Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: EYE36
MultiStage: No
DXCat Label: Glaucoma, Congenital Specificity: A
Etiology:
Congenital; Genetic (or hereditary)
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Congenital glaucoma Stage 1.01
DX 36541-36544, 74320-74322;
AND cup/disk ratio ≥ 0.3
OR asymmetric cupping
AND arcuate or paracentral scotoma
AND visual acuity ≤ 20/40
2.01 Moderate congenital glaucoma Stage 1.01
AND cup/disk ratio ≥ 0.5
AND visual field shows nasal step
AND visual acuity ≤ 20/40
2.02 Severe congenital glaucoma Stage 1.01
AND cup/disk ratio ≥ 0.8
AND visual field limited to central vision
AND pale optic nerve head
2.03 Advanced congenital glaucoma Stage 1.01
AND cup/disk ratio ≥ 0.8 [ophthalmoscopy report]
OR central field ≤ 20 degrees
AND pale optic nerve head [ophthalmoscopy report]
AND visual acuity ≤ 20/200 in either one or both eyes
STAGE 1.01 + (DX 36920-36925,
3693, 36960-3699);
NO;
STAGE 1.01-2.01 + (DX 36900-
36908, 36910-36918, 3694);
References:
Hoskins HD, Hetherington J. Developmental glaucomas. In: Duane TD, Jaeger EA, eds. Clinical Ophthalmology. Philadelphia, PA: Harper & Row; 1979, Vol. 3.
Thursday, January 07, 2010 9:21:39 AM
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