Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: RES02
MultiStage: No
DXCat Label: Asthma Specificity: A
Etiology: Idiopathic; Immune
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Asymptomatic bronchial asthma History of bronchial asthma
DX 49300, 49310, 49320, 49381-
OR history of paroxysms of wheezing or bronchoconstriction that resolve
with treatment
49382, 49390;
OR ≥ 15 % increase in forced expiratory volume in 1 second, FEV1,
following two puffs of a beta-adrenergic agonist
2.01 Mild intermittent bronchial asthma Stage 1.01
AND diffuse bilateral expiratory or inspiratory wheezing
AND peak expiratory flow rate or forced expiratory volume/min ≥ 80% predicted value
[PEFR report]
AND ≤ 2 days/week with asthma symptoms
2.02 Mild persistent bronchial asthma Stage 1.01
AND diffuse bilateral expiratory or inspiratory wheezing
AND peak expiratory flow rate or forced expiratory volume/min ≥ 80% predicted value
[PEFR report]
AND 3-6 days/week with asthma symptoms
2.03 Moderate persistent bronchial asthma Stage 1.01
AND diffuse bilateral expiratory or inspiratory wheezing
AND peak expiratory flow rate or forced expiratory volume/min ≤ 80% predicted value
[PEFR report]
AND peak expiratory flow rate or forced expiratory volume/min > 60% predicted value
[PEFR report]
OR daily asthma symptoms
3.01 Severe persistent bronchial asthma Stage 1.01
AND diffuse bilateral expiratory or inspiratory wheezing
AND peak expiratory flow rate or forced expiratory volume/min ≤ 60% predicted value
[PEFR report]
OR continuous asthma symptoms
3.02 Status asthmaticus or severe asthma Stage 2.01-3.01
AND hypoxemia:
AND peak expiratory flow rate or forced expiratory volume/min < 30% predicted value [PEFR
report]
OR PEFR < 100L/min [PEFR report]
OR status asthmaticus
3.03 with respiratory failure Stage 2.01-3.02
AND respiratory failure:
3.04 with shock Stage 1.01-3.03
AND shock:
DX 49302, 49312, 49322, 49392;
NO;
NO;
NO;
DX 49301, 49311, 49321, 49391;
STAGE 1.01-3.02 + GROUP
RESP_FAIL;
STAGE 1.01-3.03 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
Thursday, January 07, 2010 9:23:09 AM
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