Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: RES21
MultiStage: No
DXCat Label: Pulmonary Embolism Specificity: B
Etiology: Genetic (or hereditary); Metabolic; Trauma
Stage Description Diagnostic findings ICD-9-CM Codes
3.01 Pulmonary embolism Pulmonary embolism [high probability nuclear ventilation/perfusion scan or pulmonary angiogram
report]
DX 41511-41512, 41519, 4162;
Presumptive Diagnostic Findings:
Low to moderate probability pulmonary embolism [nuclear ventilation/perfusion scan ]
AND plasma D-dimer enzyme-linked immunosorbent assay (ELISA) >500 ng/mL [chemistry
report]
AND right ventricular dyskinesia [echcardiogram report]
3.02 with pulmonary infarction Stage 3.01
AND pulmonary infarction [chest x-ray reports]
3.03 with right ventricular hypokinesia Stage 3.01-3.02
AND right ventricular hypokinesia [echocardiogram report]
3.04 with pulmonary hypertension Stage 3.01-3.03
AND pulmonary hypertension:
3.05 with cor pulmonale Stage 3.01-3.04
AND cor pulmonale:
3.06 with shock Stage 2.01-3.05
AND shock:
4.00 with death Stage 1.01-3.06
AND death
NO;
STAGE 3.01 + DX 4280;
STAGE 3.01-3.03 + (DX 4160,
4168);
STAGE 3.01-3.04 + (DX 4150,
4169);
STAGE 3.01-3.05 + GROUP
SHOCKA;
NO;
References:
Anonymous. Opinions regarding the diagnosis and management of venous thromboembolic disease. ACCP Consensus Committee on Pulmonary Embolism. American College of
Chest Physicians. Chest. 1998;113(2):499-504.
Goldhaber SZ. Pulmonary thromboembolism. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. Harrison's Principles of
Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:1469-1472.
Hirsh J, Hoak J. Management of deep vein thrombosis and pulmonary embolism. a statement for healthcare professionals. council on thrombosis. Circulation. 1996;93(12):2212-
45.
Stauffer JL. Lung. In: Tierney Jr LM, McPhee SJ, Papadakis MA, eds. Current Medical Diagnosis & Treatment. Stamford, CT: Appleton & Lange; 1998:251-333.
Stern RC. Pulmonary embolism and infarction. In: Behrman RE, Kliegman RM, Arvin AM, Nelson WE, eds. Nelson Textbook of Pediatrics. 15th ed. Philadelphia, PA: WB
Saunders; 1996:1230-31.
Thursday, January 07, 2010 9:23:13 AM
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