Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: HEM07
MultiStage: No
DXCat Label: Anemia: Thalassemia Specificity: A
Etiology: Genetic (or hereditary)
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Alpha thalassemia trait Microcytosis:
DX 2824, 28249;
AND anemia:
AND serum iron > 55 ug/dl in males or > 35 ug/dl in females [chemistry report]
AND total iron binding capacity < 513 ug/dl [chemistry report]
OR serum ferritin > 12 ng/ml [chemistry report]
OR normal iron stores [bone marrow biopsy report]
OR hemoglobin Barts 5-10% in newborn [hemoglobin electrophoresis report]
1.02 Beta thalassemia trait or thalassemia minor Microcytosis:
AND anemia:
AND hemoglobin A2 > 3% [hemoglobin electrophoresis report]
2.01 Hemoglobin H disease (alpha thalassemia
intermedia)
Microcytosis:
AND anemia:
AND hemoglobin H 4-20% in child or adult [hemoglobin electrophoresis report]
OR hemoglobin Barts 5-10% in newborn [hemoglobin electrophoresis report]
2.02 Beta thalassemia intermedia Microcytosis:
AND hemoglobin 6-8 g/dl [hematology report]
AND hemoglobin A 20-40% [hemoglobin electrophoresis report]
AND hemoglobin F 60-80% [hemoglobin electrophoresis report]
3.01 Beta thalassemia major or Cooley's anemia Hemoglobin F > 90% [hemoglobin electrophoresis report]
AND hemoglobin ≤ 6 gm/dl [complete blood count report]
AND erythroid hyperplasia of the bone marrow [bone marrow report]
AND microcytosis:
AND serum iron > 209 ug/dl [chemistry report]
OR serum ferritin ≥ 370 ng/ml[chemistry report]
OR normal iron stores [bone marrow biopsy report]
AND reticulocyte count ≥ 1.5% of total erythrocytes [complete blood count report]
AND total bilirubin ≥ 3.0 mg/dl [chemistry report]
3.02 with congestive heart failure Stage 2.01-3.01
AND congestive heart failure:
3.03 Homozygous alpha thalassemia with
hydrops fetalis
4.00 with death Stage 2.01-3.03
AND death
Hemoglobin Barts 80-90%; no Hemoglobin A or F in newborn [Hemoglobin electrophoresis report]
AND hydrops fetalis
NO;
NO;
NO;
NO;
STAGE 1.01 + GROUP
CHF__NON_HTN;
STAGE 1.01-3.02 + DX 7780;
NO;
Thursday, January 07, 2010 9:22:03 AM
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