Malignancy ; 191.6; Malignant neoplasm of brain

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1 APPENDIX 15 Comparison of ICD-9 Diagnostic Codes Used to Identify Children with Life-Threatening or Life-Limiting or Comple Chronic Conditions By Five CHI PACC Programs ICD-9 Category ICD-9 Description and Chris Feudtner (July 6, 2004) ICD-9 Diagnosis Codes Infectious Human Immunodeficiency virus (HIV) disease Neoplasms/malignancy Malignant neoplasm of digestive organs & peritoneum Malignant neoplasm of colon Malignant neoplasm of liver and intrahebatic bile ducts Malignant neoplasm of pancreas Malignant neoplasm of retroperitoneum and perioteneum Malignant neoplasm other & ill defined sites in digestive orgs Malignant neoplasm of trachea, bronchus, and lung Malignant neoplasm of thymus, heart and mediastinum Malignant neoplasm of other & ill defined sites in respiratory Malignant neoplasm of bone and articular cartilage Malignant neoplasm of connective and other soft tissue Malignant neoplasm of testis Malignant neoplasm of kidney & other unspecified urinary organs Neoplasms Malignant neoplasm of eye Malignancy 191.0; 191.6; Malignant neoplasm of brain ; Malignant neoplasm other & unspecified parts of nervous sy ; Malignant neoplasm of thyroid gland 193 Malignant neoplasm other endocrine glands & related struct ; Malignant neoplasm of other ill-defined sites Malignant neoplasm without specification of site Endocrine Metabolic Malignant neoplasm of lympathic & hematopoietic tissue ; 202.8; 204.0; 205.0; 205.1; 208.0; Hemangioma and lymphangioma, any site Neoplasms of brain and spinal cord ; 237.7; Neoplasms of unspecified nature 239.6; Diabetes melitus ; Dwarfism/bone & joint anamolies Amino acid metabolism ; Carbohydrate metabolism

2 Endocrine Metabolic Blood Hematology & Immunodeficency Nervous Neuromuscular Circulatory Cardiovascular Lipid metabolism Lipidoses Disorders of mineral metabolism Cystic fibrosis Other metabolic disorders Mucopolysacchardidosis., etc ; Hereditary immunodeficiency Deficiency of cell-mediated immunity ; Combined immunity deficiency Unspecified immunity deficiency Hereditary anemias ; Sickle-cell anemia Aplastic anemia Coagulation defects ; 286.6; Hereditary immunodeficiency (diseases of white blood cells) Mental retardation Central nervous system degeneration & disease ; 330.1; 330.8; 331.4; Other cerebral degenerations Anterior horn cell disease ; Infantile cerebral palsy - Quadriplegic Infantile cerebral palsy - unspecified Epilepsy Other unspecified conditions of nervous system ; ; 348.8; 348.9; Muscular dystrophies & brain myopathies Unspecified hypertensive heart disease Acute myocaredial infarction 410 Cornary atherosclerosis Chronic ischemic heart disease, NOS Chronic pulmonary hypertension Chronic pulmonary heart disease Cardiomyopathy ; 425.4;

3 Circulatory Cardiovascular Respiratory Digestive Genitourinary Congenital Conduction disorders ; 426.8; Dysrhythmias Congestive heart disease Myocarditis, unspecified ; 429.1; 429.3; Intracerebral Hemorrhage 431 Cerebvrovascular (acute) 436 Unspecified cardiovascular disease/lesion General and unspecified artherosclerosis Acute febrile mucocutaneous lymph node syndrome Asthma Chronic airway obstruction, not elsewhere classified 496 Chronic respiratory failure Other diseases of the respiratory system Diaphragmatic hernia Inflammatory bowel disease Chronic liver disease and cirrhosis Acute renal failure 571.5; Chronic renal failure Renal failure unspecified Curvature of spine Brain& spinal cord malformations Anencephalus Spina bifida Other congenital anomalies of nervous system ; 740.2; 741.0; 741.9; ; 742.8; Heart & great vessel malformations 745.1; ; 745.5; Bulbus cordis anomalies & cardiac septal closure Other congenital anomalies of the heart Hypoplastic left heart syndrome Other specified anamolies of the heart ; Other congenital anomalies of the circulatory system ; ; 748.5; Respiratory malformations Other congenital anomalies respiratory sys Congenital anamolies - gastrointestinal

4 Congenital Perinatal Injury & Poisoning Other congenital anomalies digestive sys Congenital anamolies - gastrointestinal Congenital anamolies -renal Congenital anomalies of urinary system ; Congenital muscuskeletal ; 756.1; Osteogenesis imperfecta Anomalies of diaphragm Anomalies of abdominal wall Down's syndrome / chromosomal anomalies Patau's syndrome Edward's syndrome [and other chromosomal abnormalities] ; 753.3; 758.5; Multiple congenital anomalies, Other specified anamolies Fragile X Syndrome Congenital anomaly, unspecified Other maternal specified conditions affecting fetus/newborn Fetus/newborn affected by maternal complications of pregnancy Etreme immaturity Other preterm infants Birth asphyiation Respiratory distress syndrome in newborn Chronic respiratory disease arising in perinatal period Other infections specific to the perinatal period NEC and intestinal perforation Asphyiation & strangulation Child maltreatment syndrome Shaken infant syndrome Complications of transplanted bone marrow Eternal Injury Accidental drowning or submersion E910 Codes in bold for Utah and Florida indicate that in addition to diagnosis, other factors such as hospitalization or utilization of other services, co-morbidity, etc.are required to identify the child as having a life-threatening condition. Sources: FEUDTNER, Chris, et.al, "Deaths Attributed to Pediatric Comple Chronic Conditions: National Trends and Implications for Supportive Care Services. Pediatrics,Vol.107 No 6, June 2001, p107. UTAH - "State of Utah Application for a Section 1115 Research and Demonstration Program Promoting HOPE for Utah Children, A CHI PACC Project," February 12,

5 NEW YORK - Milliman, USA, Inc., New York, N.Y., Kate Fitch, Bruce Pyenson. "Palliative Care for Children with Life Limiting Illness: An Actuarial Evalation of Costs for a New York State Medicaid Demonstration Project," June 10, KENTUCKY - "PACC Diagnosis Codes for Potential Program Candidates," PACC Diagnosis Severity Inde January FLORIDA - Partners in Care -Agency for Health Care Administration, Florida Department of Health, Florida Hospice and Palliative Care, Inc., "An 1115 Waiver Request, Program for All-Inclusive Care for Children, Florida, "October 24, VIRGINIA - From "ICD-9 Diagnosess that Will Define the VAPACC Target Population." From a list of child deaths in Virginia between in order of frequency, this chart includes only those diagnoses with at least 2 deaths occuring during the 6-year period. 15-5

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