Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: GYN30
MultiStage: No
DXCat Label: Pregnancy-Induced Hypertension Specificity: A
Etiology: Pregnancy
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Pre-eclampsia Pregnancy
DX 64230-64244, 64270-64274;
AND blood pressure ≥ 140/90 mmHg on ≥ 2 occasions ≥ 6 hrs. apart
AND urinary protein ≥ 300 mg/24 hrs. or > 1 plus on dip stick [urinalysis report]
2.01 Severe pre-eclampsia Stage 1.01
AND blood pressure ≥ 160/110 mmHg ≥ 2 occasions ≥ 6 hrs. apart
OR urinary protein ≥ 5 gms/24 hrs [urinalysis report]
OR urine output ≤ 500 cc/24 hrs.
OR CNS symptoms (headache, visual changes)
OR epigastric pain
OR HELLP syndrome (hemolysis, AST > 70 iu/L, platelets < 100,000/mm 3 )
OR eclampsia
2.02 with abruptio placentae Stage 1.02-2.01
AND infection of incision area fat, muscle and fascia [operative/pathology report]
OR necrotizing fasciitis [operative/pathology report]
2.03 with disseminated intravascular coagulation Stage 1.01-2.02
AND DIC:
3.01 with renal failure Stage 1.01-2.03
AND renal failure:
DX 64250-64264;
STAGE 1.01-2.01 + DXCAT GYN03;
STAGE 1.01-2.02 + (DX 64130-
64133, 66630-66634, 2866);
STAGE 1.01-2.03 + (DX 66930-
66934 OR GROUP REN_FAIL_ACU);
3.02 with congestive heart failure Stage 1.01-3.01
AND congestive heart failure:
3.03 with intracerebral hemorrhage Stage 1.01-3.02
AND intracerebral hemorrhage [CT scan or MRI report]
3.04 with shock Stage 1.01-3.03
AND shock:
4.00 with death Stage 1.01-3.04
AND death
STAGE 1.01-3.01 + (DX 66811-
66812 OR GROUP
CHF__NON_HTN);
STAGE 1.01-3.02 + (DX 67400-
67404);
STAGE 1.01-3.03 + (DX 66910-
66914 OR GROUP SHOCKC OR
GROUP SHOCKN);
NO;
References:
Creasy R, Resnik R. Maternal Fetal Medicine. 4th ed. Saunders. 1999.
Cunningham FG, MacDonald PC, Gant NF, Lareno K, Gilstrap LC, eds. Williams Obstetrics. 19th ed. Norwalk, CT: Appleton & Lange; 1994.
Thursday, January 07, 2010 9:22:00 AM
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