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This study aims to analyze the accuracy of ICD-9-CM coding in Cathlab procedure claims submitted to BPJS Kesehatan under the INA-CBGs reimbursement system at RSI Aisyiyah Malang. Accurate coding is critical for determining appropriate claim grouping and tariff calculation within Indonesia’s national health insurance scheme. The research employed a mixed-methods approach, combining quantitative analysis of 244 Cathlab claims from 2024 with qualitative insights obtained through document review, interviews, and direct observation. The results showed that 182 claims (74.59%) were accepted as accurate and complete, while 62 claims (25.41%) were returned as pending. Common causes of claim inaccuracy included missing supporting documents (37.10%), incorrect ICD-9-CM codes (27.42%), and nonspecific diagnoses (19.35%). Procedural miscoding, such as omitting dual catheterization codes or stent-related procedure codes, was identified as a frequent issue, significantly impacting claim grouping and reimbursement. The study highlights systemic challenges related to documentation quality, coder competency, and institutional claim verification processes. These challenges result in delays, incorrect payments, and administrative inefficiencies, posing barriers to effective reimbursement. The findings underscore the importance of implementing Clinical Documentation Improvement (CDI) strategies, improving coder training, and transitioning to newer coding systems such as ICD-10 or ICD-11. Upgrading to these systems will support better coding accuracy, enhance claim processing efficiency, and ensure more appropriate reimbursement. Strengthening these components is essential to ensure the integrity of Indonesia’s health financing system, improve operational workflows, and ensure that healthcare providers receive timely and accurate reimbursement for services rendered. This study provides a comprehensive evaluation of the current state of coding practices in Indonesian healthcare institutions and offers actionable recommendations for improving coding accuracy and claims processing.

This study aims to analyze the accuracy of ICD-9-CM coding in Cathlab procedure claims submitted to BPJS Kesehatan under the INA-CBGs reimbursement system at RSI Aisyiyah Malang. Accurate coding is critical for determining appropriate claim grouping and tariff calculation within Indonesia’s national health insurance scheme. The research employed a mixed-methods approach, combining quantitative analysis of 244 Cathlab claims from 2024 with qualitative insights obtained through document review, interviews, and direct observation. The results showed that 182 claims (74.59%) were accepted as accurate and complete, while 62 claims (25.41%) were returned as pending. Common causes of claim inaccuracy included missing supporting documents (37.10%), incorrect ICD-9-CM codes (27.42%), and nonspecific diagnoses (19.35%). Procedural miscoding, such as omitting dual catheterization codes or stent-related procedure codes, was identified as a frequent issue, significantly impacting claim grouping and reimbursement. The study highlights systemic challenges related to documentation quality, coder competency, and institutional claim verification processes. These challenges result in delays, incorrect payments, and administrative inefficiencies, posing barriers to effective reimbursement. The findings underscore the importance of implementing Clinical Documentation Improvement (CDI) strategies, improving coder training, and transitioning to newer coding systems such as ICD-10 or ICD-11. Upgrading to these systems will support better coding accuracy, enhance claim processing efficiency, and ensure more appropriate reimbursement. Strengthening these components is essential to ensure the integrity of Indonesia’s health financing system, improve operational workflows, and ensure that healthcare providers receive timely and accurate reimbursement for services rendered. This study provides a comprehensive evaluation of the current state of coding practices in Indonesian healthcare institutions and offers actionable recommendations for improving coding accuracy and claims processing.

The inaccuracy of the disease diagnosis code is one of the problem affecting the quality of health services. Based on the preliminary result, 89 outpatient diagnosis codes in a medical record found 30 inaccuracies data from SIMPUS result of general poly at Purwoharjo Health Center. The impact of this inaccuracy has been influenced by the accuracy of disease data that resulted from making report data. The purpose of this study was to analyze the inaccuracy of disease diagnosis codes for outpatient medical records with SIMPUS at Purwoharjo Public Health Center. It was a descriptive study with observation, interviews, and documentation data collection. The object of this study was 95 outpatient medical records with simple random sampling. The result of this research was found 42% inaccuracy code of outpatient medical records with SIMPUS. The cause of these problems was the coder less careful in enforcing the disease diagnosis code because of the high workload of the coder and there’s no job description in SOP, so the advice that can be given to Purwoharo Health Center is to hold a division of tasks evenly and can be written in the SOP job description.

The inaccuracy of the disease diagnosis code is one of the problem affecting the quality of health services. Based on the preliminary result, 89 outpatient diagnosis codes in a medical record found 30 inaccuracies data from SIMPUS result of general poly at Purwoharjo Health Center. The impact of this inaccuracy has been influenced by the accuracy of disease data that resulted from making report data. The purpose of this study was to analyze the inaccuracy of disease diagnosis codes for outpatient medical records with SIMPUS at Purwoharjo Public Health Center. It was a descriptive study with observation, interviews, and documentation data collection. The object of this study was 95 outpatient medical records with simple random sampling. The result of this research was found 42% inaccuracy code of outpatient medical records with SIMPUS. The cause of these problems was the coder less careful in enforcing the disease diagnosis code because of the high workload of the coder and there’s no job description in SOP, so the advice that can be given to Purwoharo Health Center is to hold a division of tasks evenly and can be written in the SOP job description.

The competence of a medical recorder is to code diagnosis. But in the fact, there are still many medical officers who experience some difficulties in coding diagnoses quickly, precisely, and accurately. This study is here to find out the effect of the knowledge of medical personnel and medical record document facilities on the inaccuracy of the main diagnosis code according to ICD-10 in the medical record document at dr. Soepraoen Malang. This research uses a qualitative method with a case study approach design. The location of this research is DR. Soepraoen Hospital, Malang. Processing data in this study is use non statistic. The result of this study is there is a negative and significant effect of health workers knowledge partially on the inaccuracies of main diagnosis codes, there is a negative and significant effect of hospital facilities partially on the inaccuracies of main diagnosis codes, there is a simultaneous negative and significant effect of health workers knowledge and hospital facilities on the inaccuracies of main diagnosis codes.

The competence of a medical recorder is to code diagnosis. But in the fact, there are still many medical officers who experience some difficulties in coding diagnoses quickly, precisely, and accurately. This study is here to find out the effect of the knowledge of medical personnel and medical record document facilities on the inaccuracy of the main diagnosis code according to ICD-10 in the medical record document at dr. Soepraoen Malang. This research uses a qualitative method with a case study approach design. The location of this research is DR. Soepraoen Hospital, Malang. Processing data in this study is use non statistic. The result of this study is there is a negative and significant effect of health workers knowledge partially on the inaccuracies of main diagnosis codes, there is a negative and significant effect of hospital facilities partially on the inaccuracies of main diagnosis codes, there is a simultaneous negative and significant effect of health workers knowledge and hospital facilities on the inaccuracies of main diagnosis codes.

Malpractice cases are a crime that is very common in Indonesia. Malpractice is basically an act of a professional that is contrary to standard operating procedures (SOP), code of ethics, and applicable laws, whether intentional or as a result of negligence that results in loss or death to others. Aspects of legal protection for patients who are victims of malpractice by doctors based on Indonesian law, namely : preventively with the existence of regulations governing malpractice, namely in the Civil Code (KUH Perdata), the Health Law, the Consumer Protection Law, the Medical Practice Law, and the Legal Code, Penal (Penal Code) and repressively the lack of action resulted in a loss, the person who performed the action imposed sanctions in the form of civil sanctions, namely to compensate both the administrator sanctions and criminal sanctions.

Malpractice cases are a crime that is very common in Indonesia. Malpractice is basically an act of a professional that is contrary to standard operating procedures (SOP), code of ethics, and applicable laws, whether intentional or as a result of negligence that results in loss or death to others. Aspects of legal protection for patients who are victims of malpractice by doctors based on Indonesian law, namely : preventively with the existence of regulations governing malpractice, namely in the Civil Code (KUH Perdata), the Health Law, the Consumer Protection Law, the Medical Practice Law, and the Legal Code, Penal (Penal Code) and repressively the lack of action resulted in a loss, the person who performed the action imposed sanctions in the form of civil sanctions, namely to compensate both the administrator sanctions and criminal sanctions.

The problems that will be studied are: 1) How is the criminalization system in the law on the elimination of domestic violence, 2) What are the obstacles faced in punishing perpetrators of domestic violence. This research will be compiled using a normative legal research type, namely a process to find a legal rule, legal principles, and legal doctrines in order to answer the legal issues faced. The results of the study concluded that: (1). The regulation of the criminalization system in the Criminal Code with Law Number 23 of 2004 concerning the Elimination of Domestic Violence is the same, namely recognizing the imposition of imprisonment and fines, only the length of the prison sentence and the amount of the fine are not the same. Related to the legal subject and the regulatory system both in the Criminal Code and in Law Number 23 of 2004 concerning the Elimination of Domestic Violence are the same, namely using the legal subject of people and a single track system. (2). The obstacles faced in punishing perpetrators of domestic violence are: The legal factor itself, the factor of law enforcement officers, the factor of facilities and facilities.

The problems that will be studied are: 1) How is the criminalization system in the law on the elimination of domestic violence, 2) What are the obstacles faced in punishing perpetrators of domestic violence. This research will be compiled using a normative legal research type, namely a process to find a legal rule, legal principles, and legal doctrines in order to answer the legal issues faced. The results of the study concluded that: (1). The regulation of the criminalization system in the Criminal Code with Law Number 23 of 2004 concerning the Elimination of Domestic Violence is the same, namely recognizing the imposition of imprisonment and fines, only the length of the prison sentence and the amount of the fine are not the same. Related to the legal subject and the regulatory system both in the Criminal Code and in Law Number 23 of 2004 concerning the Elimination of Domestic Violence are the same, namely using the legal subject of people and a single track system. (2). The obstacles faced in punishing perpetrators of domestic violence are: The legal factor itself, the factor of law enforcement officers, the factor of facilities and facilities.

Patient satisfaction cannot be separated from the code of ethics and quality service carried out by medical personnel. This study aims to determine the effect of Ethics and Service Quality of Health Workers on Patients Satisfaction at dr. Soepraoen Hospitals Malang. The research method used is descriptive analytic research. With a cross sectional study design. The population in this study were 100 people. The result of this study is there is a positive and significant effect of ethics health workers partially on patient satisfaction, there is a positive and partially significant effect of partially Service Quality on patient satisfaction, there is a simultaneous positive and significant effect of ethics health workers and Service Quality on patient satisfaction.

Patient satisfaction cannot be separated from the code of ethics and quality service carried out by medical personnel. This study aims to determine the effect of Ethics and Service Quality of Health Workers on Patients Satisfaction at dr. Soepraoen Hospitals Malang. The research method used is descriptive analytic research. With a cross sectional study design. The population in this study were 100 people. The result of this study is there is a positive and significant effect of ethics health workers partially on patient satisfaction, there is a positive and partially significant effect of partially Service Quality on patient satisfaction, there is a simultaneous positive and significant effect of ethics health workers and Service Quality on patient satisfaction.