Table 4.
Codes and algorithms to identify diabetes complication severity index (DCSI) developed by Young et al. and modified by Chang et al.
| Complications | ICD-9-CM code | DCSI score |
|---|---|---|
| Retinopathy | ||
| Diabetic ophthalmologic disease | 250.5x | 1 |
| Background retinopathy | 362.01 | 1 |
| Other retinopathies | 362.1 | 1 |
| Retinal edema | 362.83 | 1 |
| CSME | 362.53 | 1 |
| Other retinal disorders | 362.81, 362.82 | 1 |
| Proliferative retinopathy | 362.02 | 2 |
| Retinal detachment | 361.xx | 2 |
| Blindness | 369.xx.00–0.99 | 2 |
| Vitreous hemorrhage | 379.23 | 2 |
|
| ||
| Nephropathy | ||
| Diabetic nephropathy | 250.4 | 1 |
| Acute glomerulonephritis | 580 | 1 |
| Nephrotic syndrome | 581 | 1 |
| Hypertension, nephrosis | 581.81 | 1 |
| Chronic glomerulonephritis | 582 | 1 |
| Nephritis/nephropathy | 583 | 1 |
| Chronic renal failure | 585 | |
| Renal failure NOS | 586 | |
| Renal insufficiency | 593.9 | |
|
| ||
| Neuropathy | ||
| Diabetic nephropathy | 356.9, 250.6 | 1 |
| Amyotrophy | 358.1 | 1 |
| Cranial nerve palsy | 951.0, 951.1, 951.3 | 1 |
| Mononeuropathy | 354.0–355.9 | 1 |
| Charcot's arthropathy | 713.5 | 1 |
| Polyneuropathy | 357.2 | 1 |
|
| ||
| Cerebrovascular | ||
| TIA | 435 | 1 |
| Stroke | 431, 433, 434, 436 | 2 |
|
| ||
| Cardiovascular | ||
| Atherosclerosis | 440.xx | 1 |
| Other IHD | 411 | 1 |
| Angina pectoris | 413 | 1 |
| Other chronic IHD | 414 | 1 |
| Myocardial infarction | 410 | 2 |
| Ventricular fibrillation, arrest | 427.1, 427.3 | 2 |
| Atrial fibrillation, arrest | 427.4, 427.5 | 2 |
| Other ASCVD | 429.2 | 1 |
| Old myocardial infarction | 412 | 2 |
| Heart failure | 428 | 2 |
| Atherosclerosis, severe | 440.23, 440.24 | 2 |
| Aortic aneurysm/dissection | 441 | 2 |
|
| ||
| Peripheral vascular disease | ||
| Diabetic PVD | 250.7 | 1 |
| Other aneurysms, LE | 442.3 | 1 |
| PVD | 443.81, 443.9 | 1 |
| Foot wound + complication | 892.1 | 1 |
| Claudication, intermittent | 443.9 | 1 |
| Embolism/thrombosis (LE) | 444.22 | 2 |
| Gangrene | 785.4 | 2 |
| Gas gangrene | 0.4 | 2 |
| Ulcer of lower limbs | 707.1 | 2 |
|
| ||
| Metabolic | ||
| Ketoacidosis | 250.1 | 2 |
| Hyperosmolar | 250.2 | 2 |
| Other comas | 250.3 | 1 |
Note: the table is adapted from the previous algorithm defined by Young et al. and modified by Change et al. to identify the severity of diabetes using claims database. Severity index was based on a scale ranging from 0 to 2 for each complication as follows: 0 = no abnormality, 1 = some abnormality, and 2 = severe abnormality.
ASCVD, atherosclerotic cardiovascular disease; CSME, cystoid macular edema/degeneration; DCSI, diabetes complications severity index; IHD, ischemic heart disease; ICD-9-CM, international classification of diseases, ninth revision, clinical modification; LE, lower extremity; NOS, not otherwise specified; PVD, peripheral vascular disease; TIA, transient ischemic attack.