Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: PED22
MultiStage: No
DXCat Label: Meconium Aspiration Syndrome Specificity: A
Etiology: Congenital
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Meconium stained amniotic fluid with no Newborn
DX 77984, 76384, 77011;
signs of respiratory distress
AND Meconium stained amniotic fluid with no signs of respiratory distress
1.02 Meconium aspiration with no complications Newborn
AND Presence of meconium below the vocal cords at the time of delivery
AND Tachypnea
AND Normal blood pH [ABG report]
AND hypocarbia:
AND Resolution of symptoms in 2-3 days
DX 7701, 77010, 77013, 77015,
77017, 77085;
2.01 Meconium aspiration with pneumonitis Newborn
AND Presence of meconium below the vocal cords at the time of delivery
AND Patchy infiltrates and coarse streaking in both lung fields, increased AP diameter and
flattened diaphragm [x-ray report]
2.02 with pneumothorax or pneumomediastinum Stage 2.01
AND Pneumothorax or pneumomediastinum [x-ray report]
2.03 with secondary bacterial pneumonia Stage 2.01-2.02
AND pneumonia:
OR tracheal aspirate culture reports growth of pathologic organism(s) [culture report]
3.01 with persistent pulmonary hypertension Stage 2.01-2.03
AND Right to left shunting through a patent ductus arteriosus or patent foramen ovale
[ultrasound report]
AND PaO2 < 60mmHg unresponsive to 100% O2
OR PaO2 gradient between the radial artery and the umbilical artery > 20mmHg
[ABG report]
AND normal pCO2 [ABG report]
3.02 with heart failure Stage 2.01-3.01
AND congestive heart failure:
3.03 with sepsis Stage 2.01-3.02
AND sepsis, infant:
DX 77012, 77014, 77016, 77018,
77086;
STAGE 1.02-2.01 + DX 7702;
STAGE 1.02-2.02 + (DX 7700 OR
DXCAT RES15);
STAGE 1.02-2.03 + (DX 4150,
4160, 4168);
STAGE 1.02-3.01 + GROUP
CHF__NON_HTN;
STAGE 1.02-3.02 + GROUP SEPSIS;
STAGE 1.02-3.02 + DX 41512;
3.04 with DIC Stage 2.01-3.03
AND DIC:
3.05 with respiratory failure Stage 2.01-3.04
AND respiratory failure:
STAGE 1.02-3.03 + GROUP DIC;
STAGE 1.02-3.04 + GROUP
RESP_FAIL;
Thursday, January 07, 2010 9:23:00 AM
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