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ICD-10 BAB V MENTAL AND BEHAVIOURAL DISORDERS (GANGGUAN MENTAL DAN PERILAKU) (F00 – F99) Aris Susanto
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DESKRIPSI • Satu-satunya Bab di ICD-10 yang setiap nomor
kode kategori disertai deskripsi lengkap dan rinci tentang kondisi penyakit • Termasuk Bab ini adalah gangguan
pengembangan psychologis
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DESKRIPSI (Lanjutan-1)
• Yang tidak termasuk ke Bab V ini adalah:
-
simtoma (symptoms) tanda-tanda (sign) temuan klinis abnormal temuan laboratoris abnormal yang tidak terklasifikasi di tempat lain (NEC) (R00 – R99)
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DESKRIPSI (Lanjutan-2)
• Rentang kategori dari F00 – F99 • 78 dari 100 nomor kode sudah terisi kategori. • Bab terbagi dalam 11 blok • Ada dua kategori bertanda *
F00* dan F02* • Masing kategori didahului penjelasan rinci tentang deskripsi gangguan terkait. • Ada penekanan gangguan prilaku dan juga gangguan mental.
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DESKRIPSI (Lanjutan-3)
• Blok F00 – F09 meliputi grup gangguan organik
prilaku. Yakni, gangguan-gangguan hasil dari sebab fisis, sebagai contoh: dementia pada Alzheimer’s disease. • Block F10 – F19 meliputi gangguan akibat
penggunaan psychoactive atau substansi lain. Karakter ke 3 mengindikasikan substansi yang terlibat dan karakter ke 4 mengindikasikan status klinis pasiennya.
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TUJUAN • Mampu mengenal kode kategori kondisi
gangguan mental dan prilaku. • Mampu mengenal berbagai kondisi gangguan prilaku dan menentukan kodenya. • Mampu mengenal simtoma, tanda-tanda, dan temuan abnormal klinis dan labora-torium (Kode R) yang tidak tergolong ke Bab V. • Mampu menemukan kode berdagger bagi kode F* (berasterisk)
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Contoh: F12.2 Jenis substansi yang terlibat Adalah: cannabinoid
Menunjukkan pasien nya secara klinis ketergantungan obat/ zat terkait.
[323;305] F12.- Mental and behavioural disorders due to use of cannabinoids.
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BAB V (Lanjutan-4)
• Tobacco – F17.1 dan F17.2 hanya bisa
digunakan apabila dokumentasinya jelas mengindikasikan ada hubungan causal antara merokok dan, penggunaan untuk diagnosis pengaruh jelek kegunaan tembakau pada pasien atau, penyebab ketergantungannya (dependence) kode tambahan pada kode diagnosis yang spesifik gunakan Z72.0, Z86.4 untuk menunjukkan sejarah penggunaan tembakau yang kini.
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F00* [ 312-314; 294-296] • F00* Dementia in Alzheimer’s disease (G30.- )
F00.0*, F00.1*, F00.2*, F00.9* • F02* Dementia in other diseases classified
elsewhere F02.0*, F02.1*, F02.2*, F02.3*, F02.4* dan F02.8*
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F10-F19 Mental and behavioural disorders due to psychoactive substance use [320-323; 302-304] • Tersedia karakter ke-4 dimulai dari
.0, .1, .2, .3, .4, .5, .6, .7, .8, .9, untuk merinci gangguan pada kode F10.- s/d F19.-
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GANGGUAN TERKAIT GENDER & SEKS [ 365-368; 343-345] • F64.- Gender identity disorders F64.0, F64.1, F64.2, F64.8 dan F64.9 • F65.- Disorders of sexual preference F65.0, F65.1, F65.2, F65.3, F65.4, F65.5 F65.6, F65.8 dan F65.9 • F66.- Psychological and behavioural disorders associated with sexual developement and orientation. F66.0, F66.1, F66.2, F66.8 dan F66.9
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MENTAL RETARDATION (F70-F79) [ 369; 347] • Disediakan rincian terkait peringkat gangguan
prilaku dengan kode karakter ke 4. .0 With the statement of no, or minimal, impairment of behaviour .1 Significant impairment of behaviour requiring attention or treatment .8 Other impairments and behaviour dan .9 Without mention of impairment of behav. Use additional code, if disired, to identify associated condition such as autism, other ....
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Soal Praktik Bab V 1. Trichotillomania 2. Psychogenic impotence 3. Korsakov’s psychosis 4. Huntington’s disease with dementia 5. Bipolar disorder, currently severity but not psychotic. 6. Psychogenic asthma 7. Ketergantungan narkoba 8. IQ 50
depressed
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Abaikan Prosedur
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Praktik Penyelesaian Soal Bab V Diskusi Soal 1 1.
Trichotillomania
(541; 588) Trichotillomania F63.3 [364-365; 342-343] F63 Habit and impilse disorders This category includes certain disorders of behaviour that are not classifiable under other categories. ... Excludes: habitual ... impulse and habit disorders ... F63.3 Trichotillomania
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Diskusi Soal 1 (Lanjutan)
A disorder characterized by noticeable hair-loss due to a recurrent failure to resisit impulses to pull out hairs. The hair-pulling is usually preceded by mounting tension and is followed by a sense of relief or gratification. The diagnosis should not be made, if there is a pre-existing inflammation of the skin, or if the hair-pulling is in response to delusion or hallucination. Excludes: stereotyped movement disorders with hair-plucking (F98.4)
Dx MC: Trichotillomania
Kode F63.3
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Diskusi Soal 2
2. Psychogenic Impotence (287; 313) Impotence (sexual) (psychogenic) F52.2 - counsling Z70.1 - organic origin NEC N48.4 [355; 334 ] F52.2 Failure of genital response The principal problem ... Psychogenic impotence Excludes: ...
MC: Psychogenic impotence
F52.2
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Diskusi Soal 3 3.
Korsakov’s psychosis
(463-464; 504-505)
Psychosis - Korsakov’s (alcoholic) F10.6 - - induced by other psychoactive substance – code to F11- F19 with 4th character .6 [322; 304] .6 Amnesic syndrome
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Diskusi Soal 3 (Lanjutan-1)
Karena pada kasus no. 3 ini tidak ada penjelasan substansi atau obat yang menjadi penyebab, maka kodenya cukup pada F10.6 [323; 302 - 304]
F10
Mental and behavioural disoders due to use of alcohol [See pages 321-323 for sub-division; See before F10 for subdividions]
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Diskusi Soal 3 (Lanjutan-2)
[322; 304]
Perhatikan di atasnya: .6 Anmesic syndrome ... Korsakov’s psychosis or syndrome, alcohol- or other psychoactive substanceinduced or unspecfied. Dx
Kode
MC: Korsakove’s pscychosis F10.6
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Diskusi Soal 4
4. Huntington’s disease with dementia (270; 294) Huntington’s disease or chorea G10 with dementia G10 F02.2* Tidak bisa dicari melalui disease.
Dementia [149; 162] Dementia - in - - Huntington’s disease or chorea G10 F02.2* [397; 372] G10 Huntington’s disease Huntington’s chorea
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Diskusi Soal 4 (Lanjutan)
[313; 295] F02* Dementia in other diseases classified elsewhere Cases of dementia due, .....other then Alzheimer’s disease or CVD. Onzet ... [311; 294] Asterisk categories for this chapter are provided as follows; Use additional code, if desired, to identify the undelying cause. F00* Dementia in Alzheimer’s disease F02* Dementia in other diseases classified elsewhere
DX MC: Huntington’s disease with dementia
Kode G10 F02.2*
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Diskusi Soal 5 5. Bipolar disorder, currently severity (174; 188-189) Disorder - bipolar F13.9 - - affective F13.9 - - current episode -
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- severe depression (without psychotic symptoms) F31.4
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Diskusi Soal 5 (Lanjutan)
[334; 313-314]
Bipolar affective disorder, current episode severe depression without psychotic syndroms The patient is currently depressed ... Dx Kode MC: Bipolar disorder, currently F31.4 severity
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Diskusi Soal 6
6. Psychogenic asthma Asthma (62; 66) Asthma, asthatic (bronchial) (catarrh) (spasmodic) J45.9 (219; 238) Factor(s) - psychic, associated with diseases classified elsewhere F54 - psychological - - affecting physical conditions F54
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6. Lanjutan
[357; 336] F54 Psychological and behavioural factors associated with disorders or diseases classified elsewhere ... Examples of the use of this category are: - asthma F4 and J45.[536; 506] J45 Asthma J45.1 Nonallergic asthma Idiosyncratic asthma Intrinsic nonallergic asthma Dx: Kode: MC: Psychogenic asthma F54 J45.1
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7.
Ketergantungan narkoba
Dependence (150; 163) Dependence - due to - - alcohol - - narcotic (drug) NEC F19.2 [324; 305] F19.- Mental and behavioural disorders due to multiple drug use and use of other psychoactive substance [See pages 321-323 for subdivisions]
Dx: Kode MC: Dependence syndrome due to narcotic F19.2
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8.
IQ 50
(319; 348) IQ [369; 347] F70
under 0 F73.20 – 34 F72.35 – 49 F71.50 – 69 F70.Mild mental retardation Approximate IQ range of 50 to 69 (in adults,mental age from 9 to under 12 years). Likely to result in some learning difficulties in school. Many adults will be able to work and maintain good social relationships and contribute to society.
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Diskusi Soal 8 (Lanjutan)
Includes: feeble-mindness mild mental subnormality Perhatikan keterangan di atasnya: The following fourth-character subdivisions are for use ... .0 with the statement of no, or minimal, impairment of behaviour .1 ... .8 ... .9 Without mention of impairment of behaviour.
Dx: Kode MC: Mild mental retardation IQ 50 F70.9
