Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: PED11
MultiStage: No
DXCat Label: Anomaly: Pulmonary Valve Stenosis Specificity: A
Etiology: Congenital
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Pulmonary valve stenosis Pulmonary valve stenosis with an intact ventricular septum [echocardiogram report or cardiac
catheterization report or cardiac surgery report]
DX 74602, 74683;
AND ≤ 30 mm Hg gradient across the valve [echocardiogram report or cardiac catheterization
report]
AND > 10 mm Hg gradient across the valve [echocardiogram report or cardiac catheterization
report
1.02 Moderate pulmonary valve stenosis Pulmonary valve stenosis with an intact ventricular septum [echocardiogram report or cardiac
catheterization report or cardiac surgery report]
AND ≤ 60 mm Hg gradient across the valve [echocardiogram report or cardiac catheterization
report]
AND > 30 mm Hg gradient across the valve [echocardiogram report or cardiac catheterization
report
1.03 Severe pulmonary valve stenosis Pulmonary valve stenosis with an intact ventricular septum [echocardiogram report or cardiac
catheterization report or cardiac surgery report]
AND > 60 mm Hg gradient across the valve [echocardiogram report or cardiac catheterization
report]
NO;
NO;
2.01 with hypoxemia Stage 1.01-1.03
AND hypoxemia:
3.01 with infectious endocarditis Stage 1.01-2.01
AND infectious endocarditis:
3.02 with congestive heart failure Stage 1.01-3.01
AND congestive heart failure:
3.03 with sepsis Stage 1.01-3.02
AND sepsis:
3.04 with respiratory failure Stage 1.01-3.03
AND respiratory failure:
3.05 with shock Stage 1.01-3.04
AND shock:
4.00 with death Stage 1.01-3.05
AND death
STAGE 1.01 + GROUP HYPOXEMIA;
STAGE 1.01-2.01 + GROUP
ENDOCARDITIS;
STAGE 1.01-3.01 + GROUP
CHF__NON_HTN;
STAGE 1.01-3.02 + GROUP SEPSIS;
STAGE 1.01-3.03 + GROUP
RESP_FAIL;
STAGE 1.01-3.04 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
Thursday, January 07, 2010 9:22:56 AM
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