Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: RES05
MultiStage: No
DXCat Label: Chronic Obstructive Pulmonary Disease Specificity: B
Etiology: Toxicologic; Genetic (or hereditary)
Stage Description Diagnostic findings ICD-9-CM Codes
1.01
1.02
Chronic bronchitis
Acute exacerbation of chronic bronchitis
History of a recurrent productive cough occurring for a minimum of three months during a year for
two successive years
Stage 1.01
DX 4910-49120, 4918-4919;
DX 49121-49122;
AND history of malaise
STAGE 1.01 + (DX 485-486 OR
OR history of chills
GROUP FEVER) ;
OR history of myalgia
DX 49121-49122 + (DX 485-486
OR history of sore throat
OR GROUP FEVER);
OR fever
AND productive or nonproductive cough
AND rhonchi
AND no rales
OR no lung parenchymal infiltrates (chest x-ray documents no infiltrate)
2.01 Chronic obstructive pulmonary disease, mildForced expiratory ventilation in 1 second (FEV1) < 75% of predicted value [pulmonary function tests]
AND maximal voluntary ventilation (MVV) < 80% of predicted value [pulmonary function tests]
AND residual volume (RV) > 120% of predicted value [pulmonary function tests]
2.02 Chronic obstructive pulmonary disease, Forced expiratory ventilation in 1 second (FEV1) < 60% of predicted value [pulmonary function tests]
moderate
AND maximal voluntary ventilation (MVV) < 65% of predicted value [pulmonary function tests]
AND residual volume (RV) > 150% of predicted value [pulmonary function tests]
2.03 Chronic obstructive pulmonary disease, Forced expiratory ventilation in 1 second (FEV1) < 40% of predicted value [pulmonary function tests
severe
AND maximal voluntary ventilation (MVV) < 45% of predicted value [pulmonary function tests
AND residual volume (RV) > 200% of predicted value [pulmonary function tests
3.01 Chronic obstructive pulmonary disease
with pulmonary hypertension
3.02 Chronic obstructive pulmonary disease
with cor pulmonale
3.03 Chronic obstructive pulmonary disease
with acute respiratory failure
3.04 with shock Stage 2.01-3.03
AND shock:
4.00 with death Stage 2.01-3.04
AND death
Stage 2.01-2.03
AND peak systolic pulmonary artery pressure > 30 mmHg [pulmonary artery catheter report]
Stage 2.01-3.01
AND cor pulmonale:
Stage 2.01-3.02
AND respiratory failure:
DX 496;
NO;
NO;
STAGE 1.01-2.01 + (DX 4160,
4168);
STAGE 1.01-3.01 + GROUP
COR_PULMONAL;
STAGE 1.01-3.02 + GROUP
RESP_FAIL;
STAGE 1.01-3.03 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
Thursday, January 07, 2010 9:23:09 AM
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