Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: GIS35
MultiStage: No
DXCat Label: Tropical Sprue Specificity: A
Etiology:
Idiopathic
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Tropical sprue History of residence in tropics
DX 5791;
AND tropical sprue [jejunal biopsy reports absence of villi and lymphocytic infiltrate in lamina
propria]
AND pancreatic insufficiency:
Presumptive Diagnostic Findings:
History of residence in tropics
AND sore tongue
AND history of ≥ 5 bowel movements a day
AND ≥ 5 lbs. weight loss per week for > 4 weeks
1.02 with macrocytic anemia Stage 1.01
AND macrocytosis:
AND anemia:
AND serum folate ≤ 2 ng/ml [chemistry report]
OR serum B12 ≤ 200 pg/ml [chemistry report]
2.01 with moderate malnutrition Stage 1.01-1.02
AND body weight < 85% of ideal weight
2.02 with severe malnutrition Stage 1.01-2.01
AND body weight ≥ 75% of ideal weight
OR anasarca
3.01 with congestive heart failure Stage 1.01-2.02
AND congestive heart failure:
3.02 with shock Stage 1.01-3.01
AND shock:
4.00 with death Stage 1.01-3.02
AND death
STAGE 1.01 + (GROUP
ANEM_DEF_B12 OR GROUP
ANEM_DEF_FOL OR GROUP
ANEM_OTH_UN OR GROUP
ANEM_OTH_CHR OR GROUP
MACROCYT__EY);
STAGE 1.01-1.02 + (DX 260, 2630-
2631, 2638-2639) ;
STAGE 1.01-2.01 + DX 261-262;
STAGE 1.01-2.02 + GROUP
CHF__NON_HTN;
STAGE 1.01-3.01 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
Thursday, January 07, 2010 9:21:48 AM
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