Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: PSY10
MultiStage: No
DXCat Label: Drug Abuse, Dependence, Overdose: Hallucinogen Specificity: A
Etiology:
Psychogenic; Toxicologic
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Hallucinogen abuse Hallucinogen use which meets DMS-IV criteria for abuse [psychiatrist report]
DX 30530-30533;
OR History of use
AND failure to fulfill major role obligations
OR recurrent use in physically dangerous situations
OR recurrent hallucinogen related legal problems
OR continued use despite use related social or interpersonal problems
1.02 Hallucinogen dependence Stage 1.01
AND hallucinogen use which meets DSM-IV criteria for dependence
(3 or more criteria in a 12 month period) [psychiatrist report]
tolerance
OR craving
OR increased use
OR desire or efforts to decrease use
OR increased time spent using and recovering from hallucinogen
OR reduced social or occupational activities
OR recurrent use despite negative physical
OR psychological or social effects
DX 30450-30453;
2.01 Hallucinogen intoxication Stage 1.01 - 1.02
AND perceptual changes, in a state of full alertness, < 1 hour after ingestion (depersonalization,
derealization, illusions, hallucinations)
AND two (or more) of the following, < 1 hour after ingestion
pupillary dilation
OR tachycardia:
OR sweating
OR palpitations
OR blurred vision
OR tremors
OR uncoordinated
2.02 with psychotic reaction Stage 1.01 - 2.01
History of hallucinogen abuse
AND paranoia
OR persistent personality changes
OR persistent psychotic state
OR “flashback” phenomenon
2.03 with drug related injury Stage 1.01-2.02
AND injury during period of drug effect
DX 2922 + (DX E8541, E9396);
STAGE 1.01-2.01 + (DX 2920-
29212, 29281-2929);
STAGE 1.01-2.02 + GROUP INJURY;
Thursday, January 07, 2010 9:23:07 AM
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