Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: MUS19
MultiStage: No
DXCat Label: Fracture, Dislocation, or Sprain: Foot Specificity: A
Etiology: Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Sprain or dislocation of the foot Sprain of foot
OR dislocation of foot
1.02 Closed phalangeal fractures Closed phalangeal fractures [x-ray report]
1.03 Linear fracture without displacement Linear fracture of the metatarsals without displacement [x-ray report]
DX 71827, 71837, 71877, 71887,
71897, 84510-84513, 84519,
83800-83806, 83809;
DX 8260;
DX 73394, 82520, 82525-82529;
1.04 Fracture of the metatarsals with
displacement
1.05 Fracture of the metatarsals with
concomitant divergent diastasis of the first
and second tarsometatarsal rays
1.06 Fracture of the metatarsals with
tarsometatarsal dislocation
1.07 Fracture of navicular, cuboid, cuneiform
bones, closed
Fracture of the metatarsals with displacement [x-ray report]
Fracture of the metatarsals with concomitant divergent diastasis of the first and second
tarsometatarsal rays [x-ray report]
Stage 1.01-1.05
AND tarsometatarsal dislocation [x-ray report]
Fracture of the navicular bone [x-ray report]
OR fracture of the cuboid bone [x-ray report]
OR fracture of the cuneiform bone [x-ray report]
2.01 Open phalangeal fracture or dislocation Fracture or dislocation of phalanges
AND laceration of skin with exposure of the fractured toe(s)
OR laceration of skin overlying site of dislocation of toe(s)
2.02 Open fracture or dislocation of the Fracture or dislocation of metatarsals
metatarsals
AND laceration of the skin with exposure of the fractured metatarsal bones
OR laceration of the skin overlying site of metatarsal dislocation
2.03 Open fracture or dislocation of navicular, Fracture or dislocation of navicular, cuboid, or cuneiform bone
cuboid or cuneiform bones
AND laceration of skin with exposure of the navicular bone
OR laceration of skin with exposure of the cuboid bone
OR laceration of skin with exposure of the cuneiform bone
OR laceration of the skin overlying the site of dislocation
2.04 Fracture or dislocation with injury to the
medial or lateral plantar nerve or artery
2.05 with osteomyelitis Stage 2.01-2.04
AND osteomyelitis:
3.01 with sepsis Stage 2.01-2.05
AND sepsis:
Fracture or dislocation of phalanges, metatarsals, or tarsals
AND injury to the medial or lateral plantar arteries [angiogram report]
OR injury to the medial or lateral plantar nerves [physical examination or EMG nerve
conduction study report]
NO;
STAGE 1.03 + DX 83803;
NO;
DX 82522-82524;
DX 8261, 83810, 83815-83816,
83819;
DX 83813, 83814, 82530-82531,
82535, 82539;
DX 82532-82534, 83811-83812;
STAGE 1.01-2.03 + (DX 33811,
33821, 9046-9049, 9565, 9568-
9569);
STAGE 2.01-2.04 + GROUP
OSTEOMYELIT;
STAGE 2.01-2.05 + GROUP SEPSIS;
Thursday, January 07, 2010 9:22:36 AM
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