Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: MUS32
MultiStage: No
DXCat Label: Muscular Dystrophy Specificity: A
Etiology: Genetic (or hereditary)
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Distal muscular dystrophy Distal muscular dystrophy [physical examination or genetic analysis report]
DX 3591;
1.02 Becker muscular dystrophy or limb-girdle
dystrophy
Becker muscular dystrophy [physical examination or genetic analysis report or Western Blot
analysis report]
NO;
OR limb-girdle dystrophy [physical examination or Western Blot analysis report or genetic
1.03 Myotonic dystrophy or ocular muscular
dystrophy or fascioscapulohumeral
analysis reports limb-girdle dystrophy subtype]
Myotonic dystrophy [physical examination or genetic analysis report an unstable expansion of a
CTG trinucleotide repeat sequence in a gene at 19q13.3]
DX 3590, 3592-35923, 35929;
dystrophy or congenital muscular OR ocular muscular dystrophy [physical examination]
dystrophy or oculopharyngeal muscular
dystrophy
OR facioscapulohumeral dystrophy [physical examination or genetic analysis report defect at
chromosome 4q35]
OR congenital muscular dystrophy [physical examination or laminin α2 deficiency by muscle
biopsy or defect in chromosome 6q22-23 by genetic analysis report]
OR oculopharyngeal muscular dystrophy [physical examination or genetic defect in
chromosome 14q]
2.01 Duchennic type muscular dystrophy Duchennic type muscular dystrophy [physical examination or dystrophin in muscle tissue by
Western Blot analysis report or dystrophin gene at short arm of the X chromosome at Xp21 by
genetics report]
2.02 with hypertension Stage 1.01 2.01
AND hypertension:
2.03 with mental retardation Stage 1.01-2.02
AND mental retardation:
2.04 with pneumonia Stage 1.01-2.03
AND pneumonia:
2.05 with cardiomyopathy or cardiac conduction
abnormalities
Stage 1.01-2.04
Cardiomyopathy [echocardiogram report]
OR cardiac conduction abnormalities:
3.01 with congestive heart failure Stage 1.01-2.05
AND congestive heart failure:
3.02 with respiratory failure Stage 1.01-3.01
AND respiratory failure:
3.03 with shock Stage 1.01-3.02
AND shock:
NO;
STAGE 1.01-1.03 + DXCAT CVS13;
STAGE 1.01-2.02 + DXCAT NEU15;
STAGE 1.01-2.03 + (DXCAT RES15
OR DXCAT RES16 OR DXCAT
RES17 OR DXCAT RES12 OR
DXCAT RES19 OR DX 5070);
STAGE 1.01-2.04 + (DX 4250-
4254, 4257-4259 OR DXCAT
CVS08);
STAGE 1.01-2.05 + (GROUP
CHF__HTNIVE OR GROUP
CHF__NON_HTN);
STAGE 1.01-3.01 + GROUP
RESP_FAIL;
STAGE 1.01-3.02 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
Thursday, January 07, 2010 9:22:39 AM
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