Jurnal Medika Nusantara
Vol. 4 No. 4 (2026): : Jurnal Medika Nusantara

Tinjauan Ketepatan Kodifikasi ICD-10 dalam Laporan RL 4.1 pada SIRS Versi 6.3

Nadia Rizki Pratami (Politeknik Piksi Ganesha)
Denya Rachmadhini (Politeknik Piksi Ganesha)



Article Info

Publish Date
01 Nov 2026

Abstract

The accuracy of diagnosis coding is a crucial factor in producing accurate RL 4.1 reports as the basis for hospital morbidity information. However, the implementation of the Hospital Information System (SIRS) Version 6.3 still presents potential coding inaccuracies that may affect the quality of the reports. This study aimed to examine the accuracy of diagnosis coding in RL 4.1 reports generated through SIRS Version 6.3 at Santosa Hospital Bandung Central. This study employed a descriptive qualitative approach. Data were collected through observations of the coding process, in-depth interviews with coding staff regarding the challenges they encountered, and document reviews of medical records and RL 4.1 reports. The collected data included the conformity of diagnosis with ICD-10 codes, the data processing workflow, and factors influencing coding accuracy. Data were analysed using the qualitative analysis model proposed by Sugiyono (2022), which consists of data reduction, data display, and conclusion drawing. The findings revealed that diagnosis coding accuracy had not yet reached an optimal level, as evidenced by coding discrepancies, the selection of less specific ICD-10 codes, and factors related to coders competencies and system limitations. The study concludes that improving coders competencies, enhancing the quality of medical documentation, and optimising the hospital information system are essential to improve diagnosis coding accuracy and ensure the accuracy of RL 4.1 reports.

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Journal Info

Abbrev

Medika

Publisher

Subject

Health Professions Nursing Public Health

Description

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