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All Journal Karya Kesehatan Siwalima
Revi Mariska Longa
Politeknik Piksi Ganesha
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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Analysis of Coding Accuracy in Supporting Severity Level Determination for INA-CBG's Claims among Inpatients at Muhammadiyah Bandung Hospital Revi Mariska Longa; Desy Widyaningrum
Karya Kesehatan Siwalima Vol. 5 No. 2 (2026): September-February
Publisher : Lembaga Penerbitan Fakultas Kesehatan, Universitas Kristen Indonesia Maluku

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54639/kks.v5i2.2053

Abstract

Indonesia Case Base Groups (INA-CBG's) is the healthcare payment system used in the implementation of the National Health Insurance (Jaminan Kesehatan Nasional/JKN) program, in which the accuracy of diagnosis and procedure coding forms the basis of the grouping process and the determination of severity levels. Inaccurate coding may result in an inappropriate severity level, which in turn affects the value of INA-CBG's claims. This study aimed to analyze the accuracy of diagnosis and procedure coding in supporting severity level determination for INA-CBG's claims among inpatients at Muhammadiyah Bandung Hospital. This study employed a descriptive method with a quantitative approach, with data collected through observation and a documentation study. The results showed that the number of Severity Level I patients during the first quarter of 2026 was 1,130. Based on length of stay (LOS), most patients were treated for 3-5 days, while only 3 patients had a length of stay exceeding 10 days. These results indicate that the accuracy of diagnosis and procedure coding plays an important role in supporting severity level determination, so that the INA-CBG's claim process can be carried out accurately and in accordance with patients' clinical conditions.
Co-Authors Desy Widyaningrum