Disease staging: CliniCal anD CoDeD Criteria - HCUP

Clinical Criteria with Description, Diagnostic Findings and ICD-9-CM codes
DXCat Number: END05
MultiStage: Yes
DXCat Label: Diabetes Mellitus Type 2, Unspecified Types of Diabetes, and Hyperglycemic States Specificity: A
Etiology: Metabolic
Stage Description Diagnostic findings ICD-9-CM Codes
2.04 with vascular disease (peripheral, Stage 1.03-2.03
DX 25070, 25072, 24970, 24971;
cardiovascular, or cerebral)
OR diminished arterial circulation [Doppler report or angiography report]
STAGE 1.04-2.03 + (DX 43300,
OR foot ulcers
43310, 43320, 43330, 43380,
OR hypertension:
43390, 43400, 43410, 43490,
OR angina pectoris:
44381, 70714-70715, 4139 OR
OR cerebrovascular disease [angiography report or CT report or MRI report]
DXCAT CVS13) ;
(DX 25070, 25072, 24970, 24971)
+ (DX 43300, 43310, 43320,
43330, 43380, 43390, 43400,
43410, 43490, 44381, 70714-
70715, 4139 OR DXCAT CVS13);
2.05 with cellulitis Stage 1.04-2.04
AND cellulitis: area of redness, induration, tenderness and heat with indistinct borders
OR purulent skin effusion [skin culture reports sharing growth of pathologic
organisms]
STAGE 1.04-2.04 + (DX 37313,
37531, 38010-38016, 37601, 4572,
4781, 52800, 52809, 5283, 5285,
566, 6040, 6072, 6084, 6110, 6163-
6164, 68100-6829, 683, 69589);
2.06 with pyelonephritis Stage 1.03-2.05
AND pyelonephritis
2.07 with gangrenous infection Stage 1.03-2.06
AND gangrene [operative/pathology report]
2.08 with osteomyelitis Stage 1.03-2.07
AND osteomyelitis:
3.01 with renal failure Stage 1.03-2.08
AND renal failure:
3.02 with hyperosmolar state Stage 1.03-3.01
AND serum osmolality ≥ 305 mOsm/kg [chemistry report]
STAGE 1.04-2.05 + DX 59000-5909;
(DX 25060, 25062, 25070, 25072,
25080, 25082, 24960, 24961,
24970, 24971, 24980, 24981 ) +
DX 7854;
STAGE 1.04-2.07 + GROUP
OSTEOMYELIT;
STAGE 1.04-2.08 + (GROUP
REN_FAIL_ACU OR GROUP
REN_FAIL_CHR);
DX 25020, 25022, 24920, 24921;
Thursday, January 07, 2010 9:21:24 AM
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