Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: EYE11
MultiStage: No
DXCat Label: Fracture: Orbit, Blow-Out Specificity: A
Etiology: Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Blow-out fracture of the orbit with normal Blow-out fracture of the orbit [skull x-ray report or CT scan of head report]
DX 8026-8027;
ocular alignment and normal motility and AND with normal ocular alignment
normal position
AND normal motility
AND normal position
2.01 with enophthalmos Blow-out fracture of the orbit [skull x-ray report or CT scan of head report]
AND ≥ 2 mm enophthalmos [exophthalmometer report]
2.02 with diplopia in primary gaze or down gaze Blow-out fracture of the orbit [skull x-ray report or CT scan of head]
or heterotropia or gaze restriction AND diplopia in primary gaze
OR down gaze
OR heterotropia
OR gaze restriction
2.03 with traumatic optic neuropathy Blow-out fracture [CT scan report]
AND decreased vision
AND afferent pupillary defect (APD)
2.04 with retrobulbar hemorrhage Blow-out fracture [CT scan report]
AND retrobulbar hemorrhage
STAGE 1.01 + (DX 37650, 37652);
STAGE 1.01-2.01 + (DX 36815,
3682, 37820, 37830, 37831);
STAGE 1.01-2.02 + (DX 33811,
33821, 37732, 37739 );
STAGE 1.01-2.03 + DXCAT EYE33;
References:
Dortzbach RK, Elner VM. Which orbital blowout fractures need surgery? Ophthalmology Plastic Reconstructive Surgery. 1987;(6)287.
Wilkins RB, Havins WE. Current treatment of blow-out fractures. Ophthalmology. 1982;(89)464-466.
Thursday, January 07, 2010 9:21:35 AM
©2010 Thomson Reuters. All rights reserved.