Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: MUS29
MultiStage: No
DXCat Label: Injury, Knee, Semilunar Cartilages Specificity: A
Etiology: Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
1.01
1.02
1.03
Isolated peripheral tear of the medial or
lateral meniscus
Torn discoid medial or lateral meniscus
Torn cystic medial or lateral meniscus
Isolated peripheral tear of the medial or lateral meniscus [arthroscopy, arthrotomy,
operative/pathology or stress x-ray report or physical examination]
Isolated discoid tear of the medial or lateral meniscus [arthroscopy, arthrotomy, operative/pathology
or stress x-ray report or physical examination]
Isolated cystic tear of the medial or lateral meniscus [arthroscopy, arthrotomy, operative/pathology
or stress x-ray report or physical examination]
DX 8360-8362, 7170-7175;
NO;
NO;
1.04 Tear of the medial or lateral meniscus with
displacement of the internal fragment
1.05 Tear of the anterior horn of the lateral or
medial meniscus
1.06 Tear of the posterior horn of the lateral or
medial meniscus
2.01 Tear of the medial or lateral meniscus with
tear of the medial collateral ligament
2.02 Tear of the medial or lateral meniscus with
tear of the cruciate ligament
2.03 Ligamentous tear and meniscus tear and
torn knee capsule
References:
Tear of the medial or lateral meniscus with displacement of the internal fragment [arthroscopy,
arthrotomy, operative/pathology or stress x-ray report or physical examination]
Tear of the anterior horn of the lateral or medial menisci [arthroscopy, arthrotomy,
operative/pathology or stress x-ray report or physical examination]
Tear of the posterior horn of the lateral or medial menisci [arthroscopy, arthrotomy,
operative/pathology or stress x-ray report or physical examination]
Tear of the medial or lateral meniscus with tear of the medial collateral ligament [arthroscopy,
arthrotomy, operative/pathology or stress x-ray report or physical examination]
Tear of the medial or lateral meniscus with tear of the medial collateral ligament [arthroscopy,
arthrotomy, operative/pathology or stress x-ray report or physical examination]
Stage 2.01-2.02
AND torn knee capsule [arthroscopy, arthrotomy, operative/pathology or stress x-ray report or
physical examination]
Clasby L, Young MA. Management of sports-related anterior cruciate ligament injuries. AORN Journal. 1997;66(4):609-30.
NO;
NO;
NO;
STAGE 1.01 + DX 8441;
STAGE 1.01-2.01 + (DX 33811,
33821, 8442);
Vail TP, McCollum DE. Fractures and dislocations: fractures of the pelvis, femur, and knee. In: Sabiston DC, ed. Sabiston Textbook of Surgery. 15th ed. Philadelphia, PA: WB
Saunders; 1998:1432-1443.
NO;
Thursday, January 07, 2010 9:22:39 AM
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