Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: MUS17
MultiStage: No
DXCat Label: Fracture or Sprain: Ankle Specificity: A
Etiology: Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Ankle sprain Ankle sprain
DX 84500-84503, 84509;
1.02 Nondisplaced malleolar fractures Nondisplaced fracture of the medial malleolus [ankle x-ray report]
DX 8240, 8242, 8248;
OR nondisplaced fracture of the lateral malleolus [x-ray report]
OR nondisplaced fracture of the posterior malleolus [x-ray report
1.03 Nondisplaced talar fractures Nondisplaced fracture of the talus [x-ray report]
DX 82521;
1.04 Displaced single malleolar fractures Displaced fracture of the medial malleolus [x-ray report]
NO;
OR displaced fracture of the lateral malleolus [x-ray report]
OR displaced fracture of the posterior malleolus [x-ray report
1.05 Displaced bimalleolar fractures Fracture of any two of the following bones:
Displaced fracture of the medial malleolus [x-ray report]
DX 8244;
OR displaced fracture of the lateral malleolus [x-ray report]
OR displaced fracture of the posterior malleolus [x-ray report]
1.06 Displaced trimalleolar fractures Fracture of any three of the following bones:
Displaced fracture of the medial malleolus [x-ray report]
OR displaced fracture of the lateral malleolus [x-ray report]
OR displaced fracture of the posterior malleolus [x-ray report]
1.07 Displaced talar fractures Displaced fracture of the talus [x-ray report]
1.08 Dislocation of the ankle Dislocation of the ankle [x-ray report]
2.01 Fracture and dislocation of the ankle Stage 1.02-1.07
AND Stage 1.08
2.02 Comminuted intra-articular ankle fracture Comminuted fracture of the malleolar bones [ankle x-ray report]
OR comminuted fracture of the talus bones [x-ray report]
2.03 Open fracture or dislocation of the ankle Fracture or dislocation of the ankle
AND laceration of the skin with exposure of the fractured bones
2.04 with injury to ankle tendons Stage 1.02-2.03
AND laceration of the posterior tibial tendon [x-ray report or operative/pathology report]
OR laceration of the peroneal tendon [x-ray report or operative/pathology report]
2.05 with injury to the posterior tibial nerve Stage 1.02-2.04
AND posterior tibial nerve palsy [physical examination or EMG/nerve conduction study report]
OR tarsal tunnel syndrome
2.06 with injury to the posterior or anterior tibial Stage 1.02-2.05
artery
AND posterior tibial artery laceration [angiogram report]
OR anterior tibial artery laceration [angiogram report]
2.07 with osteomyelitis Stage 2.03-2.06
AND osteomyelitis:
DX 8246;
NO;
DX 8370;
STAGE 1.02-1.06 + STAGE 1.08;
NO;
DX 8241, 8243, 8245, 8247, 8249,
8371;
STAGE 1.01 + STAGE 1.02-1.08;
STAGE 1.01-2.04 + (DX 33811,
33821, 3555, 9562);
STAGE 1.01-2.05 + (DX 90451,
90453);
STAGE 2.03-2.06 + GROUP
OSTEOMYELIT;
Thursday, January 07, 2010 9:22:35 AM
©2010 Thomson Reuters. All rights reserved.