Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: RES17
MultiStage: No
DXCat Label: Pneumonia: Legionella Specificity: A
Etiology: Infection, Bacterial
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Legionella pneumonia pneumonia:
DX 48284;
OR Legionella titer increase 4 fold ≥ 1:128 [microbiology/serology report]
OR Legionella by direct fluorescent antibody stain of exudate [ microbiology/serology report]
OR Legionella soluble urinary antigen [urine chemistry report]
OR Legionella by PCR DNA probe [molecular medicine or genetic analysis report]
1.02 with multiple lobe involvement Stage 1.01
NO;
AND multilobular infiltrate [chest x-ray report]
1.03 with atelectasis Stage 1.01-1.02
STAGE 1.01 + DX 5180;
AND atelectasis [chest x-ray report]
2.01 with diarrhea or hyponatremia Stage 1.01-1.03
STAGE 1.01-1.03 + (DX 00847,
AND diarrhea
0085, 0088, 0092, 0093, 78791 OR
OR hyponatremia:
GROUP HYPONATREMIA);
2.02 with empyema Stage 1.01-2.01
AND empyema [thoracentesis report or effusion culture reports growth of pathologic
organism(s)]
2.03 with lung abscess or cavitation Stage 1.01-2.02
AND lung abscess [operative/pathology report or CT scan report]
OR air/fluid level [chest x-ray report or CT scan report]]
2.04 with pericarditis Stage 1.01-2.02-03
AND pericarditis:
3.01 with endocarditis Stage 1.01-2.04
AND endocarditis:
3.02 with sepsis Stage 1.01-3.01
AND sepsis:
3.03 with acute respiratory failure Stage 1.01-3.02
AND respiratory failure:
3.04 with shock Stage 1.01-3.03
AND shock:
4.00 with death Stage 2.01-3.04
AND death
STAGE 1.01-2.01 + (DX 5100,
5109);
STAGE 1.01-2.02 + (DX 5130,
51889);
STAGE 1.01-2.03 + (DX 4200,
42090, 42091, 42099) ;
STAGE 1.01-2.04 + GROUP
ENDOCARDITIS;
STAGE 1.01-3.01 + GROUP SEPSIS;
STAGE 1.01-3.02 + GROUP
RESP_FAIL;
STAGE 1.01-3.03 + (GROUP
SHOCKC OR GROUP SHOCKN) ;
NO;
Thursday, January 07, 2010 9:23:13 AM
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