Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: ENT10
MultiStage: No
DXCat Label: Neoplasm, Benign: Acoustic Neuroma Specificity: A
Etiology: Neoplasm
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Acoustic neuroma with hearing loss Acoustic neuroma [operative/pathology report or CT scan report or MRI scan report]
DX 2251;
DX 2251 + DX 38900-38922;
Presumptive Diagnostic Findings:
Hearing threshold ≥ 30 dB [audiometry report]
AND impairment of speech discrimination
AND marked tone decay [audiometry report]
AND acoustic reflex decay [brainstem response audiometry report]
AND absence of wave forms [brainstem response audiometry report]
AND increased latency of 5th wave [brainstem response audiometry report]
AND absence of caloric response testing or canal paresis
1.02 with vertigo Stage 1.01
AND vertigo:
1.03 with ataxia Stage 1.01-1.02
AND ataxia:
2.01 with facial nerve involvement Stage 1.01-1.03
AND paralysis of one side of the face:
2.02 with involvement of other cranial nerves Stage 1.01-2.01
AND cranial nerve palsy:
STAGE 1.01 + (DX 38610-38619,
3869, 7804);
STAGE 1.01-1.02 + DX 7812-7813;
STAGE 1.01-1.03 + DX 3510;
STAGE 1.01-2.01 + (DX 3509,
3519-3520, 3520-3526 , 36751,
37749, 37851-37855, 3885, 7675,
7811, 7820, 7872-78729, 9982);
STAGE 1.01-2.01 + GROUP
BLINDNESS;
3.01 with mental status changes Stage 1.01-2.02
AND papilledema
OR encephalopathy:
OR persistent headache with nausea and vomiting
3.02 with respiratory failure Stage 3.01
AND respiratory failure:
3.03 with coma Stage 3.01-3.02
AND coma:
3.04 with shock Stage 3.01-3.03
AND shock:
4.00 with death Stage 2.01-3.04
AND death
STAGE 1.01-2.02 + (DX 3383,
37700 OR GROUP ENCEPHALO OR
(DX 7840 + DX 78701));
STAGE 1.01-3.01 + GROUP
RESP_FAIL;
STAGE 1.01-3.02 + GROUP COMA;
STAGE 1.01-3.03 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
Thursday, January 07, 2010 9:21:30 AM
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