Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: PED03
MultiStage: No
DXCat Label: Anomaly: Atrioventricular Defects Specificity: A
Etiology: Congenital
Stage Description Diagnostic findings ICD-9-CM Codes
2.01 Endocardial cushion defect Contiguous atrial and ventricular defects with a single atrioventricular valve [cardiac catheterization
report or cardiac surgery report or echocardiogram report]
DX 74560, 74569;
2.02 Endocardial cushion defect with pneumonia Stage 2.01
STAGE 2.01 + (GROUP
AND pneumonia:
PNEUMONIA OR DX 5070);
3.01 Endocardial cushion defect with pulmonary
hypertension
3.02 Endocardial cushion defect with infectious
endocarditis
3.03 Endocardial cushion defect with congestive
heart failure
Stage 2.01-2.02
AND pulmonary hypertension:
Stage 2.02-3.01
AND infectious endocarditis:
3.04 Endocardial cushion defect with sepsis Stage 2.02-3.03
AND sepsis:
Stage 2.02-3.02
AND congestive heart failure:
STAGE 2.01-2.02 + (DX 4150,
4160, 4168);
STAGE 2.01-3.01 + GROUP
ENDOCARDITIS;
STAGE 2.01-3.02 + GROUP
CHF__NON_HTN;
STAGE 2.01-3.03 + GROUP SEPSIS;
STAGE 2.01-3.03 + DX 41512;
3.05 Endocardial cushion defect with respiratory
failure
Stage 2.02-3.04
AND respiratory failure:
3.06 Endocardial cushion defect with shock Stage 2.02-3.05
AND shock:
4.00 Endocardial cushion defect with death Stage 2.02-3.06
AND death
STAGE 2.01-3.04 + GROUP
RESP_FAIL;
STAGE 2.01-3.05 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
References:
Bernstein D. Acyanotic congenital heart disease: the left to right shunt lesions. In: Behrman RE, Kliegman RM, Arvin AM, Nelson WE, eds. Nelson Textbook of Pediatrics. 15th
ed. Philadelphia, PA: WB Saunders; 1996:1288-1296.
Freed M. Congenital heart disease: acyanotic and cyanotic. In: Gewitz MH, ed. Primary Pediatric Cardiology. Armonk, NY: Futura; 1995:145-220.
Perloff JK. Atrial septal defect: simple and complex. In: The Clinical Recognition of Congenital Heart Disease. 4th ed. Philadelphia, PA: WB Saunders; 1994:293-380.
Perloff JK. Primary pulmonary hypertension. In: The Clinical Recognition of Congenital Heart Disease. 4th ed. Philadelphia, PA: WB Saunders; 1994:273-292.
Perloff JK. Survival patterns without cardiac surgery or interventional catheterization: a narrowing base. In: Perloff JK and Child JS. Congenital Heart Disease in Adults. 2nd ed.
Philadelphia, PA: WB Saunders; 1998:15-52.
Wolfe RR, Boucek M, Schaffer MS, and Wiggins, JW. Noncyanotic heart disease: atrial septal defect of the ostium secundum variety. In: Hay WW, Groosthius JR, Hayward AR,
Levin MJ, eds. Current Pediatric Diagnosis and Treatment. 13th ed. Stamford, CT: Appleton & Lange; 1997:492-94.
Thursday, January 07, 2010 9:22:55 AM
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