Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: ENT20
MultiStage: No
DXCat Label: Pharyngitis: Streptococcal Specificity: A
Etiology: Infection, Bacterial
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Streptococcal pharyngitis or tonsillitis Streptococcal infection of the pharynx [culture reports growth of pathologic organism(s)]
DX 0340;
2.01 with cervical suppurative adenitis Stage 1.01
AND cervical suppurative adenitis
2.02 with peritonsillar or retropharyngeal
abscess
Stage 1.01-2.01
AND peritonsillar or retropharyngeal abscess
STAGE 1.01 + (DX 2891, 2893,
683);
STAGE 1.01-2.01 + (DX 475,
47821-47824, 47829);
2.03 with bronchopneumonia Stage 1.01-2.02
AND bronchopneumonia [chest x-ray report]
2.04 with pharyngeal edema Stage 1.01-2.03
AND pharyngeal edema
2.05 Streptococcal pharyngitis and scarlet fever Stage 1.01-2.04
AND pink-red cutaneous flush that blanches on pressure; distributed on body, particularly
abdomen, lateral chest, and skin folds
STAGE 1.01-2.02 + GROUP
PNEUMONIA;
STAGE 1.01-2.03 + DX 47825;
DX 0341;
3.01 Acute post-streptococcal glomerulonephritis Stage 1.01-2.04
AND Acute poststreptococceal glomerulonephritis [operative/pathology report]
3.02 with acute renal failure Stage 3.01
AND renal failure:
3.03 with meningitis Stage 1.01-3.02
AND meningitis:
3.04 with acute rheumatic fever Stage 1.01-3.03
AND rheumatic fever [Aschoff lesions in myocardium or subcutaneous nodules in
operative/pathology report] (any one of the following:)
OR carditis
OR Sydenham's chorea
OR subcutaneous nodules
OR erythema marginatum
OR polyarthritis
OR (any one above and two of the following:)
fever:
OR polyarthralgia
OR EKG PR segment ≥ .21 seconds [EKG report]
OR antistreptolysin O titer ≥ 250 units [chemistry report]
AND antihyaluronidase titer ≥ 1000 units [chemistry report]
OR positive anti-DNAse B titer [chemistry report]
STAGE 1.01-2.04 + DX 5800;
STAGE 1.01-3.01 + GROUP
REN_FAIL_ACU;
STAGE 1.01-3.02 + DX 3200;
STAGE 1.01-3.03 + DX 390-3929;
Thursday, January 07, 2010 9:21:33 AM
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