Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: MUS37
MultiStage: No
DXCat Label: Osteomyelitis Specificity: B
Etiology: Infection
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Intervertebral disc infection Disk space narrowing with endplate blurring [spine x-ray report or MRI report or CT scan report or
physical examination]
NO;
OR Intervertebral Disc Infection [changes include decreased enhancement on T1 and
increased intensity on T2 weighted images with characteristic enhancement with
gadolinium administration on MRI report]
1.02 Vertebral osteomyelitis Vertebral osteomyelitis [growth of pathologic organism(s) by bone culture report or bone scan or
areas of hypodensity and trabecular, cortical or endplate destruction by CT report or changes
include decreased enhancement on T1 and increased intensity on T2 weighted images with
characteristic enhancement with gadolinium administration by MRI report]
NO;
2.01 Osteomyelitis Growth of pathologic organism(s) in bone other than vertebra [bone culture report]
OR involved area of bone consistent with osteomyelitis [bone scan, MRI or x-ray report]
2.02 with extension into soft tissues Stage 2.01
AND soft tissue abscess
OR sinus tract formation between overlying skin and bone lesion
2.03 with sequestrum formation Stage 2.01-2.02
AND sequestrum formation [skeletal x-ray report]
2.04 with epidural abscess Stage 2.01-2.03
AND epidural abscess [MRI report]
2.05 with paraspinal abscess Stage 2.01-2.04
AND paraspinal abscess [MRI report or cultures sensitivity report]
2.06 with pathologic fracture Stage 2.01-2.05
AND pathologic fracture [x-ray report]
2.07 involving the spinal column Stage 2.01-2.06
AND extension into spinal column
2.08 with paraplegia or paraparesis Stage 2.01-2.07
AND paraplegia
OR paraparesis
3.01 with sepsis Stage 2.01-2.08
AND sepsis:
3.02 with respiratory failure Stage 2.01-3.01
AND respiratory failure:
3.03 with shock Stage 2.01-3.02
AND shock:
4.00 with death Stage 2.01-3.02
AND death
DX 73000-73029;
NO;
STAGE 2.01 + (DX 6869, 73340-
73349);
STAGE 2.01-2.03 + (DX 3240-
3249);
NO;
STAGE 2.01-2.04 + (DX 73310-
73316, 73319);
DX 73008, 73018, 73028;
STAGE 2.01-2.07 + DX 3441;
STAGE 2.01-2.08 + GROUP SEPSIS;
STAGE 2.01-3.01 + GROUP
RESP_FAIL;
STAGE 2.01-3.02 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
Thursday, January 07, 2010 9:22:41 AM
©2010 Thomson Reuters. All rights reserved.