Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: HEM06
MultiStage: No
DXCat Label: Anemia: Sickle Cell Specificity: A
Etiology: Genetic (or hereditary)
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Sickle cell trait Hemoglobin S 32-45% [hemoglobin electrophoresis report]
DX 2825;
AND hemoglobin A 52-65% [hemoglobin electrophoresis report]
1.02 Sickle cell trait with hematuria or Stage 1.01
STAGE 1.01 + (DX 59389, 5997-
hyposthenuria
AND urine red blood cells > 2/hpf [urinalysis report]
59972);
OR specific gravity < 1.0005 [urinalysis report]
2.01 Sickle beta+ thalassemia Anemia:
AND Hemoglobin S 5-85%, hemoglobin A 10-30% [hemoglobin electrophoresis report]
AND Hemoglobin F 5-10% [hemoglobin electrophoresis report]
2.02 Hemoglobin SC disease Anemia:
AND Hemoglobin S 45-50%, Hemoglobin C 45-50% [hemoglobin electrophoresis report]
2.03 Sickle cell anemia or sickle beta0 Anemia:
thalassemia
AND Hemoglobin S 80-95% [ hemoglobin electrophoresis report]
AND Hemoglobin F 2-20% [hemoglobin electrophoresis report]
OR Hemoglobin S 75-90% [hemoglobin electrophoresis report]
AND Hemoglobin F 5-25% [hemoglobin electrophoresis report]
2.04 with skin ulcers or vitreous hemorrhage Stage 2.01-2.03
AND skin ulcerations
OR vitreous hemorrhage [fundoscopy report]
2.05 with priapism Stage 2.01-2.04
AND priapism
2.06 with retinal detachment Stage 2.01-2.05
AND retinal detachment [ophthalmologist report]
2.07 with hepatitis or choledocholithiasis or
cholelithiasis
Stage 2.01-2.06
AND hepatitis:
OR hepatomegaly
OR choledocholithiasis [sonogram or endoscopic retrograde cholangiopancreatography report]
OR cholelithiasis [sonogram or KUB x-ray report]
DX 28241, 28268;
STAGE 1.01-1.02 + DX 2824;
DX 28263;
DX 28260, 28261, 28269;
STAGE 1.01-2.03 + (DX 37923,
70710-70715, 70719, 7078, 7079);
STAGE 1.01-2.04 + DX 6073;
STAGE 1.01-2.05 + DXCAT EYE07;
STAGE 1.01-2.06 + DXCAT HEP01;
2.08 with painful crisis Stage 2.01-2.07
AND diffuse abdominal pain
AND generalized bone pain
2.09 with papillary necrosis Stage 2.01-2.08
AND papillary necrosis of the kidney [operative/pathology report]
2.10 with bacteremia Stage 2.01-2.09
AND bacteremia:
DX 28242, 28262, 28264;
STAGE 2.01-2.07 + DX 28952;
STAGE 1.01-2.08 + (DX 59000,
59001, 59010, 59011 , 59080,
59081);
STAGE 1.01-2.09 + GROUP
BACTEREMIA;
Thursday, January 07, 2010 9:22:02 AM
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