Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: GIS20
MultiStage: No
DXCat Label: Hernia, Hiatal or Reflux Esophagitis Specificity: A
Etiology: Congenital; Degenerative; Idiopathic
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Hiatal hernia Hiatal hernia [chest x-ray or barium swallow report]
DX 5533, 7506, 7566;
1.02 Reflux esophagitis Reflux esophagitis [Bernstein's acid perfusion test or biopsy or esophagoscopy report or
esophageal pH monitoring]
DX 53011, 53081;
1.03 Reflux esophagitis with chronic hoarseness Stage 1.03
STAGE 1.02 + (DX 5191-51919,
or asthma or bronchospasm or chronic AND chronic hoarseness
78449, 7862 OR DXCAT RES02);
cough
OR asthma:
OR bronchospasm
OR chronic cough
2.01 wtih iron deficency anemia Stage 1.02
AND iron deficiency anemia:
2.02 with Barrett's metaplasia Stage 1.02-2.01
AND Barrett's metaplasia [biopsy report]
2.03 with stricture Stage 1.02-2.02
AND esophageal stricture [esophagoscopy report]
2.04 Hiatal hernia with incarceration Incarcerated hiatal hernia [operative/pathology report]
2.05 with acute hemorrhage Stage 1.02-2.04
AND bleeding:
2.06 with aspiration pneumonia Stage 1.02-2.05
AND aspiration pneumonia
2.07 with perforation Stage 1.2-2.6
AND perforation of the esophagus [chest-x-ray reports free air in the mediastium or abdominal
x-ray reports free air in the diaphragm]
3.01 with sepsis Stage 2.06-2.08
AND sepsis:
3.02 with respiratory failure Stage 2.06-3.01
AND respiratory failure:
3.03 with shock Stage 2.03-3.02
AND shock:
4.00 with death Stage 2.04-3.03
AND death
STAGE 1.01-1.03 + GROUP
ANEM_DEF_FE;
DX 5302-53020, 53085;
DX 5303;
DX 5523;
DX 53021, 53082;
STAGE 1.01-2.04 + (DX 5780,
5790);
STAGE 1.01-2.05 + DX 5070;
DX 5513;
STAGE 1.01-2.06 + DX 5304;
STAGE 1.01-2.07 + GROUP SEPSIS;
STAGE 1.01-3.01 + GROUP
RESP_FAIL;
STAGE 1.01-3.02 + GROUP
SHOCKA;
NO;
Thursday, January 07, 2010 9:21:44 AM
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