Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: DEN01
MultiStage: No
DXCat Label: Anomaly: Cleft Lip or Palate Specificity: A
Etiology: Congenital
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Cleft lip Cleft lip, unilateral or bilateral
DX 74910-74914;
1.02 Cleft palate Unilateral or bilateral cleft palate not extending beyond the incisive foramen
DX 74900-74904;
1.03 Cleft lip and palate Stage 1.01
DX 74920-74925;
AND Stage 1.02
2.01 with recurrent otitis media and hearing loss Stage 1.01-1.03
AND history of recurrent otitis media
AND threshold for conductive sound ≥ 30 dB [audiometry report
STAGE 1.01-1.03 + (DXCAT ENT18
OR DX 3821, 3822, 3823, 3824) +
(DX 38900-38922, 3898, 3899) ;
2.02 with other deformities of the maxilla or
mandible or pharynx
Stage 1.01-2.01
AND maxillary retrusion or protrusion
OR mandible retrusion or protrusion
OR small mandible or Pierre Robin or Treacher Collins syndromes
OR hypertelorism
OR poor feeding
OR dysphagia
STAGE 1.01-1.03 + (DX 52400-
52406, 52409-52412, 52419, 5242-
52429, 5244, 7560, 7793-77934,
7833, 78701-78703, 7872-78729,
7961);
2.03 with aspiration pneumonia Stage 1.01-2.02
AND aspiration
AND pneumonia:
3.01 with sepsis Stage 3.01
AND sepsis:
3.02 with respiratory failure Stage 2.03
AND respiratory failure:
3.03 with shock Stage 2.03-3.02
AND shock:
4.00 Cleft lip or palate and death Stage 2.03-3.03
AND death
STAGE 1.01-2.02 + DX 5070;
STAGE 1.01-2.03 + GROUP SEPSIS;
STAGE 1.01-3.01 + GROUP
RESP_FAIL;
STAGE 1.01-3.02 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
References:
Milerad J, Larson O, Hagberg C, Ideberg M. Associated malformations in infants with cleft lip and palate: a prospective, population-based study. Pediatrics. 1997;100(2 Pt 1):180-6.
Thursday, January 07, 2010 9:21:21 AM
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