Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: MUS13
MultiStage: No
DXCat Label: Fracture: Radial Shaft, Ulna or Olecranon Specificity: A
Etiology: Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Fracture of the radius and/or ulna or
olecranon without displacement
Fracture of the radius or ulna without displacement [x-ray report]
DX 81300-81302, 81304, 81307-
81308, 81320-81323, 81343,
81346-81347;
1.02 with displacement Fracture of the radius or ulna with displacement [x-ray report]
NO;
1.03 with dislocation of the radioulnar joint or
Monteggia's fracture joint
1.04 with extensive soft tissue damage Stage 1.01-1.03
AND extensive soft tissue damage
Fracture of the radius or ulna with dislocation of the radioulnar joint [x-ray report]
OR Galeazzi’s fracture [x-ray report]
OR Monteggia’s fracture
STAGE 1.01 + DX 81342;
DX 81303;
STAGE 1.01-1.03 + (DX 8400-
84209, 9032-9039, 92310-92311,
92321);
2.01 Open fracture of the radius and/or ulna Fracture of the radius or ulna
AND laceration of the skin with exposure of the fractured or dislocated bones
2.02 with injury to the radial nerve or median Stage 1.01-2.01
nerve or ulnar nerve
AND radial nerve palsy
OR medial nerve palsy
OR ulna nerve palsy
2.03 with reflex sympathetic dystrophy Stage 1.01-2.02
AND reflex sympathetic dystrophy
OR shoulder-hand syndrome
OR Sudeck’s atrophy
OR hyperesthesia
AND skin pallor
AND trophic changes distal to fracture site
2.04 with Volkmann's ischemic contracture Stage 1.01-2.03
AND Volkmann’s ischemic contracture
2.05 with osteomyelitis Stage 2.01-2.04
AND osteomyelitis:
2.06 with gangrene Stage 2.01-2.05
AND gangrene
3.01 with sepsis Stage 2.01-2.06
AND sepsis:
3.02 with shock Stage 2.01-3.01
AND shock:
4.00 with death Stage 2.01-3.02
AND death
DX 81310-81314, 81317-81318,
81330-81333, 81353;
STAGE 1.01-2.01 + (DX 33811,
33821, 3541-3543, 9551-9554);
STAGE 1.01-2.02 + (DX 33721,
3379, 7337, 7820);
STAGE 1.01-2.03 + DX 9586;
STAGE 2.01-2.04 + GROUP
OSTEOMYELIT;
STAGE 2.01-2.05 + DX 7854;
STAGE 2.01-2.06 + GROUP SEPSIS;
STAGE 2.01-3.01 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
Thursday, January 07, 2010 9:22:34 AM
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