Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: HEM36
MultiStage: No
DXCat Label: Polycythemia Vera Specificity: A
Etiology: Idiopathic
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Polycythemia vera Red blood cell mass ≥ 26 ml/kg in males or ≥ 21 ml/kg in females [hematology report]
DX 2384;
AND arterial oxygen saturation ≥ 92% [arterial blood gas report]
AND splenomegaly [physical examination or liver-spleen scan or CT scan]
OR thrombocytosis:
OR leukocytosis:
OR plasma erythropoetin level = 4mU/ml [chemistry report]
2.01 with peptic ulcer disease Stage 1.01
AND peptic ulcer(s) [gastroscopy or UGI series report]
2.02 with hyperuricemia Stage 1.01-2.01
AND hyperuricemia:
2.03 with gouty arthritis Stage 1.01-2.02
AND gouty arthritis [Needle shaped negatively birefringent crystals in fluid or in phagocytes per
synovial fluid report]
2.04 with renal calculi Stage 1.01-2.03
AND renal calculi [KUB x-ray or sonogram or CT scan report
2.05 with myelofibrosis Stage 1.01-2.04
AND myelofibrosis [operative/pathology report]
2.06 with gastrointestinal bleeding Stage 1.01-2.05
AND gastrointestinal bleeding [endoscopy or bleeding scan or angiogram report]
OR bleeding:
2.07 with deep vein thrombosis Stage 1.01-.2.06
AND DVT:
2.08 with Budd-Chiari syndrome Stage 1.01-2.07
AND thrombosis of the hepatic veins [hepatic venography or liver/spleen scan report]
3.01 with pulmonary embolism Stage 1.01-.2.07
AND pulmonary embolism:
3.02 with myocardial infarction Stage 1.01-3.01
AND acute myocardial infarction:
3.03 with congestive heart failure Stage 1.01-3.02
AND congestive heart failure:
3.04 with cerebral vascular accident Stage 1.01-3.03
AND cerebral accident [CT scan or MRI report]
STAGE 1.01 + DXCAT GIS31;
STAGE 1.01-2.01 + GROUP
HYPER_URICEM;
STAGE 1.01-2.02 + DXCAT MUS23;
STAGE 1.01-2.03 + DXCAT GUS06;
STAGE 1.01-2.04 + (DX 2898,
28989);
STAGE 1.01-2.05 + (DX 5780,
5781, 5789, 53082);
STAGE 1.01-2.06 + (DX 4510-452,
4531-4539);
STAGE 1.01-2.07 + DX 4530;
STAGE 1.01-2.08 + GROUP
PULMEMB;
STAGE 1.01-3.01 + GROUP AMI;
STAGE 1.01-3.02 + GROUP
CHF__NON_HTN;
STAGE 1.01-3.03 + (DX 430, 431,
4320, 4321, 4329 , 43301, 43311,
43321, 43331, 43381, 43391 ,
43401, 43411, 43491, 436);
Thursday, January 07, 2010 9:22:14 AM
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