Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: INF13
MultiStage: No
DXCat Label: Infectious Mononucleosis Specificity: A
Etiology: Infection, Viral
Stage Description Diagnostic findings ICD-9-CM Codes
0.00 Past infection with Epstein-Barr virus Negative IgM antibodies to Epstein-Barr VCA [serology report]
NO;
AND negative antibodies to Epstein-Barr early antigen diffuse staining (EA-D) [serology report]
AND antibody to Epstein-Barr virus nuclear antigen (EBNA) at a dilution of 1:10-1:40 [serology
report]
OR IgG antibodies to Epstein-Barr viral capsid antigen (VCA) at a dilution of
1:40-1:160 [serology report]
1.01 Acute infectious monomucleosis Pharyngitis
AND fever:
AND lymphadenopathy
AND leukocytosis:
AND an atypical lymphocytosis > 10%
AND a positive heterophile antibody test in patients > 4 years old [serology report]
OR IgG antibodies to Epstein-Barr viral capsid antigen (VCA) at a dilution of 1:160
1:640 [serology report]
OR IgM antibodies to Epstein-Barr VCA at a dilution of 1:32-1:256 [serology report]
AND negative antibodies to Epstein-Barr early diffuse staining (EA-D) [serology report]
AND negative antibody to Epstein-Barr virus nuclear antigen (EBNA) [serology report]
1.02 with hepatosplenomegaly Stage 1.01
AND hepatomegaly
OR splenomegaly
2.01 with hepatitis Stage 1.01-1.02
AND hepatitis:
2.02 with upper airway obstruction Stage 1.01-1.02
AND upper airway obstruction
2.03 with hemolytic anemia Stage 1.01-2.02
AND hemolysis:
AND cold agglutinins against red blood cell antigen i [hematology report]
2.04 with interstitial pneumonia Stage 1.01-2.03
AND interstitial pneumonia [chest x-ray report]
2.05 with pericarditis Stage 1.01-2.04
AND pericarditis:
DX 075;
DX 075 + GROUP FEVER;
STAGE 1.01 + (DX 5718, 7891-
7892);
STAGE 1.01-1.02 + (DX 5731 OR
DXCAT HEP04 OR DXCAT HEP05
OR DXCAT HEP06 OR DXCAT
HEP07 OR DXCAT HEP08 OR
DXCAT HEP09 OR GROUP
HEPATITIS);
STAGE 1.01-2.01 + DX 5198;
STAGE 1.01-2.02 + GROUP
ANEM_HEM_ACQ;
STAGE 1.01-2.03 + DX 5168;
STAGE 1.01-2.04 + (DX 4200,
42090-42099);
Thursday, January 07, 2010 9:22:24 AM
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