra, flexion-rotation type
(IM)

S22.04 Fracture of thoracic vertebra, shear type
(IM)

S22.05 Fracture of thoracic vertebra, flexion-distraction type
(IM)

S22.09 Fracture of thoracic vertebra, mechanism unspecified
(IM)

S22.1 Multiple fractures of thoracic spine
S22.10 Multiple fractures of thoracic spine, T1-T6 level
(IM)

S22.11 Multiple fractures of thoracic spine, T7-T12 level
(IM)

S22.12 Multiple fractures of thoracic and lumbar spine [T and L spine]
(IM)

S22.18 Multiple fractures of thoracic spine, other specified
(IM)

S22.19 Multiple fractures of thoracic spine, unspecified
(IM)

S27 Injury of other and unspecified intrathoracic organs
S27.3 Other injuries of lung
S27.32 Laceration of lung
(IM)

71. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S27.33 Contusio and hematoma of lung
(IM)
Injuries to the abdomen, lower back, lumbar spine and pelvis
(S30-S39)
S32 Fracture of lumbar spine and pelvis
S32.0 Fracture of lumbar vertebra
Fracture of lumbar spine

S32.00 Fracture of lumbar vertebra, compression type
(IM)

S32.01 Fracture of lumbar vertebra, burst type
(IM)

S32.02 Fracture of lumbar vertebra, seat-belt type
(IM)

S32.03 Fracture of lumbar vertebra, flexion-rotation type
(IM)

S32.04 Fracture of lumbar vertebra, shear type
(IM)

S32.05 Fracture of lumbar vertebra, flexion-distraction type
(IM)

S32.09 Fracture of lumbar vertebra, mechanism unspecified
(IM)

72. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S32.6 Fracture of Pelvis
(IM)

S32.60 Fracture of pelvis, stable type
(IM)

S32.61 Fracture of pelvis, rotary unstable type
(IM)

S32.62 Fracture of pelvis, vertical shear type
(IM)

S32.68 Fracture of pelvis, other types
(IM)

S32.69 Fracture of pelvis, unspecified type
(IM)

Injuries to the shoulder and upper arm
(S40-S49)
S40 Superficial injury of shoulder and upper arm
S40.8 Other superficial injuries of shoulder and upper arm
S40.80 Abrasion of shoulder and arm
(IM)

S40.81 Blister of shoulder and arm
(IM)

S40.82 Insect bite of shoulder and arm
(IM)

S40.83 Superficial foreign body of shoulder and arm
(IM)

S40.88 Other superficial injuries of shoulder and arm
(IM)

S42 Fracture of shoulder and upper arm
The following subdivisions are provided for optional use in a supplementary character
position where it is not possible or not desired to use multiple coding to identify fracture and
open wound; a fracture not indicated as closed or open should be classified as closed.
0 closed
1 open
S42.0 Fracture of clavicle
Clavicle:
• acromial end
• shaft
Collar bone

S42.00 Fracture of clavicle, sternal end
(IM)

S42.01 Fracture of clavicle, shaft
(IM)

S42.02 Fracture of clavicle, acromial end
(IM)

S42.07 Fracture of clavicle, multiple fractures
(IM)

S42.09 Fracture of clavicle, unspecified part
(IM)

S42.1 Fracture of scapula
Acromial process
Acromion (process)
Scapula (body)(glenoid cavity)(neck)
Shoulder blade

S42.10 Fracture of scapula, body
(IM)

73. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S42.11 Fracture of scapula, acromion process
(IM)

S42.12 Fracture of scapula, coracoid
(IM)

S42.13 Fracture of scapula, glenoid and neck of scapula
(IM)

S42.17 Fracture of scapula, multiple fractures
(IM)

S42.19 Fracture of scapula, unspecified part
(IM)

S42.2 Fracture of upper end of humerus
Anatomical neck
Great tuberosity
Proximal end
Surgical neck
Upper epiphysis

S42.20 Fracture of proximal humerus, non-displaced
(IM)
S42.21 Fracture of proximal humerus, 2 parts
(IM)
S42.22 Fracture of proximal humerus, 3 parts
(IM)
S42.23 Fracture of proximal humerus, 4 parts
(IM)

S42.24 Fracture of proximal humerus, with articular involvement
(IM)
S42.25 Fracture of epiphysis of proximal humerus
(IM)

S42.28 Fracture of proximal humerus, others
(IM)

S42.29 Fracture of proximal humerus, unspecified
(IM)

74. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S42.3 Fracture of shaft of humerus
Humerus NOS
Upper arm NOS

S42.30 Fracture of shaft of humerus, simple fracture
(IM)

S42.31 Fracture of shaft of humerus, butterfly fracture
(IM)

S42.32 Fracture of shaft of humerus, comminuted fracture
(IM)

S42.37 Multiple fractures of shaft of humerus
(IM)

S42.39 Fracture of shaft of humerus, unspecified
(IM)

S42.4 Fracture of lower end of humerus
Articular process
Distal end
External condyle
Intercondylar
Internal epicondyle
Lower epiphysis
Supracondylar
Excl.:
fracture of elbow NOS (S52.0)

S42.40 Fracture of distal humerus, supracondylar
(IM)

S42.41 Fracture of distal humerus, lateral condyle
(IM)

S42.42 Fracture of distal humerus, medial condyle
(IM)

S42.43 Fracture of distal humerus, other parts of condyle and epicondyle
(IM)

S42.44 Fracture of distal humerus, T-shape intraarticular fracture
(IM)

S42.45 Fracture of distal humerus, multifragment intraarticular fracture
(IM)

S42.46 Fracture of physis and apophysis of distal humerus
(IM)

S42.47 Multiple fractures of distal humerus
(IM)

S42.48 Fracture of distal humerus, others
(IM)

S42.49 Fracture of distal humerus, unspecified
(IM)

75. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S43 Dislocation, sprain and strain of joints and ligaments of shoulder girdle
S43.0 Dislocation of shoulder joint
Glenohumeral joint

S43.00 Dislocation of shoulder joint, anterior
(IM)

S43.01 Dislocation of shoulder joint, posterior
(IM)

S43.02 Dislocation of shoulder joint, inferior
(IM)

S43.08 Dislocation of shoulder joint, other
(IM)

S43.09 Dislocation of shoulder joint, unspecified
(IM)

Injuries to the elbow and forearm
(S50-S59)
S50 Superficial injury of forearm
S50.8 Other superficial injuries of forearm
S50.80 Abrasion of elbow and forearm
(IM)

S50.81 Blister of elbow and forearm
(IM)

S50.82 Insect bite of elbow and forearm
(IM)

S50.83 Superficial foreign body of elbow and forearm
(IM)

S50.88 Other superficial injuries of elbow and forearm
(IM)

S51 Open wound of forearm
S51.1 Open wound of forearm
(IM)

S52 Fracture of forearm
The following subdivisions are provided for optional use in a supplementary character
position where it is not possible or not desired to use multiple coding to identify fracture and
open wound; a fracture not indicated as closed or open should be classified as closed.
0 closed
1 open

76. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S52.0 Fracture of upper end of ulna
Coronoid process
Elbow NOS
Monteggia fracture-dislocation
Olecranon process
Proximal end

S52.00 Fracture of proximal ulna, olecranon
(IM)
S52.01 Fracture of proximal ulna, coronoid process
(IM)
S52.02 Fracture of proximal ulna, with dislocation of radial head
(IM)
S52.03 Fracture of epiphysis of proximal ulna
(IM)
S52.07 Fracture of proximal ulna, multiple fracture
(IM)
S52.08 Fracture of proximal ulna, others
(IM)

S52.09 Fracture of proximal ulna, unspecified
(IM)
S52.1 Fracture of upper end of radius
Head
Neck
Proximal end

S52.10 Fracture of head of radius
(IM)

S52.11 Fracture of neck of radius
(IM)

S52.12 Fracture of epiphysis of upper end of radius
(IM)

S52.17 Fracture of upper end of radius, multiple fractures
(IM)

S52.18 Fracture of upper end of radius, others
(IM)

S52.19 Fracture of upper end of radius, unspecified
(IM)

S52.2 Fracture of shaft of ulna

S52.20 Fracture of shaft of ulna, simple fracture
(IM)

S52.21 Fracture of shaft of ulna, butterfly fracture
(IM)

S52.22 Fracture of shaft of ulna, comminuted fracture
(IM)

S52.23 Fracture of shaft of ulna, with dislocation of radial head
(IM)

S52.27 Fracture of shaft of ulna, bifocal and segmental and multiple fractures
(IM)

S52.29 Fracture of shaft of ulna, unspecified
(IM)

S52.3 Fracture of shaft of radius
S52.30 Fracture of shaft of radius, simple fracture
(IM)

S52.31 Fracture of shaft of radius, butterfly fracture
(IM)

S52.32 Fracture of shaft of radius, comminuted fracture
(IM)

S52.33 Fracture of shaft of radius, with dislocation of head of ulna
(IM)

S52.37 Fracture of shaft of radius, bifocal and segmental and multiple fractures
(IM)
S52.39 Fracture of shaft of radius, unspecified
(IM)

S52.5 Fracture of lower end of radius
Colles fracture
Smith fracture

77. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S52.50 Fracture of distal radius, extraarticular with dorsal angulation
(IM)

S52.51 Fracture of distal radius, extraarticular with volar angulation
(IM)

S52.52 Fracture of distal radius, partial intraarticular
(IM)
S52.53 Fracture of distal radius, complete intraarticular
(IM)

S52.54 Fracture of epiphysis of distal radius
(IM)

S52.57 Fracture of distal radius, multiple fractures
(IM)

S52.58 Fracture of distal radius, others
(IM)

S52.59 Fracture of distal radius, unspecified
(IM)

S52.7 Multiple fractures of forearm
Excl.:
fractures of both ulna and radius:
• lower end (S52.6)
• shafts (S52.4)
S52.70 Closed Fracture both bones of proximal part of radius and ulna
(IM)

S52.78 Multiple closed fractures of forearm, others
(IM)

S52.79 Multiple closed fractures of forearm, unspecified
(IM)

S53 Dislocation, sprain and strain of joints and ligaments of elbow
S53.0 Dislocation of radial head
Radiohumeral joint
Excl.:
Monteggia fracture-dislocation (S52.0)

S53.00 Dislocation of radial head
(IM)

S53.01 Subluxation of radial head
(IM)

S53.02 Pulled elbow in children
(IM)

S53.1 Dislocation of elbow, unspecified
Ulnohumeral joint
Excl.:
dislocation of radial head alone (S53.0)

S53.10 Dislocation of elbow, anterior
(IM)

S53.11 Dislocation of elbow, posterior
(IM)

S53.12 Dislocation of elbow, medial
(IM)

S53.13 Dislocation of elbow, lateral
(IM)

S53.14 Dislocation of elbow, divergen
(IM)

S53.15 Dislocation of elbow, with associated fracture
(IM)

S53.18 Dislocation of elbow, other
(IM)

S53.19 Dislocation of elbow, unspecified
(IM)

Injuries to the wrist and hand
(S60-S69)
S60 Superficial injury of wrist and hand
S60.8 Other superficial injuries of wrist and hand
S60.80 Abrasion of wrist and hand
(IM)

78. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S60.81 Blister of wrist and hand
(IM)

S60.82 Insect bite of wrist and hand
(IM)

S60.83 Superficial foreign body of wrist and hand
(IM)

S60.88 Other superficial injuries of wrist and hand
(IM)

79. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S62 Fracture at wrist and hand level
Excl.:
fracture of distal parts of ulna and radius (S52.-)
The following subdivisions are provided for optional use in a supplementary character
position where it is not possible or not desired to use multiple coding to identify
fracture and open wound; a fracture not indicated as closed or open should be
classified as closed.
0 closed
1 open
S62.1 Fracture of other carpal bone(s)
Capitate [os magnum]
Hamate [unciform]
Lunate [semilunar]
Pisiform
Trapezium [greater multangular]
Trapezoid [lesser multangular]
Triquetrum [cuneiform of carpus]

S62.10 Fracture of lunate [semilunar]
(IM)

S62.11 Fracture of triquetrum [cuneiform]
(IM)

S62.12 Fracture of pisiform
(IM)

S62.13 Fracture of trapezium [greater multangular]
(IM)

S62.14 Fracture of trapezoid [lesser multangular]
(IM)

S62.15 Fracture of capitate [os magnum]
(IM)

S62.16 Fracture of hamate [unciform]
(IM)

S62.17 Fracture of other carpal bones, multiple fractures
(IM)

S62.19 Fracture of other carpal bones, unspecified
(IM)

S63 Dislocation, sprain and strain of joints and ligaments at wrist and hand level
S63.0 Dislocation of wrist
Carpal (bone)
Carpometacarpal (joint)
Metacarpal (bone), proximal end
Midcarpal (joint)
Radiocarpal (joint)
Radioulnar (joint), distal
Radius, distal end
Ulna, distal end

S63.00 Dislocation of wrist, distal radioulnar joint
(IM)

S63.01 Dislocation of wrist, radiocarpal joint
(IM)

S63.02 Dislocation of wrist, midcarpal joint
(IM)

S63.03 Dislocation of wrist, carpometacarpal joint
(IM)

S63.08 Dislocation of wrist, other
(IM)

S63.09 Dislocation of wrist, unspecified joint
(IM)

S63.10 Dislocation of metacarpophalangeal joint (MCP) of thumb and fingers
(IM)

80. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S63.11 Dislocation of interphalangeal joint of thumb and finger
(IM)

S63.19 Dislocation of thumb and finger, unspecified joint
(IM)


Injuries to the hip and thigh
(S70-S79)
S70 Superficial injury of hip and thigh
S70.8 Other superficial injuries of hip and thigh
S70.80 Abrasion of hip and thigh
(IM)

S70.81 Blister of hip and thigh
(IM)

S70.82 Insect bite of hip and thigh
(IM)

S70.83 Superficial foreign body of hip and thigh
(IM)

S70.88 Other superficial injuries of hip and thigh
(IM)

S72 Fracture of femur
The following subdivisions are provided for optional use in a supplementary character
position where it is not possible or not desired to use multiple coding to identify fracture and
open wound; a fracture not indicated as closed or open should be classified as closed.
0 closed
1 open
S72.0 Fracture of neck of femur
Fracture of hip NOS

S72.00 Fracture of neck of femur, undisplaced intracapsular fracture
(IM)

S72.01 Fracture of neck of femur, displaced intracapsular fracture
(IM)

S72.02 Fracture of neck of femur, impacted intracapsular fracture
(IM)

S72.03 Fracture of neck of femur, midcervical shear fracture
(IM)

S72.04 Fracture of neck of femur, base of neck (cervicotrochanteric)
(IM)

S72.05 Fracture of head of femur
(IM)

S72.06 Fracture of epiphysis of upper femur
(IM)

S72.07 Fracture of neck of femur, multiple
(IM)

S72.08 Fracture of neck of femur, others
(IM)

S72.09 Fracture of neck of femur, unspecified
(IM)

S72.1 Pertrochanteric fracture
Intertrochanteric fracture
Trochanteric fracture

S72.10 Intertrochanteric fracture of femur, stable type
(IM)

S72.11 Intertrochanteric fracture of femur, unstable type
(IM)

S72.18 Fracture of trochanteric region of femur, others
(IM)

S72.19 Intertrochanteric fracture of femur, stable type
(IM)

81. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

Indonesian Modification Version_01 2025
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S72.3 Fracture of shaft of femur
S72.30 Fracture of shaft of femur, simple fracture
(IM)
S72.31 Fracture of shaft of femur, butterfly fracture
(IM)

S72.32 Fracture of shaft of femur, comminuted fracture
(IM)

S72.37 Fracture of shaft of femur, bifocal and segmental and
(IM)

S72.39 Fracture of shaft of femur, unspecified
(IM)

S72.4 Fracture of lower end of femur
S72.40 Fracture of distal femur, supracondylar
(IM)

S72.41 Fracture of distal femur, lateral condyle
(IM)
S72.42 Fracture of distal femur, medial condyle
(IM)

S72.43 Fracture of distal femur, other parts of condyle and epicondyle
(IM)

S72.44 Fracture of distal femur, T-shape intraarticular fracture
(IM)

S72.45 Fracture of distal femur, multifragment intraarticular fracture
(IM)

S72.46 Fracture of distal femur, multiple fractures
(IM)

S72.47 Fracture of distal femoral epiphysis
(IM)

S72.48 Fracture of distal femur, others
(IM)

S72.49 Fracture of distal femur, unspecified
(IM)

S73 Dislocation, sprain and strain of joint and ligaments of hip
S73.0 Dislocation of hip
S73.00 Dislocation of hip, anterior
(IM)

S73.01 Dislocation of hip, posterior type with or without minor fracture
(IM)

S73.02 Dislocation of hip, posterior type with large single fracture
(IM)

S73.03 Dislocation of hip, posterior type with comminution of rim
(IM)

S73.04 Dislocation of hip, posterior type with fracture of the acetabular
(IM)

S73.05 Dislocation of hip, posterior type with fracture of head of femur
(IM)

S73.08 Dislocation of hip, other
(IM)

S73.09 Dislocation of hip, unspecified
(IM)

Injuries to the knee and lower leg
(S80-S89)
S80 Superficial injury of lower leg
S80.8 Other superficial injuries of lower leg
S80.80 Abrasion of knee and leg
(IM)

S80.81 Blister of knee and leg
(IM)

S80.82 Insect bite of knee and leg
(IM)

S80.83 Superficial foreign body of knee and leg
(IM)

S80.88 Other superficial injuries of knee and leg
(IM)

82. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S81 Open wound of lower leg
S81.1 Open wound of leg
(IM)

S82 Fracture of lower leg, including ankle
Incl.:
malleolus
Excl.:
fracture of foot, except ankle (S92.-)
The following subdivisions are provided for optional use in a supplementary character
position where it is not possible or not desired to use multiple coding to identify
fracture and open wound; a fracture not indicated as closed or open should be
classified as closed.
0 closed
1 open
S82.1 Fracture of upper end of tibia
• Tibial:
• condyles
• head
• proximal end
• tuberosity
• with or without mention of fracture of fibula
S82.10 Fracture of proximal tibia, extraarticular
(IM)

S82.11 Fracture of proximal tibia, medial condyle
(IM)

S82.12 Fracture of proximal tibia, lateral condyle [split]
(IM)

S82.13 Fracture of proximal tibia, bicondyle
(IM)

S82.14 Fracture of proximal tibia, with ligamentous injury
(IM)
S82.15 Isolated fracture of tibial spine and intercondylar eminence
(IM)

S82.16 Fracture of epiphysis of proximal tibia
(IM)
S82.17 Fracture of proximal tibia, multiple fractures
(IM)

S82.18 Fracture of proximal tibia, others
(IM)

S82.19 Fracture of proximal tibia, unspecified
(IM)

S82.2 Fracture of shaft of tibia
With or without mention of fracture of fibula

S82.20 Fracture of shaft of tibia with intact fibula
(IM)

S82.21 Closed Fracture of shaft of tibia with fracture of fibula at same level
(IM)

S82.22 Fracture of shaft of tibia with fracture of fibula at different level
(IM)

S82.27 Fracture of shaft of tibia, bifocal and segmental and multiple
(IM)

S82.28 Fracture of shaft of tibia, others
(IM)

S82.29 Fracture of shaft of tibia, unspecified
(IM)

S82.3 Fracture of lower end of tibia
With or without mention of fracture of fibula
Excl.:
medial malleolus (S82.5)

S82.30 Fracture of distal tibia, extraarticular
(IM)

83. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S82.31 Fracture of distal tibia, nondisplaced intraarticular
(IM)

S82.32 Fracture of distal tibia, displaced intraarticular
(IM)

S82.33 Fracture of epiphysis of distal tibia
(IM)

S82.37 Fracture of distal tibia, multiple fractures
(IM)

S82.38 Fracture of distal tibia, others
(IM)

S82.39 Fracture of distal tibia, unspecified
(IM)

S83 Dislocation, sprain and strain of joints and ligaments of knee
S83.5 Sprain and strain involving (anterior)(posterior) cruciate ligament of knee
S83.50 Avulsion of anterior cruciate ligament (ACL)
(IM)

S83.51 Avulsion of posterior cruciate ligament (PCL)
(IM)

S83.59 Sprain and strain involving cruciate ligament of knee, unspecified
(IM)

S87 Crushing injury of lower leg
S87.9 Crushing injury of unspecified parts of knee and leg
(IM)

Injuries to the ankle and foot
(S90-S99)
S90 Superficial injury of ankle and foot
S90.8 Other superficial injuries of ankle and foot
S90.80 Abrasion of ankle and foot
(IM)

S90.81 Blister of ankle and foot
(IM)

S90.82 Insect bite of ankle and foot
(IM)

S90.83 Superficial foreign body of ankle and foot
(IM)

S90.88 Other superficial injuries of ankle and foot
(IM)

S91 Open wound of ankle and foot
S91.9 Open wound of ankle and foot, unspecified
(IM)

S92 Fracture of foot, except ankle
Excl.:
ankle (S82.-)
malleolus (S82.-)
The followig subdivisions are provided for optional use in a supplementary character
position where it is not possible or not desired to use multiple coding to identify
fracture and open wound; a fracture not indicated as closed or open should be
classified as closed.
0 closed

84. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

Indonesian Modification Version_01 2025
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1 open

85. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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S92.3 Fracture of metatarsal bone
S92.30 Metatarsal fracture, one metatarsal
(IM)

S92.31 Metatarsal fracture, two metatarsals
(IM)

S92.32 Metatarsal fracture, three or more metatarsals
(IM)

S92.39 Metatarsal fracture, unspecified number of metatarsals
(IM)

Effects of foreign body entering through natural orifice
(T15-T19)
T19 Foreign body in genitourinary tract
T19.4 Foreign body in penis
(IM)

Burns and corrosions
(T20-T32)
T21 Burn and corrosion of trunk
T21.0 Burn of unspecified degree of trunk
T21.06 Burn of unspecifeid degree of male genital region
(IM)

T21.1 Burn of first degree of trunk
T21.16 Burn of first degree of male genital region
(IM)

T21.2 Burn of second degree of trunk
T21.26 Burn of second degree of male genital region
(IM)

T21.3 Burn of third degree of trunk
T21.36 Burn of third degree of male genital region
(IM)

T21.4 Corrosion of unspecified degree of trunk
T21.46 Corrosion of unspecified degree of male genital region
(IM)

Toxic effects of substances chiefly nonmedicinal as to source
(T51-T65)
T63 Toxic effect of contact with venomous animals
T63.0 Snake venom
Sea-snake venom

T63.00 Toxic effect of snake venom, haematotoxin
(IM)

T63.01 Toxic effect of snake venom, neurotoxin
(IM)

T63.02 Toxic effect of snake venom, muscular toxin
(IM)

T63.03 Toxic effect of snake venom, mixed haematomuscular and neurotoxin
(IM)

T63.08 Toxic effect of other specified snake venom
(IM)

T63.09 Toxic effect of snake venom, unspecified
(IM)

86. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Certain early complications of trauma
(T79-T79)
T79.7 Traumatic subcutaneous emphysema
Excl.:
emphysema (subcutaneous) resulting from a procedure (T81.8)

T79.70 Subcutaneous emphysema without trauma
(IM)

Complications of surgical and medical care, not elsewhere classified
(T80-T88)
T81 Complications of procedures, not elsewhere classified
T81.5 Foreign body accidentally left in body cavity or operation wound following a
procedure
• Adhesions
• Obstruction
• Perforation
• due to foreign body accidentally left in operation wound or body cavity
Excl.:
obstruction or perforation due to prosthetic devices and implants intentionally left in body
(T82.0-T82.5, T83.0-T83.4, T84.0-T84.4, T85.0-T85.6)

T81.50 Amalgam tattoo
(IM)

T81.58 Other specified foreign body accidentally left in body cavity or operation
wound following a procedure
(IM)

T81.59 Unspecified foreign body accidentally left in body cavity or operation wound
following a procedure
(IM)

T83 Complications of genitourinary prosthetic devices, implants and grafts
T83.7 Complications due to implanted mesh and other prosthetic materials
(IM)

87. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter XX
External causes of morbidity and mortality
(V01-Y98)


No Additional Code Of Indonesian Modification
(IM)

88. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter XXI
Factors influencing health status and contact with health services
(Z00-Z99)

Z51 Other medical care
Z51.7 Chemotherapy and Radiotherapy session
(IM)

89. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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Chapter XXII
Codes for special purposes
(U00-U89)
(U00-U49) Complications of surgical and medical care, not elsewhere classified
U08 Tuberculoma
(IM)

U08 Tuberculoma of lung
(IM)


Bacterial agents resistant to antibiotics
(U80-U89)

Resistance to antimicrobial and antineoplastic drugs (U82-U85)
(IM)


Note: These categories should never be used in primary coding. The codes are provided for use as
supplementary or additional codes when it is desired to identify the resistance, non-responsiveness
and refractive properties of a condition to antimicrobials and antineoplastic drugs.
(IM)

U82 Resistance to betalactam antibiotics
(IM)

Use additional code (B95-B98), if desired, to identify agents resistant to betalactam antibiotic
treatment.
(IM)


U82.20 Respiratory diseases with resistance of betalactamase (ESBL) resistance
(IM)

U82.80 Respiratory diseases with resistance of betalactam antibiotics
(IM)

U83Resistance to other antibiotics (IM)
Use additional code (B95-B98), if desired, to identify agents resistant to other antibiotic
treatment
(IM)

U83.3 Respiratory diseases with resistance to other antibiotics
(IM)

U84 Resistance to other antimicrobial drugs
(IM)

Use additional code (B95-B98), if desired, to identify agents resistant to other antibiotic
treatment. (IM)
Excl.:
Resistance to antibiotics (U82-U83)
(IM)


U84.10 Respiratory diseases with resistance to antifungal drugs
(IM)

U84.20 Respiratory diseases with resistance to antiviral drugs
(IM)

U84.31 Tuberculosis with multidrug resistance
(IM)

U84.32 Tuberculosis with pre extreme drug resistance
(IM)

U84.33 Tuberculosis with extreme drug resistance
(IM)

U84.34 Tuberculosis with poly drug resistance
(IM)

U84.35 Tuberculosis with mono drug resistance
(IM)

90. List Code ICD 10 2010 Indonesian Modification (IM)
Daftar Kode Diagnosa Tambahan Dalam Indonesian Modification (IM)
MERAH : Kode Tambahan Baru
BIRU : Tambahan / revisi Desripsi Include dalam list kode
HIJAU :Catatan / Penjelasan Tambahan (Note)

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U85 Resistance to antineoplastic drugs (IM)
Incl.:
Non-responsiveness to antineoplastic drugs (IM)
Refractory cancer (IM)

U85.0 Respiratory diseases with resistance to antineoplastic drugs
(IM)