Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: END01
MultiStage: No
DXCat Label: Adrenal Insufficiency Specificity: A
Etiology: Metabolic
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Primary adrenal insufficiency or Addison's Hyperpigmentation
DX 2554-25542, 2555;
disease
OR serum ACTH ≥ 120 pg/ml at 9 a.m. [chemistry report]
OR serum ACTH ≥ 35 pg/ml at midnight [chemistry report]
OR serum a.m. cortisol ≤ 4 mg/dl [chemistry report]
AND positive cosyntropin stimulation test:
at ≥ 60 minute post infusion, serum cortisol is ≤ 2 times
baseline serum cortisol level [chemistry report]
OR positive ACTH stimulation test: at ≥ 60 minute post infusion,
serum cortisol ≤ 18 mg/dl [chemistry report]
1.02 Secondary adrenal insufficiency Serum ACTH < 35 pg/ml [chemistry report]
AND serum a.m. cortisol ≤ 4 mg/dl [chemistry report]
AND positive cosyntropin stimulation test: at ≥ 60 minute
post infusion, serum cortisol is ≤ 2 times baseline
serum cortisol level [chemistry report]
2.01 with hyponatremia or hyperkalemia or
hypochloremia
Stage 1.01
AND hyponatremia:
OR hyperkalemia:
OR hypochloremia:
3.01 Addisonian crisis Stage 1.01-2.01
AND hypotension:
AND generalized weakness
3.02 with renal failure Stage 2.01-3.01
AND renal failure:
4.00 with death Stage 2.1-3.3
AND death
References:
NO;
STAGE 1.01 + (GROUP
HYPONATREMIA OR GROUP
HYPER_KALEM OR GROUP
HYPOCHLOREM);
STAGE 1.01-2.01 + DX 78079 +
GROUP HYPOTENSION;
STAGE 1.01-3.01 + GROUP
REN_FAIL_ACU;
Fitzgerald PA. Adrenocortical hypofunction. In: Tierney Jr LM, McPhee SJ Papadakis MA, eds. Current Medical Diagnosis & Treatment. Stamford, CT: Appleton & Lange;
1998:1072-1075.
White PC. Disorders of aldosterone biosynthesis and action. N Engl J Med. 1994;331(4):250-258.
Williams GH, Dluhy RG. Diseases of the adrenal cortex. 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: 2035-2057.
NO;
Thursday, January 07, 2010 9:21:23 AM
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