Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: MUS44
MultiStage: Yes
DXCat Label: Systemic Lupus Erythematosus Specificity: A
Etiology:
Immune
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Systemic lupus erythematosus Systemic lupus erythematosus
DX 7100;
OR Four or more of the following criteria:
Malar rash
OR Discoid rash
OR Photosensitivity
OR Oral ulcers
OR arthritis:
OR Serositis
OR 0.5 g/d proteinuria [urinalysis report]
OR 3 + dipstick proteinuria [urinalysis report]
OR Cellular casts [urinalysis report]
OR Seizures [EEG report]
OR Psychosis
OR hemolysis:
OR leukopenia:
OR lymphocytopenia:
OR thrombocytopenia:
OR Positive LE cell preparation [chemistry report]
OR Double stranded anti-DNA antibody titer ≥ 1:40 [chemistry report]
OR Smith antigen titer ≥ 1:40 [chemistry report]
OR positive serologic test for syphilis [chemistry report]
OR antiphospholipid antibodies
OR ANA antibody titer ≥ 1:40[chemistry report]
2.01 with lupus anticoagulant or deep vein Stage 1.01
thrombosis
AND anticardiolipin antibodies positive [serology report]
OR history of recurrent deep vein thrombosis
OR DVT:
2.02 with pneumonia or lupus pneumonitis Stage 1.01-2.01
AND pneumonia:
OR lupus pneumonitis
2.03 with pleural effusion Stage 1.01-2.02
AND pleural effusion [x-ray report or thoracentesis report]
2.04 with lupus nephritis Stage 1.01-2.03
AND lupus nephritis [renal biopsy report]
2.05 with peritonitis Stage 1.01-2.04
AND peritonitis [operative/pathology report]
STAGE 1.01 + GROUP DVT;
STAGE 1.01-2.01 + (GROUP
PNEUMONIA OR DX 5070, 5178);
STAGE 1.01-2.02 + (DX 5111,
5118-5119);
STAGE 1.01-2.03 + (DX 58181,
58381);
STAGE 1.01-2.04 + (DX 5672-
5679, 56983);
Thursday, January 07, 2010 9:22:43 AM
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