Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: GYN09
MultiStage: No
DXCat Label: Delivery, Cesarean Section Specificity: A
Etiology:
Pregnancy
Stage Description Diagnostic findings ICD-9-CM Codes
1.03 with superficial abscess of incision area or Stage 1.02
cellulitis
AND superficial abscess formation of incision area
OR cellulitis of incision area[s]
1.04 with endometritis Stage 1.01
AND fever:
AND uterine tenderness
2.01 with incision area dehiscence Stage 1.02-1.03
AND dehiscence of incision area
AND serous drainage
OR sanguinous drainage
2.02 with deep abscess or necrotizing fascitis Stage 1.02-2.01
AND infection of incision area fat, muscle and fascia [operative/pathology report]
OR necrotizing fasciitis [operative/pathology report]
STAGE 1.01-1.02 + (DX 68100-
6829, 99859);
(GROUP FEVER OR DX 64661-
64662, 67012) + (GROUP C_SECT
OR DX 66971);
(DX 67410-67414) + (GROUP
C_SECT OR DX 66971);
DX 67412;
STAGE 1.01-2.01 + DX 72886;
DX 66431 + (GROUP C_SECT OR
DX 66971, 67412);
2.03 with peritonitis Stage 1.02-2.02
AND peritonitis [operative/pathology report]
OR purulent abdominal drainage [(effusion culture reports growth of pathologic
organism(s)]
2.04 with rupture of the uterus Stage 1.01-2.03
AND rupture of the uterus [operative/pathology report]
STAGE 1.01-2.02 + (DX 67000,
67004);
(DX 67002, 67082) + (GROUP
C_SECT OR DX 66971, 67412);
(DX 66501, 66511, 66522, 66531,
66541, 66551, 66561, 66571-
66572, 66581-66582, 66591-
66592, 66602, 66612, 66622,
67131, 67142) + (GROUP C_SECT
OR DX 66971, 67412) ;
Thursday, January 07, 2010 9:21:55 AM
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