Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: PED06
MultiStage: No
DXCat Label: Anomaly: Defects of Kidney Specificity: A
Etiology: Congenital
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Unilateral renal agenesis or unilateral renal Renal agenesis [intravenous urography report or CT scan report or sonogram report]
DX 7530, 7534, 7537, 7539;
hypoplasia
OR renal hypoplasia [intravenous urography report or CT scan or sonogram report]
2.01 Horseshoe kidney or supernumerary
kidney or fusion of the kidney
2.02 Renal dysplasia or juvenile polycystic
kidney, or medullary cystic or sponge
kidney or juvenile nephronophthisis
Horseshoe kidney [intravenous urography report or CT scan or sonogram report]
OR supernumerary kidney [intravenous urography report or CT scan or sonogram report]
OR fusion of the kidney [intravenous urography report CT scan or sonogram report]
Renal dysplasia [intravenous urography report or CT scan or sonogram report or
operative/pathology report]
OR polycystic kidney [intravenous urography report or CT scan or sonogram report or
operative/pathology report]
OR medullary cystic or sponge kidney[intravenous urography report or CT scan or sonogram
report or operative/pathology report]
OR juvenile nephronophthisis [intravenous urography report or CT scan or sonogram report or
operative/pathology report]
DX 7533;
DX 75310-75312, 75314-75317,
75319;
2.03 Segmental renal hypoplasia or Ask-Upmark
syndrome
Segmental renal hypoplasia [operative/pathology report]
2.04 Adult polycystic kidney Adult polycystic kidney [intravenous urography report or CT scan or sonogram report or
operative/pathology report]
2.05 Hydronephrosis Hydronephrosis [intravenous urography report or CT scan or sonogram report]
2.06 Hypoplastic kidneys Hypoplastic kidneys [intravenous urography report or CT scan or sonogram report]
2.07 with pyelonephritis Stage 1.01-2.06
AND pyelonephritis:
3.01 with renal failure Stage 1.01-2.07
AND renal failure:
3.02 with sepsis Stage 1.01-3.01
AND sepsis:
3.03 with shock Stage 3.02
AND shock:
4.00 with death Stage 3.01-3.03
AND death
NO;
DX 75313;
STAGE 1.01-2.04 + DX 591;
DX 75320-75329;
NO;
STAGE 1.01-2.05 + (DX 59000,
59010, 59011, 59080 );
STAGE 1.01-2.07 + (GROUP
REN_FAIL_ACU OR GROUP
REN_FAIL_CHR);
STAGE 1.01-2.07 + (DX 40301,
40391) + AGE 0;
STAGE 1.01-3.01 + GROUP SEPSIS;
STAGE 1.01-3.02 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
Thursday, January 07, 2010 9:22:55 AM
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