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2012AA International Classification of Diseases, 10th Edition, Clinical Modification Source Information




Skip to: Atoms, Attributes, Definitions, Relationships, Mappings

VSAB: ICD10CM_2012

Summary of Changes

General:  For consistency, plain ASCII text forms of atoms and attributes containing UTF-8 characters were created during Metathesaurus source processing.

New TTYs:  

  • AB (short description)
  • MTH_ET  (plain text version of entry term)
  • MTH_PT  (plain text version of preferred term)
  • MTH_HT  (plain text version of hierarchical term)

Deleted TTY:

  • DET

New REL/RELAs:

  • AB atoms are connected with SY/mth_expanded_form_of REL/RELA to the PT with the same code
  • MTH_atoms are connected with SY/plain_text_form_of REL/RELA to their non-MTH atom

New ATNs:

  • ORDER_NO (indicates the line order in icd10cm_order_2012.txt)
  • MTH_CODE_FIRST (plain text version of CODE_FIRST attribute)
  • MTH_EXCLUDES1 (plain text version of EXCLUDES1 attribute)
  • MTH_EXCLUDES2 (plain text version of EXCLUDES2 attribute)

Deleted ATNs:

  • CHAPTER_NOTE
  • MAPSETTYPE (deprecated mapping attribute)

Note:  Due to an error processing the "reimbursement" map set, ICD-10-CM codes with no mapping to ICD-9CM are misrepresented in MRMAP.RRF and MRSMAP.RRF.  This affects 669 lines in MRMAP.RRF and MRSMAP.RRF.

For example, in MRMAP.RRF, this line: 

C2936851|ICD10CM|||AT133799328||Z67.10||Z67.10|SDUI|||RQ|mapped_to|17285||NOD.X|SDUI|||||||||

Should be:

C2936851|ICD10CM|||AT133799328||Z67.10||Z67.10|SDUI|||XR||||||||||||||

In MRSMAP.RRF, this line:

C2936851|ICD10CM|AT133774791||T49.6X6D|SDUI|RQ|mapped_to|NOD.X|SDUI||

Should be:

C2936851|ICD10CM|AT133774791||T49.6X6D|SDUI|XR|||||

Source Provided Files:

The Metathesaurus uses files submitted in TREF (Terminology Representation and Exchange Format).  These files are produced by the National Center for Health Statistics (NCHS) for Metathesaurus processing, and are not currently available publicly.  TREF was developed by the NLM and is a subset of the Rich Release Format (RRF) – the format in which the UMLS Metathesaurus is released.  The following files are submitted for ICD10CM:

  • MRCONSO.TREF
  • MRDOC.TREF
  • MRREL.TREF
  • MRSAB.TREF
  • MRSAT.TREF

The TREF files align with the publically-available .pdf release of ICD10CM.  In addition, the following files were downloaded from When relevant, the origin of data from the NCHS .pdf file is noted in the tables below. 

In addition, the following files were downloaded from http://www.cms.gov/Medicare/Coding/ICD10/2012-ICD-10-CM-and-GEMs.html:

  • icd10cm_order_2012.txt
  • 2012_I10gem.txt
  • 2012_I9gem.txt
  • reimb_map_dx_2012.txt

Identifiers:

Identifiers are assigned as follows:

  • CODE: MRCONSO.TREF.DUI
  • SAUI: Not Applicable
  • SCUI: Not Applicable
  • SDUI: MRCONSO.TREF.DUI

Atoms (MRCONSO):

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Term Type Description
 Origin
AB
 Abbreviation (Short description)
 CODE = MRCONSO.TREF.TTY (field 5)
STR = MRCONSO.TREF.STR (field 2)
SDUI = MRCONSO.TREF.DUI (field 4)
SUPPRESS = "Y"
Note:  Also found in icd10cm_order_2012.txt (character positions 17-76)
ET Entry Term
 CODE = MRCONSO.TREF.TTY (field 5)
STR = MRCONSO.TREF.STR (field 2)
SDUI = MRCONSO.TREF.DUI (field 4)

Note:  In the NCHS tabluar .pdf file, ETs are listed directly below the preferred name of a code, with no tag.
MTH_ET

HT
 Hierarchical Term
 CODE = MRCONSO.TREF.TTY (field 5)
STR = MRCONSO.TREF.STR (field 2)
SDUI = MRCONSO.TREF.DUI (field 4)

Note:  In icd10cm_order_2012.txt, a value of "0" in character position 15 indicates that the code is a header and not valid for submission on a UB04;  the long description begins at character 78 and continues for up to 300 characters.  In the TREF version of the files, additional concepts have been added to create a complete representation of the hierarchy. 
MTH_HT

PT
 Preferred Term
 CODE = MRCONSO.TREF.TTY (field 5)
STR = MRCONSO.TREF.STR (field 2)
SDUI = MRCONSO.TREF.DUI (field 4)

Note:  In icd10cm_order_2012.txt, a value of "1" in character position 15 indicates that the code is valid for submission on a UB04;  the long description begins at character 78 and continues for up to 300 characters.
MTH_PT

XM
 Cross Mapping Set
 This data is added during Metathesaurus source processing.

Attributes (MRSAT):

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Most attribute names are extracted from MRSAT.TREF.ATN (field 5);  Attribute values are extracted from MRSAT.TREF.ATV (field 5).  ATNs used in MRSAT align with the tags found in the NCHS tabular .pdf file.

Mapping attributes are added during Metathesaurus source processing.

ATN Description Origin
ALT_SORT_CODE

CODE_ALSO

CODE_FIRST

MTH_CODE_FIRST

EXCLUDES1

MTH_EXCLUDES1

EXCLUDES2

MTH_EXCLUDES2

NOTE

ORDER_NO

SOS

USE_ADDITIONAL

FROMRSAB

FROMVSAB

MAPSETRSAB

MAPSETVERSION

MAPSETVSAB

MAPSETXRTARGETID

MTH_MAPFROMCOMPLEXITY

MTH_MAPFROMEXHAUSTIVE

MTH_MAPSETCOMPLEXITY

MTH_MAPTOCOMPLEXITY

MTH_MAPTOEXHAUSTIVE

TORSAB

TOVSAB


Definitions (MRDEF):

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There are no DEFINITIONs for ICD10CM.


Relationships (MRREL):

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REL RELA
Inverse RELA		 Origin
CHD
PAR
 (no rela) Hierarchy created from MRREL.TREF.REL (field 4) = "PAR"
SIB relationships are computed during Metathesaurus production
RQ (no rela)
Connect Entry Terms (TTY = "ET") to their preferred form (TTY = "PT" or TTY = "HT")
SY
 expanded_form_of
has_expanded_form
SY
 mth_plain_text_form_of
mth_has_plain_text_form

Mappings (MRMAP):

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Three Mapsets ("XM" atoms, along with associated attributes and mappings), are included for ICD-10-CM. These are extracted from the General Equivalence Mappings (GEMs) and reimbursement mappings.

Note:  The original mapping files do not include decimal points for the ICD-9-CM and ICD-10-CM codes.  For clarity, decimals are added appropriately to the MRMAP.RRF representation, e.g. "A021" is converted to "A02.1" for use as a FROMID or TOID.

Field Origin (GEMs)
 Origin (Reiumbursement mappings)
MAPSUBSETID
 Compound value of "Scenario:Choice"
Note: Anything with the same FROMEXPR and MAPSUBSETID values should be "OR'd" together. 		Not populated
REL
 RO where approximate flag = "1"
SY where approxmiate flag = "0"
XR where target value = "NoDx"
 RQ
RELA
 approximately_mapped_to where approximate flag = "1"
mapped_to where approxmiate flag = "0"
null (empty) where target value = "NoDX" or "NODX"
 mapped_to
TOTYPE
 SDUI
 SDUI