Extended criteria (experimental).
This is the broader ten-condition engine, kept as a secondary area. It shows ICD-10-CM codes and illustrative grouping effects
for CDI staff. The primary surface is Before you sign (kidney, measurement only).
All extended pages.
Rules: published criteria as versioned data
Each rule is a YAML file in apps/exactdx/rules/, evaluated by a small safe expression language (no eval). Every rule names its
published source and an ICD-10-CM specificity ladder. Where a source requires judgement, or definitions are contested, the rule returns
"clinical judgement required" instead of a conclusion. Code tables: CMS FY2026 IPPS final rule (CMS-1833-F): Tables 5, 6I, 6J, 6K.
| Rule | Version | Published source | Ladder | Notes |
|---|---|---|---|---|
| Acute kidney injury (KDIGO staging) | 2026.11-1 | KDIGO Clinical Practice Guideline for Acute Kidney Injury (Kidney Int Suppl 2012;2:19-36) (2012), Recommendations 2.1.1 (definition) and 2.1.2 (staging), Table 2 · link | N28.9 → N17.9 | |
| Acute blood loss anaemia | 2026.11-1 | WHO guideline on haemoglobin cutoffs to define anaemia in individuals and populations (2024), Adult cut-offs: men <13 g/dL, non-pregnant women <12 g/dL (unchanged from 2011) · link
Also: ISTH definition of major bleeding in non-surgical patients (Schulman and Kearon, J Thromb Haemost 2005;3:692-694) (2005) |
D64.9 → D62 | contested / local convention |
| Chronic kidney disease stage (eGFR, CKD-EPI 2021) | 2026.11-1 | KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (2024), Chapter 1, Table 1 (definition: abnormality for a minimum of 3 months) and Table 2 (GFR categories) · link
Also: National Kidney Foundation: CKD-EPI Creatinine Equation (2021) (2021) |
N18.9 → N18.30 → N18.31 → N18.32 → N18.4 → N18.5 | |
| Heart failure type (LVEF) and acuity | 2026.11-1 | Universal Definition and Classification of Heart Failure (HFSA/HFA/JHFS, 2021), as restated in Chandramouli et al., Clin Cardiol 2022 (2021), LVEF classification: HFrEF <=40%, HFmrEF 41-49%, HFpEF >=50%; HFimpEF = baseline <=40%, rise >=10 points, second LVEF >40% · link
Also: 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (2021) Also: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure (2022) |
I50.9 → I50.20 → I50.30 → I50.22 → I50.21 → I50.23 → I50.32 → I50.31 → I50.33 | contested / local convention
never prompts for an undocumented diagnosis |
| Hyponatraemia | 2026.11-1 | Clinical practice guideline on diagnosis and treatment of hyponatraemia (Spasovski et al., Eur J Endocrinol 2014;170:G1-G47) (2014), Classification by biochemical severity: mild 130-135, moderate 125-129, profound <125 mmol/L · link | E87.1 | |
| Malnutrition severity (ASPEN/Academy 2012 consensus characteristics) | 2026.11-1 | Consensus statement: Academy of Nutrition and Dietetics and ASPEN: characteristics recommended for the identification and documentation of adult malnutrition (White JV et al., J Acad Nutr Diet 2012;112:730-738) (2012), Table: clinical characteristics; at least two of six characteristics; acute illness and chronic illness contexts · link
Also: GLIM criteria for the diagnosis of malnutrition (Cederholm et al., Clin Nutr 2019) (2019) |
E46 → E44.0 → E43 | contested / local convention |
| Obesity class from BMI | 2026.11-1 | CDC: Adult BMI Categories (2024), Class 1: 30 to <35; class 2: 35 to <40; class 3: 40 or higher (adults aged 20 and over) · link | E66.9 → E66.01 → E66.811 → E66.812 → E66.813 | |
| Pressure injury stage (sacral region) | 2026.11-1 | NPIAP Pressure Injury Stages (revised staging system) (2016), Stage 1-4, unstageable, deep tissue pressure injury definitions · link
Also: ICD-10-CM Official Guidelines for Coding and Reporting FY2027 (2026) |
L89.159 → L89.151 → L89.152 → L89.153 → L89.154 → L89.150 → L89.156 | |
| Acute hypoxic respiratory failure | 2026.11-1 | Merck Manual Professional Version: Acute Hypoxemic Respiratory Failure (AHRF), including ARDS (2026), Definition/evaluation: PaO2 <60 mmHg, PaO2/FiO2 <300, or SpO2 <88%, with dyspnea and tachypnea · link
Also: Caring for patients in respiratory failure (Am Nurse J 2014): SpO2 <91% on room air, PaCO2 >50 with pH <7.35 (2014) |
R09.02 → J96.00 → J96.01 → J96.21 | contested / local convention |
| Sepsis (clinical validation; Sepsis-3 and Sepsis-2 shown side by side) | 2026.11-1 | The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), Singer et al., JAMA 2016;315:801-810 (2016), Boxes 3-4: sepsis = infection + acute change in total SOFA >=2 (baseline 0 unless known); septic shock = vasopressors for MAP >=65 and lactate >2 mmol/L despite adequate volume · link
Also: Sepsis-2 / 1991-2001 consensus (SIRS), as restated in Sepsis-3 Box 1 (2001) Also: CMS SEP-1 measure (v5.17a): severe sepsis = infection + >=2 SIRS criteria + organ dysfunction within 6 hours (2025) |
A41.9 → R65.20 → R65.21 | contested / local convention
never prompts for an undocumented diagnosis |