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All Journal Jurnal Wiyata : Penelitian Sains dan Kesehatan ARKESMAS [Arsip Kesehatan Masyarakat] Jurnal Rekam Medis dan Informasi Kesehatan Infokes : Jurnal Ilmiah Rekam Medis dan Informasi Kesehatan Jurnal Promotif Preventif J-REMI : Jurnal Rekam Medik dan Informasi Kesehatan JOURNAL OF COMMUNITY ENGAGEMENT AND EMPOWERMENT PELS (Procedia of Engineering and Life Science) Journal of Information Systems for Public Health Journal Health Information Management Indonesian Antigen: Jurnal Kesehatan Masyarakat dan Ilmu Gizi JENGGALA: Jurnal Riset Pengembangan dan Pelayanan Kesehatan Jurnal Pengabdian Masyarakat SAPANGAMBEI MANOKTOK HITEI Jurnal Rekam Medis dan Informasi Kesehatan Indonesia
Hidayat, Andra Dwitama
Institut Ilmu Kesehatan Bhakti Wiyata
Agriculture, Biological Sciences & Forestry Humanities Computer Science & IT Control & Systems Engineering Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Electrical & Electronics Engineering Engineering Environmental Science Health Professions Library & Information Science Medicine & Pharmacology Nursing Public Health Social Sciences Veterinary Other

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Journal : PELS (Procedia of Engineering and Life Science)

 1 
Analysis of the Accuracy of Diagnosis and Action Codification with Reconfirmation of BPJS Inpatient Patient Claims for the January-April Period of 2024 at SLG Kediri Hospital: Analisis Keakuratan Kodifikasi Diagnosis dan Tindakan dengan Konfirmasi Ulang Klaim Pasien BPJS Rawat Inap Periode Bulan Januari-April Tahun 2024 di RSUD SLG Kediri Puspitasari, Syndia; Hidayat, Andra Dwitama; Pangestuti, Ayu
Procedia of Engineering and Life Science Vol. 7 (2025): Prosiding Seminar Nasional dan Rakernas PORMIKI X
Publisher : Universitas Muhammadiyah Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21070/pels.v7i0.2095

Abstract

The accuracy of the coding of diagnoses and procedures is determined based on the completeness of the medical record documents. A dispute case or dispute claim is a claim submitted by a hospital that is declared Dispute by BPJS Health if there is a discrepancy or disagreement between BPJS and the hospital regarding claims involving services or clinical actions that impact payment of patient claims. Accurate disease and procedure coding is very important to support the smooth submission of health service claims health service cost claims. The purpose of this study was to analyze the accuracy of coding diagnoses and actions with reconfirmation of claims for inpatient BPJS patients for the period January-April 2024. The research method used is a case study approach. Techniques data collection techniques in the form of observation, literature study and interviews. The population in this study is the number of BPJS patient claim files returned in January-April 2024. The sample used in this study is the number of BPJS inpatient claim files that are returned with coding inaccuracies in January-April 2024. The research results show that from January to April 2024, reconfirmation of inpatient BPJS patients tends to fluctuate. The highest reconfirmation was in April with a total of 89 documents. Meanwhile, reconfirmation with the highest codification inaccuracy was in January with a total of 26 documents. This reconfirmation is sent in Excel form which must be confirmed by the hospital. From the results of the research conducted, the cause of re-confirmation of inpatient BPJS patients related to coding inaccuracies is still high. Accurate coding can minimize hospital losses and the risk of fraud in health service facilities.
Challenges, Benefits and Considerations of Transitioning Disease Classification and Codification to ICD-11: Tantangan, Manfaat dan Pertimbangan Transisi Klasifikasi dan Kodifikasi Penyakit Menuju ICD-11 Perwirani, Resia; Hidayat, Andra Dwitama; Raharjo, Untoro Dwi
Procedia of Engineering and Life Science Vol. 7 (2025): Prosiding Seminar Nasional dan Rakernas PORMIKI X
Publisher : Universitas Muhammadiyah Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21070/pels.v7i0.2105

Abstract

ICD-11 was developed to address the limitations of ICD-10, adapting to advances in medicine and technology. ICD-11 has not been implemented in Indonesia due to the absence of supporting regulations that enforce the use of ICD-11 as a disease coding guideline to replace ICD-10. This study analyses information related to the benefits, challenges and considerations of implementing ICD-11 in the form of a narrative literature review conducted using the PRISMA framework. The databases used were Google Scholar, Pubmed, ScienceDirect and Scopus. Article search keywords used the SPICE research question framework. Inclusion criteria included articles published within 2019-2024 in English or Indonesian. Article screening was conducted using the Rayyan.ai tool, followed by critical appraisal using the MMAT instrument with a cut-off point of 80%. We obtained 5,813 articles from the database. A total of 5,776 articles were excluded, 4 articles were duplicated, leaving 13 articles selected for extraction and analysis. ICD-11 has many benefits, including a more complete list of diagnoses and health-related problems, from the update of classification data in each organ system/disease group category to the inclusion of new categories. ICD-11 also has a “post- coordination” feature and cluster codes allow for more specific diagnosis codes. One of the barriers to the implementation of ICD-11 is that there are other classification guidelines in some particular diseases that overlap with ICD-11, for example in the classification of mental illness and CHD. The implementation of SNOMED-CT, which is expected to go in parallel with the use of ICD-11, requires a Common Ontology to map the semantics of each system’s terminology. Successful implementation requires policy support, effective training, improved clinical documentation, and promotion so that ICD-11 can be implemented effectively, ensuring relevance and usefulness in various health fields.
A Death Rate in Patients Ngudi Waluyo Blitar District Hospital Jayanti, Krisnita Dwi; Hidayat, Andra Dwitama; Wahyuni, Titin; Prodyanatasari, Arshy; Bisono, Eva Firdayanti; Maharani, Eva Ratih
Procedia of Engineering and Life Science Vol. 6 (2024): The 3rd International Scientific Meeting on Health Information Management (3rd ISMoHI
Publisher : Universitas Muhammadiyah Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21070/pels.v6i0.1965

Abstract

Record by integration (RME) management efficiency has improved the health care database at the hospital, including mortality data. Mortalitas data an indicator of health service that evaluates the quality of critical care in a hospital, that is essential for decision making strategic and policy evaluation. The research aimed to identify the mortality in patients at Ngudi Waluyo Blitar District Hospital in 2023. This research used the descriptive to describe method mortality in patients at hospital Ngudi Waluyo Blitar District in 2023. The result showed that the total number of patients alive and died in 2023 was 14.485, with the number of 13410 live patients and the patient dies of 1.075. The analysis shows ICCU death as a room with the highest death, especially in time; it is < 25 ‰ or < 2.5 ‰ per year. Factors such as age, associated territories, and some septicemia as a medical condition, chronic kidney disease, stage 5, intracerebral hemorrhage, intraventricular, keys respiratory failure, and pneumonia, unspecified as the cause of death. For that reason, we need to repair constants on information systems and electronic medical records to support better decision making in the management of health services. Evaluation deep to events of death, especially in the ICCU, and focus on management of elderly patients and patients with chronic diseases such as septicemia and chronic kidney disease, be a key to increasing the quality of services.
Co-Authors Abhiseka, Rengga Bagas Arshy Prodyanatasari Arsy, Salsa Al Avrileta, Noryfumi Cinta Ayu Pangestuti Bisono, Eva Firdayanti Cahyani, Vony Rista Cici Nila Ardila Deni Luvi Jayanto Dianti Ias Oktaviasari Dianti Ias Oktaviasari, Dianti Ias Dinda Agnes Wahyu Aprilia dr. AG Nugroho Pudji Lestarjo Dwi, Titania Elok Rizma Hapsari Endah Retnani Wismaningsih Endah Retnani Wismaningsih Endah Retnani Wismaningsih, Endah Retnani Erlina, Tita Eva Firdayanti Bisono Eva Firdayanti Bisono Fatmawati, A’yuni Nur Ghafar, Siti Aisyah Abd Ilahi, Nasywa Shifi Intan Ayudya Novitasari Karina, Ina Komala Anggraeni Krisnita Dwi Jayanti Krisnita Dwi Jayanti Krisnita Dwi Jayanti Krisnita Dwi Jayanti, Krisnita Dwi Kurniasari, Mia Ashari Lestarjo, Agustinus Nugroho Pudji Maharani, Eva Ratih Maria Sulistyaningsih Mayhimamia, Arrsillaufiatma Muhammad Atnang Mukti Lestari, Tri Mulya Ike Ardila, Ninda Munir, Mochammad Miftahul Ninda Mulya Ike Ardila Ningrat, Usama Jaya Ni’matu Zuliana Nurhadi Nurhadi NURHADI Nurhadi Nurhadi Nurhadi Nurhadi Nurhadi Nurhadi Oktrianadewi, Sevi Pangestuti, Ayu Perwirani, Resia Poonwong, Prakasit Prakasit Poonwong Puspitasari, Syndia Putri Indra Suryandari Putri, Alfira Maudy Sukmaning Putri, Elisa Triana Kamila Raharjo, Untoro Dwi Rahmadi, Nadifatul Rama Wahyu Susilo Putra Ramli, Nalisha Mohamed Rany Eka Putranti Ratna Frenty Nurkhalim Raya Mulyasari Reni Triyaningtyas Roma Firmansyah Rosa Aulia Sari Setyawan, Hari Krisna Sevi Oktrianadewi Simorangkir, Anggia Dini Marsaroha Boru Panggabean Suryandari, Putri Indra Titin Wahyuni Tri Mukti Lestari Tyas, Reni Trianing Vicky Bin Djusmin Wahyu Putra Alfiansyah Widiyanto, Wahyu Wijaya Yusof, Ainuddin Yushar Zuliana, Ni'matu Zuliana, Ni’matu