Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: RES12
MultiStage: No
DXCat Label: Mycoplasma pneumoniae Infection Specificity: A
Etiology: Infection, Bacterial
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Mycoplasma pharyngitis or bullous Mycoplasma pneumonia titer increase 4 fold [microbiology/serology report]
DX 04181;
myringitis or otitis media or sinusitis
OR cold hemagglutinins > 1:32 [microbiology/serology report]
DX 04181 + (DX 4610-4619, 38200-
AND pharyngitis
38202, 3821-3829, 462, 38400-
OR bullous myringitis
38409);
OR otitis media
OR sinusitis [physical examination or sinus x-ray report]
OR air/fluid level in tympanic membrane
1.02 Mycoplasma bronchopneumonia Stage 1.01
AND new infiltrate [chest x-ray report]
2.01 with pleural effusion Stage 1.02
AND pleural effusion [chest x-ray report]
2.02 with polyarthritis Stage 1.01-2.01
AND polyarthritis
2.03 with hemolytic anemia Stage 1.01-2.02
AND hemolysis:
AND anemia:
2.04 with Guillain-Barre syndrome Stage 1.01-2.03
AND progressive monoparesis or paraparesis within 6 weeks of a viral infection
OR progressing paresthesia of lower extremities within 6 weeks of a viral infection
2.05 with Stevens-Johnson syndrome Stage 1.01-2.04
AND erythema multiforme involving the skin and mucosae
2.06 with cardiac arrhythmias Stage 1.01-2.05
AND arrhythmias:
3.01 with myocarditis or pericarditis Stage 1.01-2.05
AND myocarditis:
OR pericarditis:
3.02 with aseptic meningitis Stage 1.01-3.01
AND aseptic meningitis:
3.03 with respiratory failure Stage 2.01-3.02
AND respiratory failure:
3.04 with shock Stage 1.01-3.03
AND shock:
4.00 with death Stage 2.01-3.04
DX 4830;
STAGE 1.01-1.02 + DX 5118-5119;
STAGE 1.01-2.01 + (DX 71140-
71149, 71190-71199);
STAGE 1.01-2.02 + (DX 2820-
2821, 2823, 2827-2829 OR GROUP
ANEM_HEM_ACQ);
STAGE 1.01-2.03 + DX 3570;
STAGE 1.01-2.04 + DXCAT SKN02;
STAGE 1.01-2.05 + DXCAT CVS06;
STAGE 1.01-2.06 + (DX 4200,
42090-42099 OR GROUP
MYOCARDITIS);
STAGE 1.01-3.01 + GROUP
MENING__VIR;
STAGE 1.01-3.02 + GROUP
RESP_FAIL;
STAGE 1.01-3.03 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
Thursday, January 07, 2010 9:23:11 AM
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