Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: MUS02
MultiStage: No
DXCat Label: Dislocation: Elbow Specificity: A
Etiology: Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Sprains of elbow and forearm Sprain of elbow
DX 8410-8419;
OR sprain of forearm
1.02 Dislocation of the elbow Dislocation of the elbow [x-ray report]
DX 71822, 71832, 71872, 71882,
71892, 83200-83219, 8322;
1.03 Humeroradioulnar dislocation Humeroradioulnar dislocation [x-ray report]
1.04 Dislocation of the elbow with fracture of Stage 1.02-1.03
the coronoid process
AND fracture of the coronoid process [x-ray report]
1.05 Dislocation of the elbow with fracture of Stage 1.02-1.03
the head of the radius or epicondyle Fracture of the head of the radius [x-ray report]
OR fracture of the median epicondyle [x-ray report]
OR fracture of the lateral epicondyle [x-ray report]
1.06 Dislocation of the elbow with injury to the Stage 1.02-1.05
brachialis muscle or triceps muscle AND injury to the brachialis muscle
OR injury to the triceps muscle
2.01 Dislocation of the elbow with injury to the
median nerve or ulnar nerve
2.02 Dislocation of the elbow with injury to the
brachial artery
Stage 1.02-1.06
AND ulnar nerve palsy
OR median nerve palsy
Stage 1.02-2.01
AND brachial artery injury [angiography report]
NO;
STAGE 1.02-1.03 + (DX 81302,
81312);
STAGE 1.02-1.04 + (DX 81242-
81244, 81252-81254, 81305,
81315);
STAGE 1.01 + STAGE 1.02-1.05;
STAGE 1.02-1.06 + (DX 33811,
33821, 3540, 3542, 9551-9552);
STAGE 1.02-2.01 + DX 9031;
References:
Dowling J. Musculoskeletal disease: staged for rapid comprehension. Year Book Medical Publishers Inc. 1985:217-218.
Fitch RD, Speer KP. Fractures and dislocations: fractures and dislocations of the shoulder, arm, and forearm. In: Sabiston DC, ed. Sabiston Textbook of Surgery. 15th ed.
Philadelphia, PA: WB Saunders; 1998:1408-1414.
Ring D, Jupiter JB. Fracture-dislocation of the elbow. Journal of Bone & Joint Surgery - American Volume. 1998;80(4):566-80.
Thursday, January 07, 2010 9:22:32 AM
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