Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: GIS19
MultiStage: No
DXCat Label: Hernia, External Specificity: A
Etiology: Congenital; Degenerative
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Spontaneously reducible external hernia Spontaneously reducible external hernia
DX 55090-55093, 55300-55303,
AND inguinal hernia
5531-55329, 5538-5539;
OR femoral hernia
OR epigastric hernia
OR umbilical hernia
OR spigelian hernia
OR lumbar hernia
OR pelvic hernia
1.02 External hernia reducible only by pressure Spontaneously reducible external hernia
AND inguinal hernia
OR femoral hernia
OR epigastric hernia
OR umbilical hernia
OR spigelian hernia
OR lumbar hernia
OR pelvic hernia
1.03 Irreducible external hernia External hernia not reducible by pressure
AND inguinal hernia
OR femoral hernia
OR epigastric hernia
OR umbilical hernia
OR spigelian hernia
OR lumbar hernia
OR pelvic hernia
2.01 Irreducible external hernia with intestinal Stage 1.03
obstruction
AND small bowel obstruction or large bowel obstruction [operative/pathology report or KUB
x-ray report]
2.02 Strangulated external hernia Stage 1.03-2.01
AND strangulated herniated segment [operative/pathology report]
2.03 Strangulated hernia with gangrene Stage 1.03-2.02
AND gangrene of herniated segment [operative/pathology report]
2.04 Strangulated hernia with perforation Stage 1.03-2.03
AND strangulated hernia with perforation [operative/pathology report]
2.05 Strangulated hernia with peritonitis Stage 1.03-2.04
AND strangulated hernia with peritonitis [operative/pathology report or peritoneal effusion culture
reports growth of pathologic organisms]
NO;
DX 55010-55013, 55200-55203,
5521-55229, 5528-5529;
NO;
NO;
DX 55000-55003, 55100-55103,
5511-55129, 5518-5519;
STAGE 1.01-2.03 + DX 56983;
STAGE 1.01-2.04 + DX 5672-5679;
Thursday, January 07, 2010 9:21:44 AM
©2010 Thomson Reuters. All rights reserved.