Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: MUS41
MultiStage: No
DXCat Label: Scoliosis of the Lumbar Spine Specificity: A
Etiology:
Congenital; Degenerative; Idiopathic
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Dysplastic scoliosis Scoliosis < 30 degrees [spine x-ray report or MRI report or CT scan report or physical examination NO;
AND Neurofibromatosis Type I [genetic analysis report]
OR cutaneous neurofibromatosis [operative/pathology report]
OR subcutaneous neurofibromatosis [operative/pathology report]
OR Autosomal dominant, chromosome 17, gene codes for neurofibromin [genetic
analysis report]
OR Two or more of the following must be present:
cafe-au-lait spot ≥ 1.5 cm in diameter for age > 13 years old
OR cafe-au-lait spot ≥ 0.5 cm in diameter for < age 13 years old
AND total of ≥ 6 cafe-au-lait spots
OR ≥ two neurofibromas of any type
OR ≥ 1 plexiform neurofibroma
OR freckling in the axillary and inguinal regions
OR ≥ 1 optic pathways glioma
OR ≥ 2 Lisch nodules (iris amartomas)
OR osseous lesion, such as sphenoid wing dysplasia or thinning of the cortex of long
bones
OR a first-degree relative with NF1 by the above criteria
1.02 Marfan's Scoliosis Scoliosis < 30 degrees [spine x-ray report or MRI report or CT scan report or physical examination]
AND Marfan's Scoliosis
1.03 with skeletal dysplasia Scoliosis ≥ 30 degrees [spine x-ray report or MRI report or CT scan report or physical examination]
AND diastrophic dysplasia
OR mucopoloysaccharidosis
OR pseudoachondroplasia
OR spondyloepiphyseal dysplasia
OR chondroplasia
1.04 with osteogenesis imperfecta Scoliosis ≥ 30 degrees [spine x-ray report or MRI report or CT scan report or physical examination]
AND osteogenesis imperfecta [pathology report]
1.05 with familial dysautonomia Scoliosis ≥ 30 degrees [spine x-ray report or MRI report or CT scan report or physical examination]
AND Riley-Tay syndrome or familial dysautonomia
1.06 Congenital scoliosis Scoliosis ≥ 30 degrees [spine x-ray report or MRI report or CT scan report or physical examination]
AND Type I: Failure of formation
OR Type II: Failure of segmentation
OR Type III: Mixture with rib abnormalities
1.07 Infantile and juvenile scoliosis Scoliosis ≥ 30 degrees [spine x-ray report or MRI report or CT scan report or physical examination]
AND infantile scoliosis present from birth to three years of age
OR juvenile scoliosis present from four to ten years of age
NO;
NO;
NO;
NO;
NO;
NO;
Thursday, January 07, 2010 9:22:42 AM
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