Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: MUS43
MultiStage: No
DXCat Label: Spondylitis, Ankylosing Specificity: A
Etiology: Immune
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Ankylosing spondylitis Sacroiliitis [sacroiliac x-ray report or axial skeleton report describes ‘bamboo’ appearance of spine
x-ray report]
DX 7200-7202, 72089-7209, 7216,
72081;
OR New York criteria (1984): a history of inflammatory back pain
OR back pain onset ≤ 40 years old
AND insidious onset
AND ≥ 3 months before medical attention is sought
AND morning stiffness improves with exercise
OR limitation of motion of the lumbar spine in both the sagittal and frontal planes
OR positive Schober test
OR ≤ 4 cm separation of horizontal line markers between the posterosuperior iliac spines
OR limited chest expansion
OR maximal inspiration and maximal forced expiration at 4 th intercostal space < 5 cm
2.01 with cervical fusion or atlantoaxial
subluxation
Stage 1.01
AND cervical fusion [x-ray report]
OR atlantoaxial subluxation [x-ray report]
2.02 with uveitis Stage 1.01-2.01
AND uveitis [ophthalmologist’s report]
2.03 with pulmonary fibrosis Stage 1.01-2.02
AND pulmonary fibrosis [x-ray report]
2.04 with cardiac conduction abnormalities Stage 1.01-2.03
AND cardiac conduction abnormalities:
2.05 with cauda equina syndrome Stage 1.01-2.04
AND cauda equina syndrome:
2.06 with quadriparesis Stage 1.01-2.05
AND quadriparesis
3.01 with renal failure Stage 1.01-2.06
AND renal failure:
3.02 with respiratory failure Stage 1.01-3.01
AND respiratory failure:
3.03 with shock Stage 2.01-3.03
AND shock:
4.00 with death Stage 2.01-3.03
AND death
STAGE 1.01 + (DX 83910, 83911,
71828);
DX 7215;
STAGE 1.01-2.01 + (DX 36400,
36404, 36411, 3643) ;
STAGE 1.01-2.02 + DX 5163;
STAGE 1.01-2.03 + GROUP
COND_BBBS;
STAGE 1.01-2.04 + (DX 34460-
34461);
STAGE 1.01-2.05 + (DX 34400-
34409);
STAGE 1.01-2.06 + (GROUP
REN_FAIL_ACU OR GROUP
REN_FAIL_CHR);
STAGE 1.01-3.01 + GROUP
RESP_FAIL;
STAGE 1.01-3.02 + GROUP
SHOCKA;
NO;
Thursday, January 07, 2010 9:22:43 AM
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