Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: ENT21
MultiStage: No
DXCat Label: Sinusitis Specificity: A
Etiology: Immune; Infection
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Acute sinusitis with one sinus involved Tenderness over sinus area
DX 4610-4613, 4619;
OR swelling over sinus area
OR pain over sinus area
AND rhinorrhea
OR air/fluid levels or radiopaque densities or sclerotic bone in sinus
[sinus x-ray report or CT scan or MRI report]
1.02 Multiple sinus involvement Stage 1.01
AND involvement of > 1 sinus
1.03 Chronic sinusitis Chronic sinusitis
OR history of recurrent episodes of acute sinusitis
AND nasal congestion
AND chronic discharge
AND nasal injection
AND facial pressure
2.01 with preseptal cellulitis or osteitis Stage 1.01-1.03
AND preseptal cellulitis
OR osteitis [operative/pathology report]
2.02 with osteomyelitis of surrounding bone Stage 1.01-2.01
AND fever:
AND edema of surrounding tissue
OR osteomyelitis:
2.03 with extension into the orbit Stage 1.01-2.02
AND orbital abscess [operative/pathology report or MRI or CT scan report]
OR orbital cellulitis
OR subperiosteal abscess [operative/pathology report or MRI or CT scan report]
OR optic neuritis [ophthalmology report]
OR superior orbital fissure [MRI or CT scan report]
OR cavernous sinus trombosis [operative/pathology report or MRI or CT scan report]
2.04 with mucocele or pyocele Stage 1.01-2.03
AND mucocele or pyocele
3.01 with meningitis Stage 1.01-2.04
AND meningitis:
3.02 with intracranial abscess Stage 1.01-3.01
AND brain abscess [CT scan report or MRI report]
OR epidemal abscess [CT scan report or MRI report]
OR subdural abscess [CT scan report or MRI report]
DX 4618;
DX 4730-4739;
STAGE 1.01-1.02 + DX 78491;
DX 4730-4739 + DX 78491;
STAGE 1.01-1.03 + (DX 4781,
6820);
STAGE 1.01-2.01 + (DX 73300,
73302, 73309 OR GROUP FEVER);
STAGE 1.01-2.02 + (DX 37601,
37603, 37610, 37630 );
STAGE 1.01-2.03 + DX 37681;
STAGE 1.01-2.04 + (GROUP
MENGIT__BACT OR GROUP
MENING__VIR);
STAGE 1.01-3.01 + (DX 3240,
3249);
Thursday, January 07, 2010 9:21:33 AM
©2010 Thomson Reuters. All rights reserved.