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All Journal Infokes : Jurnal Ilmiah Rekam Medis dan Informasi Kesehatan Medika Promkes : Jurnal Kreativitas Kesehatan
Vidya Widowati
Politeknik Kesehatan Bhakti Setya Indonesia
Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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ANALISIS KEBUTUHAN PETUGAS KODER KLAIM JKN MENURUT ABK KES DI RUMAH SAKIT JIWA GRHASIA Vidya Widowati; Elsye Maria Rosa
Jurnal Infokes Vol 13 No 1 (2023): Jurnal Ilmiah Rekam Medis dan Informatika Kesehatan
Publisher : Universitas Duta Bangsa Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47701/infokes.v13i1.2481

Abstract

Adequate and competent Health Human Resources are needed to manage the Jaminan Kesehatan Nasional (JKN) program on an ongoing basis. Calculation of needs can use Analisis Beban Kerja Kesehatan (ABK Kes) according to PMK No 33 of 2015. According to information obtained from interviews with a claim officer, there is 1 Medical Recorder and Health Information (PMIK) who served as a coder to code for JKN claims. This resulted in the reimbursement of service costs from third parties to the hospital being late. The aim of the study was to calculate the need for coder officers using the ABK Kes method for JKN claim. This research method is qualitative with a case study approach. The results of the study showed that the number of coder officers needed with the Kes ABK method was 2 people, so it was necessary to meet the required staff.
Analisis Ketidaktepatan Kode Diagnosa  Kasus Perinatal Rawat Inap di Rumah Sakit Nur Hidayah Bantul Hery Setiyawan; Vidya Widowati; Carissa Maharani Istu Putri
Medika Promkes : Jurnal Kreativitas Kesehatan Vol. 1 No. 2 (2026): Medika Promkes : Jurnal Kreativitas Kesehatan
Publisher : PT. Promosi Kesehatan Media

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Abstract

Background: The accuracy of diagnosis codes significantly impacts morbidity statistics, epidemiological studies, and clinical decision-making. However, a preliminary study at Nur Hidayah Hospital, Bantul, showed that the rate of diagnosis code inaccuracy remained high, reaching 60% (6 out of 10 medical records), even though the treatment code inaccuracy was 0%. This study aimed to analyze the coding process, the percentage of accuracy, and the factors causing inaccurate diagnosis and treatment codes in perinatal inpatients at the hospital. Methods: This descriptive, qualitative, cross-sectional study was conducted in February–March 2025. Subjects included coding staff and the head of medical records (triangulation), with 26 medical records of perinatal inpatients from 2023–2024 as subjects. The coding process was conducted post-assembly and was regulated by the official SOP of Nur Hidayah Hospital. Results and Discussion: Implementation of inpatient perinatal case coding at Nur Hidayah Hospital, Bantul, is suboptimal in the diagnosis sector (inaccuracy reached 53.8%), although the treatment sector is very good (100% accuracy). This high rate of inaccurate diagnosis codes is rooted in a combination of internal management factors (People, Method, Money), including a lack of uniformity in staff competency and accuracy, a lack of support from specific coding procedures, and the hospital's failure to allocate a budget for capacity building (training). Conclusion: Perinatal case coding at Nur Hidayah Hospital, Bantul, is suboptimal, with a diagnosis code inaccuracy rate reaching 53.8%, despite 100% accuracy in the treatment codes. This problem is caused by factors such as People (staff have not been trained, are not thorough, and have different understandings of lead terms), Method (the new SOP regulates the technical aspects of the electronic ICD, not the coding method), and Money (a training budget exists but has not been realized).   Keywords: Coding Inaccuracy, Perinatal; Hospital.  
Co-Authors Carissa Maharani Istu Putri Elsye Maria Rosa Hery Setiyawan