Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: EYE01
MultiStage: No
DXCat Label: Cataract Specificity: A
Etiology: Degenerative; Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Lens opacities, nonsenile or traumatic Cortical spokes [slit lamp ophthalmoscopy report]
DX 36600-36611, 36613-36616,
cataract or congenital lens anomalies or OR nuclear sclerosis [slit lamp ophthalmoscopy report]
36619-36634, 36642-36645, 36650-
after-cataract
OR posterior or anterior subscapular opacities [slit lamp ophthalmoscopy report]
3669, 74330-74339;
1.02 Senile immature cataract Stage 1.01
AND fundus poorly visualized [indirect ophthalmoscopy report]
AND visual acuity ≤ 20/50
1.03 Senile mature cataract Stage 1.01-1.02
AND visual acuity ≤ 20/400, Snellen notation, in either one or both eyes with cataract
AND fundus not visualized
2.01 Cataract with intumescent lens and
secondary glaucoma
Stage 1.01-1.03
AND swollen opaque lens [slit lamp ophthalmoscopy]
AND chamber angle closed [slit lamp ophthalmoscopy]
AND intraocular pressure ≥ 21 mmHg [tonometer report]
DX 36612;
DX 36617-36618;
STAGE 1.01-1.03 + DXCAT EYE13;
STAGE 1.01-1.03 + (DX 36520-
36524, 36551, 36560, 36589,
3659);
2.02 Hypermature lens with phacolytic uveitis Stage 1.01-2.01
AND nucleus floats within lens [ophthalmoscopy report]
AND lens capsule is wrinkled [ophthalmoscopy report]
AND flare in anterior chamber [ophthalmoscopy report]
STAGE 1.01-2.01 + (DX 36404,
36423, 3643);
References:
Datiles III MB, Magno BV. Cataract: clinical types. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. Philadelphia, PA: Lippincott-Raven; 1998.
Datiles III MB. Clinical evaluation of cataracts. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. Philadelphia, PA: Lippincott-Raven; 1998.
Duke-Elder S. Diseases of the lens. System of Ophthalmology. Vol IX. Henry Klimpton. 1969.
Thursday, January 07, 2010 9:21:34 AM
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