Download - Daftar Tindakan Informed Consent
DAFTAR TINDAKANTINDAKAN YANG PERLUINFORMED CONSENT
Sesuai Undang Undang No. 44 tahun 2009 tentang Rumah Sakit, terdapat beberapa tindakan kedokteran dan kedokteran gigi yang wajib diberikan informed consent. Tindakan tersebut yaitu:A. Semua Tindakan Pembedahan dan Tindakan InvasiveB. Semua Tindakan Anestesi & Sedasi (Sedasi Sedang dan Sedasi Dalam) C. Semua Tindakan Pemberian Produk Darah & Komponen DarahC. Semua Tindakan/ PENGOBATAN yang Berisiko Tinggi.
A. Tindakan Pembedahan dan Tindakan Invasive yang memerlukan informed consent antara lain:
NoKSM/ INSTALASI/ UNITTINDAKAN
1KSM BedahSaraf1. Amygdala Hypocampectomy (Epilepsi)
2. Anterior Temporomesial Lobectomi (Epilepsi)
3. Biopsi Saraf Tepi/ Otot
4. Blok Saraf Perifer I
5. Cingulotomy (Psichiatric)
6. Corpus Callosotomi (Epilepsi)
7. Debrimen Rekonstruksi Vulnus Kulit Kepala
8. Dekompresi Saraf Tepi
9. Dekompresi Tulang Durameter
10. Dekortikasi Sinus Frontalis
11. Denervasi Facet
12. DREZ Lession (Pain)
13. Eksisi Ensefalokel/ Mielokel
14. Eksisi Kista Jinak Kulit Kepala
15. Eksisi Osteoma/ Osteositosis
16. Elevasi Kraniotomi Fraktur Impresi,Dengan Robekan
17. Dura
18. Elevasi Kraniotomi Fraktur Impresi Tanpa Robekan
19. Dura
20. Extirpasi Tumor Jinak Saraf Kulit Kepala
NoKSM/ INSTALASI/ UNIT
TINDAKAN
21. Fusi Stabilisasi Corpus Vertebra
22. Graft/ Transposisi Saraf Tepi
23. Hemis ferektomi (Epilepsi)
24. Hemis ferektomi (Epilepsi)
25. Injeksi saraf perifer (dengan radio frekuensi)
26. Injeksi spinal (Pain)
27. Insersi Elektrode Intradural (Epilepsi, Movement, Psikiatrik)
28. Kordotomi Perkutan
29. Kordotomi Servikal Open (Pain)
30. Kordotomi Servikal Perkutan (Pain)
31. Kranioplasti dua sisi
32. Kranioplasti satu sisi
33. Kraniotomi Biopsi otak
34. Laminektomi Eksisi Tumor Spinal
35. Laminoplasti
36. Laminotomi Biopsi Mielum
37. Laminotomi Diskektomi HNP/ Stenosis >1 level
38. Laminotomi Diskektomi HNP/ Stenosis 1 level
39. Lesionectomy (Epilepsi)
40. Lobektomi (Epilepsi)
41. Mesencephalectomy (Pain)
42. Mikrodisekktomi HNP
43. MVD (Microvascular Decompression)
44. Neurektomi/ Neurolise
45. Neuroendoskopi (Otak, Spinal)
46. Neuroplasti
47. Omayadrain
48. Pallidotomi (movement Disorder)
49. Paravertebral Blok Perkutan
50. Pemasangan Traksi Servikal
51. Penjahitan Saraf Tepi
52. Punksi Cairan Otak
53. Reseksi Extra-Temporal (Epilepsi)
54. Revisi VP Shunt
55. Rhizotomi Selektif (Spastisitas)
56. Rhizotomy (Pain)
57. Selective Nerve Root Block
NoKSM/ INSTALASI/ UNITTINDAKAN
58. Selective Thalamotomi (Movement Disorder)
59. Simpatektomi Open (Pain)
60. Simpatektomi Perkutan
61. SLTH
62. Stereotactic Ablative Procedure (Psichiatric)
63. Subthalamotomy (Movement Disorder)
64. Suturektomi Kraniostenosis
65. Thalomotomy (Pain)
66. Transposisi kraniostenosis, dengan orbital advancement
67. Transposisi kraniostenosis, tanpa orbital advancement
68. Trepanasi Cedera Kepala (4jam)
70. Trepanasi CVA Bleeding
71. Trepanasi kelainan Saraf Kranial
72. Trepanasi Kelainan Vascular Otak
73. Trepanasi Tumor Otak
74. VA Shunt
75. VP Shunt Multiple
76. VP Shunt Satu Sisi
No.KSM/ INSTALASI/ UNITTINDAKAN
2KSM BEDAH KEPALA LEHER1. AffArchBarr
2. AffArchBarr dan suspensi maksila
3. Biopsy Insisi onal dengan anastesi lokal
4. Deseksi submandibula
5. Diseksi leher radikal/ radikal neckdissection
6. Eksisi gldsubmandibula
7. Eksisi higroma leher
8. Eksisi kistatiroglosus
9. Eksisi luastumor ganas bibir dengan rekontruksi
10. Flap lokal
11. Eksisi luastumor ganas dengan rekontruksi flap jauh
12. Eksisi luas tumor ganas kulit dengan rekontruksi
13. Flap local
14. Eksisi luas tumor ganas rongga mulut dengan Rekontruksi flap local
15. Eksisi parsial + marsupialisasi Ranula
No.KSM/ INSTALASI/ UINITTINDAKAN
16. Eksisi tumor ganas kulit dengan flap local atau graft
17. Kulit
18. Eksisi tumor ganas kulit dengan flap local jauh
19. Fiksasi interna frakturnasal
20. Fiksasi inter napan-facial
21. Hemiglosektomi
22. Insisi abses dengan anastesi lokal
23. Insisi flegmon dasar mulut
24. Internal Fiksasi fraktur condylusmandibula
25. Internal Fiksasi fraktur maksilofasial 3-4 tempat patahan
26. Internal fiksasi fraktur maksilo fasial 5 tempat patahan atau lebih
27. Laringectomi
No.KSM/ INSTALASI/ UNITTINDAKAN
3BEDAH THT-KL
1. Adenotonsilektomi
2. Anthrostomi+Sinuskopi
3. BLM Simple (Kista,Polip,Nodul,Granulasi)
4. BiopsiTumor
5. Bronkoskopi Rigid
6. BLM Advance (Stenosis, Subjektif/Trakea,Papiloma Laring/ Trakea
7. CaldWellLuc
8. Cochlear Implant/ImplanBaha
9. Dekompresi NervusFasialis
10. DCR
11. Eksisi Ekstostosis
12. Ekstirpasi KistaBranchial
13. Ekstirpasi KistaDuctusTiroglosus
14. Ekstraksi granulasi MAE/Kolesteatosis
15. Ekstraksi Polip
16. Esofagoskopi Rigid&Fleksibel
17. Ethmoidektomi (Intranasal)
18. Ekstraksi Korpus Alienum KavumNasi
19. EkstraksiKorpusAlienumKavumNasiEndoskopi
20. EkstirpasiFistelPre Aurikuler
21. EkstraksiKorpusAlienumMAE
22. EkstirpasiKelenjarSubMandibula
23. EkstirpasiAngiofibromaNasofaring
24. EksplorasiAbsesParafaringeal
No.KSM/ INSTALASI/ UNITTINDAKAN
25. EkstirpasiTumorJinakKepala&Leher(AteromLipoma)
26. Faringotomi
27. FESS
28. FESSAdvance
29. FrontalSinusotomi
30. ForeHeadFlap
31. FrontoEtmoidektomi(Ekstranasal)
32. FOL
33. GlosektomiTotal/Parsial
34. GlosektomiTotal/Hemiglosektomi+RND
35. Hemiglosektomi+SOHND
36. InsisiAbsesLeherDalam
37. InversiGrommet
38. InsisiPerikondritis
39. IrigasiSinusMaksila
40. InsisiAbsesPeritonsil
41. Imunoterapi
42. KonkaReduksi
43. KaustikKonkaInferior
44. Laringektomi
45. Laringektomi+ND
46. LaringoFisur/EksplorasiLaring
47. LigasiA.KarotisEksternal
48. Laringoskopi Rigid
49. Laringoskopi Fleksible
50. Laringoskopi Direkta
51. MaksilektomiTotal+Rekontruksi
52. Mastoidektomi Radikal
53. Mini FESS
54. MyocutaneusFlap(Pectoral Mayor)
55. Myringoplasty/Timpaniplasti
56. Mandibulekromi
57. Neurektomi SarafVidian
58. Osteotomi+Septumkoreksi
59. Rekontruksi Fraktur MaksilaMultiple
60. Rekontruksi Fraktur MaksilaSederhana
61. Rhinoplasti
62. Rinotomi Lateral+Maksilektomi Medial
63. RekontruksiLaringTrakea
64. Reposisi Fraktur OsNasal
65. Reposisi &Fiksasi Fraktur Mandibula
66. Septum Koreksi+Konkotomi
67. Stapedektomi
68. SkinPricleTest
No.KSM/ INSTALASI/ UNITTINDAKAN
69. Tiroidektomi Sub-Total
70. Tonsilektomi/Adenoidektomi
71. Tracheostomi
72. Turbinektomi
73. TiroidektomiTotal+ND
74. Temporal BoneResection
75. TerapiWicarapadaAnak-Anakdandewasa
76. TerapiWicaraTunaLaring
No.KSM/ INTALASI/ UNITTINDAKAN
4KSM Orthopedi DanTraumatologi1. Abdominopelvic amputation
2. Achillotenotomy
3. Adductor tenotomyofhip
4. Advancement oftendon
5. Advancement oftendonof hand
6. Amputationaboveknee
7. Amputationanddisarticulation offinger- general anaesthesia
8. Amputationanddisarticulation offinger local anaesthesia
9. Amputationanddisarticulation ofthumb-general anaesthesia
10. Amputationanddisarticulation offinger- general anaesthesia
11. Amputationanddisarticulation offinger local anaesthesia
12. Amputationanddisarticulation ofthumb-general anaesthesia
13. Amputationanddisarticulation ofthumb-local anaesthesia
14. Amputation of anklethroughmalleoli oftibiaand fibula
15. Amputation oftoe-general anaesthesia
16. Amputation oftoe-localanaesthesia
17. Amputationthroughfoot
18. Amputationthroughforearm
19. Amputationthroughhand,Amputationthrough carpals
20. Amputationthroughhumerus, Upper arm amputation
21. Amputation,not otherwisespecified
22. Anklefusion
23. Applicationof externalfixator device
24. Applicationof externalfixator device,monoplanar system
25. Applicationof externalfixator device,ringsystem
26. Applicationof hybridexternal fixator device
27. Arthrocentesis
28. Arthrodesisof elbow
29. Arthrodesisof hip
30. Arthrodesisofknee
31. Arthrodesisof other specifiedjoints
32. Arthrodesisofshoulder
No.KSM/ INSTALASI/ UNITTINDAKAN
33. Arthrodesisof unspecifiedjoint
34. Arthroplastyofcarpocarpal or carpometacarpal joint withimplant
35. Arthroplastyofcarpocarpal or carpometacarpal joint with out implant
36. Arthroplastyofmetacarpophalangealand interphalangeal jointwithimplant
37. Arthroplastyofmetacarpophalangealand interphalangeal jointwithoutimplant
38. Arthroscopy
39. Arthrotomyfor removal ofprosthesiswithout replacement
40. Aspiration of bursa
41. Aspiration of bursa of hand
42. Aspiration of other softtissue
43. Aspiration of other softtissue ofhand
44. Atlas-axisspinalfusion
45. Biopsyofbone
46. Biopsyofjointstructure
47. Biopsyofspinal cord or spinalmeninges
48. Bone graft
49. Bone marrowor hematopoieticstemcell transplant (all proceduresincludedinthisclass
50. Bunionectomywithsofttissuecorrectionand arthrodesis
51. Bunionectomywithsofttissuecorrectionand osteotomyofthefirstmetatarsal
52. Bursectomy
53. Bursectomyofhand
54. Bursotomy
55. Bursotomyofhand
56. Carporadialfusion
57. Closedreductionof dislocation General anaesthesia
58. Closedreductionof dislocation of ankle
59. Closedreductionof dislocation of elbow
60. Closedreductionof dislocation offoot andtoe- general naesthesia
61. Close dreduction of dislocation of foot and toe-local naesthesia
62. Closedreductionof dislocation of handandfinger- general naesthesia
63. Closedreductionof dislocation of handandfinger- local naesthesia
64. Closedreductionof dislocation of hip
65. Closedreductionof dislocation ofknee
66. Closedreductionof dislocation of other specified sites-general anaesthesia
No.KSM/ INSTALASI/ UNITTINDAKAN
67. Closedreductionof dislocation of other specified sites-local anaesthesia
68. Closedreductionof dislocation of other specified sites-local anaesthesia
69. Closedreductionof dislocation ofshoulder
70. Closedreductionof dislocation ofwrist
71. Closedreductionof dislocation-Localanaesthesia
72. Closedreductionoffracturewithinternalfixation- Carpal andmetacarpal
73. Closedreductionoffracturewithinternalfixation- Femur (Including:MIPO,interlocking nail,TEN)
74. Closedreductionoffracturewithinternalfixation- Humerus(including:Interlockingnail,TEN, MIPO)
75. Closedreductionoffracturewithinternalfixation- Intrarticular Major Bone
76. Closedreductionoffracturewithinternalfixation- Phalang offoot
77. Closedreductionoffracturewithinternalfixation- Phalang offhand
78. Closedreductionoffracturewithinternalfixation- Radiusandulna(MIPO,TEN)
79. Closedreductionoffracturewithinternalfixation- Tarsalandmetatarsal
80. Excisionof bonefor graft
81. Excisionofintervertebral disc
82. Excisionoflesionofmuscle
83. Excisionoflesionofmuscleofhand
84. Excisionoflesionofother softtissue
85. Dorsal anddorsolumbarfusion oftheanterior column,anterior technique
86. Dorsal anddorsolumbarfusion oftheposterior column,posterior technique
87. Excisionof bonefor graft
88. Excisionofintervertebral disc
89. Excisionoflesion ofmuscle
90. Excisionoflesion ofmuscleof hand
91. Excisionoflesion of other softtissue
92. Excisionoflesion oftendonsheath
93. Excisionoflesion oftendonsheath of hand,Ganglionectomyoftendonsheath(wrist)-General anaesthesia
94. Excisionoflesion oftendonsheath of hand, Ganglionectomy of tendons heath (wrist)-Lokal Anestesi
95. Excisionofmuscleor fasciafor graft
96. Excisionofmuscleor fasciaof handfor graft
No.SKM/ INSTALASI/ UNITTINDAKAN
97. Excisionof other lesionofsofttissue of hand
98. Excisionofsemilunar cartilageofknee
99. Excisionoftendonfor graft
100. Excisionoftendonofhandfor graft
101. Excisionor correction ofbunionette,Thatwith osteotomy
102. Excisionor destruction ofintervertebral disc, unspecified
103. Explorationoftendonsheath
104. Explorationoftendonsheathofhand
105. Exploratorythoracotomy
106. Fasciotomy
107. Fasciotomyofhand
108. Finger reattachment
109. Five-in-onerepair ofknee
110. Footreattachment
111. Forearm,wrist, or handreattachment
112. Fusionor refusionof2-3vertebrae
113. Fusionor refusionof4- 8vertebrae
114. Fusionor refusionof9or morevertebrae
115. Graftofmuscleorfascia
116. Hipbearingsurface,ceramic-on-ceramic
117. Hipbearingsurface,ceramic-on-polyethylene,Hip bearingsurface, oxidizedzirconium-on-polyethylene
118. Hipbearingsurface, metal-on-metal
119. Hipbearingsurface, metal-on-polyethylene
120. Implantation ofinternallimblengtheningdevicewith kinetic distraction
121. Implantation of other internal limblengthening device
122. Implantationor replacementof peripheral neurostimulator lead(s)
123. Implantationor replacementofspinal neurostimulator lead(s)
124. Incisionanddrainage ofpalmaror thenar space
125. Injectionof anestheticintoperipheral nervefor analgesia
126. Injectionof anestheticintospinal canalfor analgesia
127. Injectionof destructiveagentintospinal canal
128. Injectionoflocally-actingtherapeuticsubstanceinto other softtissue
129. injection ofsteroid,Subarachnoidperfusion of Refrigeratedsaline
130. Injectionoftherapeuticsubstanceintobursa
131. Injectionoftherapeuticsubstanceintobursaofhand
132. Injectionoftherapeuticsubstanceintojointor ligament
133. Injectionoftherapeuticsubstanceintotendon
134. Injectionoftherapeuticsubstanceintotendon of hand
135. Insertion of bonegrowthstimulator
No.SKM/ INSTALASI/ UNITTINDAKAN
136. Insertion of bonevoidfiller
137. Insertion ofcatheter intospinal canalfor infusionof therapeuticor palliativesubstances, Insertionof catheter intoepidural,subarachnoid, or subdural space ofspinewithintermittentor continuous infusion of drug (with creation of anyreservoir)
138. Insertion ofinterbodyspinalfusiondevice
139. Insertion of other spinal devices
140. Insertion of partial spinal disc prosthesis,cervical
141. Insertion of partial spinal disc prosthesis, lumbosacral
142. Insertion ofrecombinantbone morphogenetic protein
143. Insertion ofspinaldiscprosthesis,not otherwise specified,Replacementofspinaldisc,NOS
144. Insertion ofspinaldiscprosthesis,thoracic
145. insertion ofsternalfixationdevicewithrigidplates
146. Insertion oftotal spinal disc prosthesis,cervical
147. Insertion oftotal spinal disc prosthesis,lumbosacral
148. Insertionor replacementof(cement) spacer
149. Insertionor replacementoffacetreplacement device(s)
150. Insertionor replacementofinterspinousprocess device(s)
151. Insertionor replacementof pedicle-baseddynamic stabilizationdevice(s)
152. Insertionor replacementofskeletal musclestimulator
153. Internalfixationofbonewithoutfracturereduction
154. Interphalangealfusion
155. Interthoracoscapular amputation,Forequarter amputation
156. Intra-operativeneurophysiologicmonitoring Neuromonitoring
157. Intervertebral chemonucleolysis
158. limblengtheningprocedures
159. Limbshorteningprocedures
160. Localexcisionoflesionor tissueof bone
161. Lower legor anklereattachment
162. Lower limbamputation, nototherwisespecified
163. Lumbarandlumbosacralfusionoftheanterior column,anterior technique
164. Lumbarandlumbosacralfusionoftheanterior column,posterior technique
165. Lumbarandlumbosacralfusionoftheposterior column,posterior technique
166. Lysis of adhesionsofhand
167. Lysis of adhesionsofmuscle,tendon,fascia,and bursa
168. Lysis of adhesionsofspinal cordandnerveroots
169. Metacarpocarpalfusion
170. Metacarpophalangeal fusion
No.KMS/ INSTALASI/ UNITTINDAKAN
171. Metatarsophalangealfusion
172. Midtarsalfusion
173. Muscletransfer or transplantation
174. Myotomy
175. Myotomyof hand
176. Neurectasis
177. Openbiopsyofcranial or peripheral nerveorganglion
178. Openbiopsyofsoft tissue
179. Openreductionofdislocationofankle Neglected dislocation
180. Openreductionofdislocationofelbow Fresh dislocation
181. Openreductionofdislocationofhandandfinger-Fresh dislocation
182. Openreductionofdislocationofhip -Fresh dislocation
183. Openreductionofdislocationofhip Neglected dislocation
184. Openreductionofdislocationof knee- Neglected dislocation
185. Openreductionofdislocationof knee-Fresh dislocation
186. Openreductionofdislocationofother specifiedsites
187. Openreductionofdislocationofshoulder-Fresh dislocation
188. Openreductionofdislocationofshoulder-Neglected dislocation
189. Openreductionofdislocationofunspecifiedsite-Fresh dislocation
190. Openreductionofdislocationofunspecifiedsite- Neglected dislocation
191. Openreductionofdislocationofwrist-Fresh dislocation
192. Openreductionoffracturewithinternalfixation- radius andulna-Simplefracture
193. Openreductionof fracturewithinternalfixation- unspecifiedsite(PeriarticularMajorBone)
194. Openreductionof fracturewithinternalfixation-carpals and metacarpals - plate& screws HandNOS-Plate&Screw
195. Openreductionof fracturewithinternalfixation-carpals and metacarpals - plate& screws HandNOS-Plate&Screw
196. Openreductionof fracturewithinternalfixation-carpals and metacarpals - simpleimplants(K-wire) HandNOS-implant sederhana(K-wire)
197. Openreductionof fracturewithinternalfixation-femur Comminutiveor Segmental
198. Openreductionof fracturewithinternalfixation-femur- Simplefracture
199. Open reduction offracturewithinternalfixation- humerus Simplefracture
200. Open reduction offracturewithinternalfixation humerus- Comminutiveor Segmental
No.KSM/ INSTALASI/ UNITTINDAKAN
201. Open reduction offracturewithinternalfixation-phalangesoffoot- simpleimplants(K-wire)
202. Open reduction offracturewithinternalfixation-phalangesoffoot-Plate& Screws
203. Open reduction offracturewithinternalfixation-phalangesof hand- Plate&Screws
204. Open reduction offracturewithinternalfixation-phalangesof hand- simpleimplants
205. Open reduction offracturewithinternalfixation-tarsals andmetatarsals- Plate&Screws
206. Open reduction offracturewithinternalfixation- tarsalsandmetatarsals- simpleimplants
207. Open reduction offracturewithinternalfixation-tibia andfibula Simplefracture
208. Open reduction offracturewithinternalfixation-tibia andfibula-Comminutiveor Segmental
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