Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: EYE31
MultiStage: No
DXCat Label: Prematurity: Retinopathy Specificity: A
Etiology: Congenital
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Demarcation line separating vascular from Demarcation line separating vascular from avascular retina [indirect ophthalmoscopy report]
DX 36220-36223, 36274;
avascular retina
OR Stage 0 or I retinopathy of prematurity
1.02 Elevated retinal ridge Elevated retinal ridge [indirect ophthalmoscopy report]
DX 36224;
OR Stage II retinopathy of prematurity
2.01 Retinal ridge with extraretinal fibrovascular
proliferation
2.02 Subtotal traction detachment of
retinopathy of prematurity
2.03 Total traction detachment of retinopathy of
prematurity
2.04 Retinopathy of prematurity with total
blindness or cataract or glaucoma
References:
Stage 1.02
AND retinal ridge with extraretinal fibrovascular proliferation [indirect ophthalmoscopy report]
OR Stage III retinopathy of prematurity
Stage 1.01-2.01
AND subtotal traction retinal detachment [indirect ophthalmoscopy report]
OR Stage IV retinopathy of prematurity
Stage 1.01-2.01
AND total traction retinal detachment [indirect ophthalmoscopy report]
OR Stage V retinopathy of prematurity
Stage 1.01-2.02
AND vision limited to light perception
OR cataract [slit lamp report or operative/pathology report]
OR intraocular pressure > 21 mmHg tonometer report]
DX 36225;
DX 36181, 36226;
DX 36227;
STAGE 1.01-2.02 + (DXCAT EYE01
OR DXCAT EYE13);
Committee for the Classification of Retinopathy of Prematurity. An international classification of retinopathy of prematurity, Arch Ophthalmology. 1984; 102:1130-1134.
International Committee for the Classification of the Late Stages of Retinopathy of Prematurity, II. The classification of retinal detachment. Arch Ophthalmology. 1987;105:906-
912.
Thursday, January 07, 2010 9:21:38 AM
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