Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: EYE07
MultiStage: No
DXCat Label: Detachment of the Retina Specificity: A
Etiology:
Degenerative; Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Posterior vitreous detachment (PVD) Posterior vitreous detachment [indirect ophthalmoscopy report]
DX 36106, 36189-3619, 37921;
1.02 Posterior vitreous detachment and breaks Stage 1.01
AND retinal breaks [indirect ophthalmoscopy report]
OR retinal tears [indirect ophthalmoscopy report]
OR round holes [indirect ophthalmoscopy report]
OR senile retinoschisis [indirect ophthalmoscopy report]
OR dialysis [indirect ophthalmoscopy report]
OR vitreous hemorrhage [indirect ophthalmoscopy report]
AND pigmentation cells in vitreous [indirect ophthalmoscopy report]
1.03 Retinal detachment with subretinal fluid Stage 1.01-1.02
AND subretinal fluid [ophthalmoscopy report]
2.01 Retinal detachment with proliferative Stage 1.01-1.03
retinopathy
AND preretinal fibrous scar tissue [indirect ophthalmoscopy report]
OR subretinal fibrous scar tissue [indirect ophthalmoscopy report]report]
2.02 Retinal detachment with phthisis bulbi Stage 1.01-2.01
AND no light perception
AND globe shrunken
DX 36100-36105, 36107, 36110-
36112, 3612, 36130-36133;
NO;
STAGE 1.01-1.02 + DX 36229;
STAGE 1.01-2.01 + (DX 33811,
33821, 36040, 36041 , 36901,
36903, 36906, 36907, 36912,
36916 , 3694, 36962, 36963);
2.03 PVD and macular hole Stage 1.01
AND macular hole [ophthalmoscopy report]report]
STAGE 1.01-2.02 + DX 36254;
References:
Benson, W. Retinal detachment: diagnosis and management. Hagerstown, MD: Harper and Row; 1988.
The Retina Society Terminology Committee. The classification of retinal detachment with proliferative vitreoretinopathy. Ophthalmology. 1983;(90)121-125.
Vander, JF. In: Clinical Decisions in Medical Retinal Disease. Tasman, W, ed. St. Louis: Mosby, 1994.
Thursday, January 07, 2010 9:21:35 AM
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