Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: PED04
MultiStage: No
DXCat Label: Anomaly: Coarctation of the Aorta Specificity: A
Etiology: Congenital
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Asymptomatic post-ductal coarctation of
the aorta
Post-ductal coarctation of the aorta [cardiac catheterization report or MRI report or echocardiogram
report]
DX 74710-74711;
OR absent femoral pulses
AND upper extremity hypertension:
AND rib notching [x-ray report]
1.02 Asymptomatic pre-ductal coarctation of the
aorta
Pre-ductal coarctation of the aorta [cardiac catheterization report or MRI report or echocardiogram
report]
OR absent femoral pulses
AND
AND
1.03 with intermittent claudication Stage 1.01
AND intermittent claudication
upper extremity hypertension:
rib notching [x-ray report]
2.01 with aortic insufficiency Stage 1.01-1.02
AND aortic valve insufficiency [cardiac catheterization report or echocardiogram report]
3.01 with endocarditis Stage 1.01-2.01
AND endocarditis:
3.02 with acute myocardial infarction Stage 1.01-3.01
AND acute myocardial infarction:
3.03 with congestive heart failure Stage 1.01-3.02
AND congestive heart failure:
3.04 with new cerebrovascular accident Stage 1.01-3.03
AND new cerebrovascular accident [MRI report or CT scan report]
NO;
STAGE 1.01 + DX 4439;
STAGE 1.01-1.03 + DX 7464;
STAGE 1.01-2.01 + DX 4253;
STAGE 1.01-3.01 + (DX 41001,
41011, 41021, 41031 , 41041,
41051, 41061, 41071, 41081,
41091 );
STAGE 1.01-3.02 + GROUP
CHF__NON_HTN;
STAGE 1.01-3.03 + (DX 430, 431,
4320-4321, 4329, 43301, 43311,
43321, 43331, 43381, 43391,
43401, 43411, 43491, 436, 77210-
77214);
3.05 with sepsis Stage 1.01-3.04
AND sepsis:
3.06 with aortic dissection Stage 1.01-3.05
AND aortic dissection [CT scan or MRI report]
3.07 with respiratory failure Stage 3.01-3.06
AND respiratory failure:
3.08 with shock Stage 1.01-3.07
AND shock:
STAGE 1.01-3.04 + GROUP SEPSIS;
STAGE 1.01-3.05 + DX 44100-
44103;
STAGE 1.01-3.06 + GROUP
RESP_FAIL;
STAGE 1.01-3.07 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
Thursday, January 07, 2010 9:22:55 AM
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