Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: EYE05
MultiStage: No
DXCat Label: Contusion or Ruptured Globe Specificity: A
Etiology:
Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Contusion of the globe Ocular contusion
DX 9213;
OR subconjunctival hemorrhage
AND history of trauma to the eye
AND vision unchanged from baseline
AND pupillary reactions unchanged from baseline
2.01 with hyphema Stage 1.01
AND vision changed from baseline
OR pupillary reactions changed from baseline
AND blood in anterior chamber [slit lamp examination]
AND ocular pressure ≥ 21 mmHg [tonometer report]
AND corneal staining
2.02 with subluxation of the crystalline lens or
retinal detachment or choroidal rupture or
iridodialysis or angle recession
Stage 1.01-Stage 2.01
AND subluxation of the crystalline lens [ophthalmoscopy report]
OR retinal detachment [ophthalmoscopy report]
OR choroidal rupture [ophthalmoscopy report]
OR iridodialysis [ophthalmoscopy report]
OR angle recession [ophthalmoscopy report]
2.03 Ruptured globe or injury to optic nerve Stage 1.01-2.02
AND ruptured globe [operative/pathology report]
OR loss of lens [operative/pathology report]
OR loss of uvea [operative/pathology report]
OR loss of vitreous [operative/pathology report]
OR loss of retina [operative/pathology report]
OR optic nerve injury [operative/pathology report]
2.04 with degenerated globe No light perception
AND shrunken globe
OR opacified cornea
OR opacified lens [ophthalmoscopy report]
OR retinal detachment [ophthalmoscopy report]
NO;
STAGE 1.01 + DXCAT EYE07;
STAGE 1.01 + (DX 33811, 33821,
36363, 36476, 36477, 37932-
37934);
DX 8711-8713, 9405, 9500;
STAGE 1.01-2.03 + DXCAT EYE01;
STAGE 1.01-2.03 + (DX 36902-
36904, 36906-36907, 36912-
36913, 36916-36917, 3694, 36961-
36966, 37100-37103);
References:
Berman W, Jefffers J. Blunt trauma. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. Philadelphia, PA: Lippincott-Raven; 1998, Vol 3.
Deutsch TA, Feller DB. Paton and Goldberg’s Management of Ocular Injuries. 2nd ed. Philadelphia, PA: WB Saunders; 1985.
Thursday, January 07, 2010 9:21:34 AM
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