Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: HEM12
MultiStage: No
DXCat Label: Hemophilia A or B Specificity: A
Etiology: Genetic (or hereditary)
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Mild asymptomatic, hemophilia A or B Factor VIII:C 6-30% [hematology report]
DX 2860, 2861, V8301;
OR Factor IX 6-30% [hematology report]
1.02 Moderate hemophilia A or B Factor VIII:C ≤ 5 % and ≥ 1% [hematology report]
DX V8302;
OR Factor IX ≤ 5 % and ≥ 1%[hematology report]
2.01 Severe hemophilia A or B Factor VIII:C < 1% [hematology report]
OR Factor IX < 1% [hematology report]
2.02 with intramuscular hematoma Stage 1.01-2.01
AND intramuscular hematoma
NO;
STAGE 1.01 + (DX 920, 9210-9213,
9220-9224, 9228-9229, 92300-
92303, 92309, 92310-92311 ,
92320-92321, 9233, 9238-9239,
92400-92401, 92410-92411, 92420-
92421, 9243-9245, 9248-9249);
2.03 with hemarthrosis Stage 1.01-2.02
AND hemarthrosis
2.04 with ankylosis of the elbow or knee joints Stage 1.01-2.03
AND ankylosis of the elbow [elbow x-ray report]
OR ankylosis of the knee [knee x-ray report]
2.05 with upper airway obstruction Stage 1.01-2.04
AND sublingual hematoma
OR laryngeal hematoma
OR retropharyngeal hematoma
3.01 with hemorrhage into the central nervous
system or the heart of pericardium or
thorax
3.02 with respiratory failure Stage 101-3.01
AND respiratory failure:
3.03 with shock Stage 101-3.02
AND shock:
4.00 with death Stage 101-3.03
AND death
Stage 1.01-2.05
AND intracranial hemorrhage [CT scan or MRI report]
OR hemopericardium [echocardiogram report]
OR hemothorax [chest x-ray report]
DX 2864;
STAGE 1.01-2.02 + DX 71910-
71919;
STAGE 1.01-2.03 + (DX 71852,
71856);
STAGE 1.01-2.04 + DX 5198;
STAGE 1.01-2.04 + (DX 4230,
42989, 430, 431, 4320-4321, 4329,
5118, 7863);
STAGE 1.01-3.01 + GROUP
RESP_FAIL;
STAGE 1.01-3.02 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
Thursday, January 07, 2010 9:22:04 AM
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