Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: EYE32
MultiStage: No
DXCat Label: Ptosis of Upper Lid Specificity: A
Etiology: Congenital; Degenerative; Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Ptosis of upper lid, acquired Unilateral or bilateral drooping of upper lid
DX 37430-37433;
1.02 Ptosis of upper lid, congenital Stage 1.01
DX 74361;
AND decreased function of levator palpebrae muscle
AND congenital
1.03 Ptosis of upper lid, acquired with systemic Stage 1.01
disease
AND history of Myastenia gravis
OR muscular dystrophy
2.01 Ptosis of upper lid with visual field defect Stages 1.01-1.03
AND decreased superior visual field to less than 30 degrees vertically
[automated visual field testing]
2.02 Ptosis of upper lid, congenital with
amblyopia or abnormal head position
References:
Stage 1.02
AND decreased visual function due to occlusion
OR elevated chin position
Cliff WJ, Pacheco EM. Ptosis sSurgery. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. Philadelphia, PA: Lippencott-Raven; 1998.
McCulloch DL, Wright KW. Unilateral congenital ptosis: compensatory head posturing and amblyopia. Ophthalm Plast and Reconstr Surg. 1996;9:196.
STAGE 1.01 + (DXCAT MUS32 OR
DXCAT NEU17);
STAGE 1.01-1.03 + (DX 36840,
36843, 36844, 36846 , 36847);
STAGE 1.02 + DX 36800;
Thursday, January 07, 2010 9:21:38 AM
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