Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: MUS34
MultiStage: No
DXCat Label: Osteoarthritis, Except Spine Specificity: A
Etiology: Degenerative; Immune; Metabolic; Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
2.01 with radiculopathy Stage 1.03-1.06
STAGE 1.03-1.06 + (DX 71941-
AND radiculopathy [EMG report]
71943, 7211, 72191);
OR no history of trauma to areas of pain
AND pain in either arm
OR pain in shoulders
2.02 with compression of the
metacarpophalangeal joints or
compression of the interphalangeal joints
Stage 1.01
AND no range of motion of fingers
OR compression of the metacarpophalangeal joints [x-ray report]
OR compression of the interphalangeal joints [x-ray report]
STAGE 1.01 + DX 3450-3459;
2.03 with compression of the knee joints or hip
joints
2.04
Stage 1.05-2.01
AND no range of motion of the lower extremities
OR compression of the knee joints [knee x-ray report]
OR compression of the hip joints [pelvic x-ray report or CT scan report]
STAGE 1.05-2.01 + (DX 3530-
3539, 3550-3559);
NO;
References:
Brandt KD. Osteoarthritis. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. Harrison's Principles of Internal Medicine. 14th
ed. New York, NY: McGraw-Hill; 1998:1935-1941.
Creamer P, Hochberg MC. Osteoarthritis. Lancet. 1997;350(9076):503-8.
Dowling J. Musculoskeletal disease: staged for rapid comprehension. Year Book Medical Publishers Inc. 1985:32-35.
Hellmann DB. Arthritis & musculoskeletal disorders. In: Tierney Jr LM, McPhee SJ, Papadakis MA, eds. Current Medical Diagnosis & Treatment. Stamford, CT: Appleton & Lange;
1998:774-824.
Lane NE, Thompson JM. Management of osteoarthritis in the primary-care setting: an evidence-based approach to treatment. American Journal of Medicine. 1997;103(6A):25S-
30S.
Thursday, January 07, 2010 9:22:40 AM
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