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. 2015 Jul 4;8:293. doi: 10.1186/s13104-015-1185-x

Table 5.

Serious illnesses

Disease Definition
Cancer Diagnosis of cancer (except for non-melanoma skin cancers)
Selected antineoplastic agents
Hematologic diseases Sickle cell diagnosis, aplastic anemia
Neuromuscular diseases Cerebral palsy, muscular dystrophy, multiple sclerosis, ALS, quadriplegia, paraplegia, hemiplegia, spinal cord injury, stroke
Chromosomal anomalies Down’s syndrome, trisomy 13, trisomy 18, autosomal deletion syndrome and others
Other congenital anomalies-non cardiovascular Cystic fibrosis, anencephalus, spina bifida, hydrocephalus, microcephalus, encephalocele
Congenital anomalies-cardiovascular Common truncus, transposition great vessels, tetralogy of Fallot, common ventricle, endocardial cushion defect, pulmonary atresia, tricuspid atresia, hypoplastic left heart, coarctation of aorta, other anomalies of aorta, total anomalous pulmonary venous connection
Gastrointestinal diseases Ulcerative colitis, Crohn’s disease
Liver disease: acute and subacute necrosis of the liver, chronic liver disease and cirrhosis, hepatic encephalopathy, portal hypertension, hepatorenal syndrome, other sequelae of chronic liver disease, other disorders
Hospitalization for any other liver disease: abscess of the liver, portal pyemia, hepatopulmonary syndrome, other specified disorders of the liver
Acute or chronic pancreatitis
Mental retardation Moderate to profound intellectual disability
HIV and other serious infections Diagnosis of HIV
Use of antiretroviral agents appropriate for HIV or pentamidine
Hepatitis B and/or C
Treatment for viral hepatitis
Tuberculosis
Treatment for tuberculosis
Other immunologic conditions Immune deficiencies (deficiency of humoral immunity, deficiency of cell-mediated immunity, combined immunity deficiency, unspecified immunity deficiency)
Renal disease Diagnosis or procedure code for dialysis or end-stage renal disease outside of the hospital
Cardio-respiratory diseases Any diagnosis of primary pulmonary hypertension
Inpatient diagnosis of chronic respiratory failure, cardio-respiratory failure, or pulmonary heart disease
Tracheostomy (excluding temporary)
Organ transplant Includes kidney, heart, lung, liver, bone marrow, and pancreas
Medications: azathioprine, cyclosporine, tacrolimus (except derm preparation), mycophenolate mofetil, mycophenolate sodium, sirolimus, daclizumab, antithymocyte immune, bevacizumab, basiliximab, muromonab
Other serious illness Hospice care
Diagnosis of coma, vegetative state, debility, cachexia
Total parenteral nutrition/gastrostomy
Gangrene
Intravenous medications outside of the hospital
Severe metabolic disorders: disturbances of the amino-acid transport, disturbances of carbohydrate, mucopolysaccharidosis, other specified disorders of the metabolism