Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: TRA05
MultiStage: No
DXCat Label: Burns, Chemical: Esophagus, Stomach, or Small Intestine Specificity: A
Etiology: Toxicologic
Stage Description Diagnostic findings ICD-9-CM Codes
1.01 Caustic esophagitis or gastritis or caustic
burn of small intestines
Mucosal erythema and edema [esophagoscopy report, upper endoscopy report or upper
gastrointestinal series report]
DX 9472, 9473;
2.01 with ulcerations Stage 1.01
AND ulcerations [esophagoscopy report, upper endoscopy report or
upper gastrointestinal series report]
2.02 with strictures Stage 1.01-2.01
AND strictures [esophagoscopy report, upper endoscopy report or
upper gastrointestinal series report]
2.03 with necrosis of muscle Stage 1.01-2.02
AND muscle necrosis [esophagoscopy report, upper endoscopy report or
upper gastrointestinal series report]
2.04 with perforation of esphasgus or stomach Stage 1.01-2.03
AND subcutaneous emphysema
OR free air in the peritoneal cavity [KUB x-ray or chest x-ray report]
OR perforation (UGI series reports spilling of contrast into the peritoneal cavity
or thoracic cavity)
OR bleeding:
2.05 with mediastinitis or mediastinal abscess Stage 1.01-2.04
AND mediastinitis [operative/pathology report]
OR mediastinal abscess [operative/pathology report or CT scan report]
2.06 with peritonitis or abscess Stage 1.01-2.05
AND peritonitis [operative/pathology report]
OR abscess [operative/pathology report]
STAGE 1.01 + (DX 33811, 5302,
53100-53131, 53200-53231, 53300-
53331, 53400-53431, 53500-
53501, 5354);
STAGE 1.01-2.02 + (DX 33821,
5376, 5303, 5373);
NO;
STAGE 1.01-2.02 + (DX 5301,
53082, 53541, 5780);
STAGE 1.01-2.04 + DX 5131;
STAGE 1.01-2.05 + (DX 33811,
33821, 5672-5679, 56983, 6143-
6146);
3.01 with sepsis Stage 1.01-2.05
AND sepsis:
3.02 with shock Stage 2.01-3.01
AND shock:
4.00 with death Stage 2.01-3.02
AND death
STAGE 1.01-2.06 + GROUP SEPSIS;
STAGE 1.01-3.01 + GROUP
SHOCKA;
NO;
Thursday, January 07, 2010 9:23:20 AM
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