Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: IMM01
MultiStage: No
DXCat Label: Human Immunodeficiency Virus Type I (HIV) Infection Specificity: A
Etiology: Infection, Viral
Stage Description Diagnostic findings ICD-9-CM Codes
0.00 Counseling for, contact with or exposure to Inconclusive HIV testi or counseling for HIV
HIV
NO;
1.01 Human immunodeficiency virus infection,
Type I
Human immunodeficiency virus infection [Western blot assay report and ELISA report]
1.02 with significant immunosuppression Stage 1.01
AND CD4 count < 500/mm 3 [hematology report]
AND CD4 count > 200 /mm 3 [hematology report]
OR bDNA < 20,000 copies/mL [hematology report]
OR HIV RNA levels or viral load tests 5000 copies/mL [hematology report]
DX V08;
NO;
2.01 Presumptive Acquired Immune Deficiency
Syndrome
Stage 1.01-1.02
AND recent onset of retrosternal pain on swallowing
AND oral candidiasis [culture report]
OR Cytomegalovirus retinitis [ophthalmoscopic report]
OR Mycobacteriosis [acid-fast bacilli not identified as reported by culture report]
OR Erythematous or violaceous plaque-like lesion on skin or mucous membrane
OR a history of dyspnea on exertion or nonproductive cough of recent onset ≤ 3
months
AND diffuse bilateral interstitial infiltrates [chest x-ray report]
OR diffuse bilateral pulmonary disease [gallium scan report]
AND arterial oxygen partial pressure of < 70 mm Hg [blood gas report]
OR respiratory diffusing capacity of < 80% of predicted values [PFT report]
AND no evidence of bacterial pneumonia
OR recent onset of a focal neurologic abnormality or a reduced level of
consciousness
AND brain lesion having a mass effect [CT scan or MRI report]
OR radiographic appearance enhanced by injection of contrast medium [CT scan or
MRI report]
AND serum antibody to toxoplasmosis [serology report]
OR apical or miliary infiltrates [chest x-ray report]
DX 042;
Thursday, January 07, 2010 9:22:19 AM
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