Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: CVS12
MultiStage: No
DXCat Label: Digoxin Toxicity Specificity: A
Etiology: Toxicologic
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Digoxin toxicity Digoxin level ≥ 3.0 ng/ml [chemistry report]
DX 9721, E8583, E9421;
(DX 2752, 2765-2766, 2768-2769,
29281, 36815, 36859, 37734,
7804, 7830, 7840, 78701-78703,
78900-78909, 9952-99529) + ( DX
E8583, E9421);
2.01 with unifocal PVCs Stage 1.01
AND unifocal premature ventricular contractions [EKG report]
2.02 with Mobitz type I heart block Stage 1.01-2.01
AND Mobitz type I heart block [EKG report]
2.03 with multifocal PVCs Stage 1.01-2.02
AND multifocal premature ventricular contractions [EKG report]
3.01 with Mobitz II or third degree heart block Stage 1.01-2.03
AND Mobitz type II heart block or 2:1 heart block [EKG report or Holter report]
OR third degree heart block [EKG report or Holter report]
3.02 with ventricular tachycardia Stage 1.01-3.01
AND ventricular tachycardia [EKG report or Holter report or CRT monitor report]
3.03 with ventricular fibrillation or flutter or Stage 1.01-3.02
shock
AND ventricular fibrillation [EKG report or Holter report or CRT monitor report]
OR ventricular flutter [EKG report or Holter report or CRT monitor report]
OR shock:
4.00 with death Stage 1.01-3.03
AND death
STAGE 1.01 + DX 42769;
STAGE 1.01-2.01 + (DX 42613,
4266);
NO;
STAGE 1.01-2.03 + (DX 4260,
42612, 42689, 4269);
STAGE 1.01-3.01 + DX 4271;
STAGE 1.01-3.02 + (DX 42741-
42742);
STAGE 1.01-3.02 + (GROUP
SHOCKC OR GROUP SHOCKN);
NO;
References:
Linden CH, Lovejoy Jr. FH. Poisoning and drug overdosage. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo, DL, eds. Harrison’s
Principles of Internal Medicine. 14th Ed. New York, NY: McGraw-Hill; 1998:2523-2544.
Massie BM, Amidon TM. Heart failure. In: Tierney Jr LM, McPhee SJ Papadakis MA, eds. Current Medical Diagnosis & Treatment. Stamford, CT: Appleton & Lange; 1998:403-
412.
Sopher SM, Camm AJ. Atrial fibrillation: maintenance of sinus rhythm versus rate control. American Journal of Cardiology. 1996:77(3):24A-37A.
Thursday, January 07, 2010 9:21:17 AM
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