Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: GYN13
MultiStage: No
DXCat Label: Endometriosis Specificity: A
Etiology: Idiopathic
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Endometriosis interna Endometriosis interna [laparoscopy or operative/pathology report]
DX 6170, 6178-6179;
OR adenomyosis [laparoscopy or operative/pathology report
1.02 Endometriosis externa, mild Endometriosis externa [operative/pathology report]
NO;
2.01 Endometriosis externa Stage 1.01
DX 6171-6176;
AND endometrial implants [laparoscopy or operative/pathology report]
OR endometrioma [operative/path report]
OR chocolate cysts [operative/pathology
OR endometriosis, distant site [operative/pathology report]
AND dense adhesions [laparoscopy or operative/pathology report]
OR ovarian enclosure [laparoscopy or operative/pathology report]
OR tubal enclosure [laparoscopy or operative/pathology report]
2.02 with ureteral obstruction or hydronephrosis Stage 1.01
AND endometrial implants [laparoscopy or operative/pathology report]
OR endometrioma [operative/path report]
OR chocolate cysts [operative/pathology
OR endometriosis, distant site [operative/pathology report]
AND dense adhesions [laparoscopy or operative/pathology report]
OR ovarian enclosure [laparoscopy or operative/pathology report]
OR tubal enclosure [laparoscopy or operative/pathology report]
2.03 with intestinal obstruction Stage 1.01-2.02
AND large bowel obstruction [KUB x-ray or operative/pathology report]
OR small bowel obstruction [KUB x-ray or operative/pathology report]
2.04 with peritonitis Stage 1.01-2.03
AND peritonitis [operative/pathology report]
3.01 with renal failure Stage 2.02-2.04
AND renal failure:
3.02 with sepsis Stage 1.01-3.01
AND sepsis:
3.03 with shock Stage 2.01-3.02
AND shock:
4.00 with death Stage 2.01-3.03
AND death
STAGE 1.01-2.01 + (DX 591, 5934,
5935);
STAGE 1.01-2.02 + (DX 56081,
56089, 5609);
STAGE 1.01-2.03 + (DX 5670-
5679, 6145, 6147-6149 );
STAGE 1.01-2.04 + GROUP
REN_FAIL_ACU;
STAGE 1.01-3.01 + GROUP SEPSIS;
STAGE 1.01-3.02 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
Thursday, January 07, 2010 9:21:56 AM
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