Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: PED09
MultiStage: No
DXCat Label: Anomaly: Neural Tube Defects Specificity: A
Etiology: Congenital; Genetic (or hereditary)
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Dermal sinus Dermal sinus, lumbosacral defect with connection to the subarachnoid [operative/pathology report] NO;
1.02 Spina bifida occulta Spina bifida occulta, failure of fusion of vertebral laminae without protrusion of the spinal cord or
meninges [operative/pathology report or lumbosacral x-ray report or CT scan or MRI or myelogram
report]
DX 75617;
1.03 Spina bifida occulta with tethered umbilical
cord
Stage 1.02
AND tethered umbilical cord
1.04 Spinal bifida occulta with diastematomyelia Stage 1.02-1.03
AND diastematomyelia
2.01 Meningocele Meningocele, failure of fusion of vertebral laminae with protrusion of the meninges
[operative/pathology report or lumbosacral x-ray report or CT scan or MRI or myelogram report]
2.02 Defects of the neural tube with
Stage 1.01-2.01
hemiparesis or paraparesis
AND hemiparesis
OR paraparesis
2.03 Defects of the neural tube with bladder
dysfunction
2.04 Defects of the neural tube with urinary
tract infection
Stage 1.01-2.02
AND bladder dysfunction [urology report]
Stage 1.01-2.03
AND UTI:
2.05 Syringomyelia Syringomyelia [operative/pathology report]
2.06 Defects of the neural tube with paralysis Stage 1.01-2.05
AND quadriplegia
OR hemiplegia
OR paraplegia
NO;
DX 74251;
DX 74190-74193;
STAGE 1.01-2.01 + (DX 3430-
3431, 3434);
STAGE 1.01-2.02 + (DX 34461,
5965, 59651-59659);
STAGE 1.01-2.04 + DXCAT GUS10;
DX 3360;
STAGE 1.01-2.05 + DX 34400-
34409;
3.01 Myelomeningocele Myelomeningocele, failure of fusion of vertebral laminae with protrusion of the meninges and spinal
cord [operative/pathology report or lumbosacral x-ray report or CT scan or MRI report]
3.02 Encephalocele Encephalocele, cyst or cavity in the cerebral hemispheres with a ventricle connection [CT scan
report]
3.03 with meningitis Stage 1.01-3.02
AND meningitis:
3.04 with hydrocephalus Stage 1.01-3.03
AND hydrocephalus, ventricular dilatation [CT scan report or operative/pathology report]
3.05 Hydrocephalus with herniation of the Stage 1.01-3.03
medulla and cerebellar tonsils ("Chiari AND hydrocephalus, ventricular dilatation [CT scan report or operative/pathology report]
crisis") or respiratory failure
NO;
DX 7420;
STAGE 1.01-3.02 + (GROUP
MENGIT__BACT OR GROUP
MENING__VIR);
DX 74100-74103, 7423;
STAGE 3.04 + (DX 3484 OR GROUP
RESP_FAIL);
Thursday, January 07, 2010 9:22:56 AM
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