Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: CVS15
MultiStage: No
DXCat Label: Mitral Regurgitation Specificity: A
Etiology:
Congenital; Degenerative
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Mitral valve prolapse without regurgitation Mitral valve prolapse without regurgitation [echocardiogram report or cardiac catheterization report] NO;
1.02 Mild chronic mitral regurgitation Chronic:
AND mild mitral regurgitation [echocardiogram report or cardiac catheterization report]
2.01 Mild chronic mitral regurgitation with left
atrial enlargement
Stage 1.02
AND chronic:
AND left atrial enlargement [echocardiogram report or cardiac catheterization report
2.02 Moderate chronic mitral regurgitation Chronic:
Moderate mitral regurgitation [echocardiogram report or cardiac catheterization report]
2.03 Mild chronic mitral regurgitation with atrial Chronic:
fibrillation
Mild mitral regurgitation [echocardiogram report or cardiac catheterization report]
AND atrial fibrillation [EKG report]
2.04 Moderate chronic mitral regurgitation with
atrial fibrillation
Chronic:
Mild mitral regurgitation [echocardiogram report or cardiac catheterization report]
AND atrial fibrillation [EKG report]
2.05 Severe chronic mitral regurgitation Chronic:
AND severe mitral regurgitation [echocardiogram report or cardiac catheterization report]
3.01 Severe acute mitral regurgitation Acute:
AND severe mitral regurgitation [echocardiogram report or cardiac catheterization report]
3.02 Mild chronic mitral regurgitation with Chronic:
congestive heart failure
AND mild mitral regurgitation [echocardiogram report or cardiac catheterization report]
AND congestive heart failure:
3.03 Moderate chronic mitral regurgitation with Chronic:
congestive heart failure
AND moderate mitral regurgitation [echocardiogram report or cardiac catheterization report]
AND congestive heart failure:
3.04 Mitral regurgitation with low ejection Stage 3.01-3.03
fraction
AND left ventricular ejection fraction < 60% [echocardiogram report or cardiac catheterization
report or radionucleide ventriculogram report]
3.05 Severe mitral regurgitation with congestive
heart failure
Stage 3.01
AND congestive heart failure:
3.06 Mitral regurgitation with sepsis Stage 3.01-3.05
AND sepsis:
3.07 Mitral regurgitation with respiratory failure Stage 3.01-3.06
AND respiratory failure:
3.08 Mitral regurgitation with shock Stage 3.01-3.07
AND shock:
DX 7466;
STAGE 1.01-1.02 + DX 4293;
NO;
STAGE 1.01-2.01 + (DX 42731-
42732);
NO;
NO;
NO;
STAGE 1.01-2.03 + GROUP
CHF__NON_HTN;
NO;
NO;
NO;
STAGE 1.01-3.02 + GROUP SEPSIS;
STAGE 1.01-3.06 + GROUP
RESP_FAIL;
STAGE 1.01-3.07 + GROUP
SHOCKN;
Thursday, January 07, 2010 9:21:18 AM
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