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Unified Medical Language System® (UMLS®)

2014AA UMLS ICD-10-CM Source Information

This page lists UMLS Metathesaurus data elements and traces them back to the specific source data that populates them.

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

VSAB: ICD10CM_2014

Summary of Change

Plain text forms of UTF-8 strings are no longer created. 

Deprecated TTYs:
    MTH_AB
    MTH_ET
    MTH_HT
    MTH_PT

Deprecated REL/RELA
    SY|has_plain_text_form/plain_text_form_of

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.  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/ICD10/2014-ICD-10-CM-and-GEMs.html:

icd10cm_order_2014.txt
2014_I10gem.txt
2014_I9gem.txt
reimb_map_dx_2014.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_2014.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.
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_2014.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. 
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_2014.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.
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);  Most 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
ALT_SORT_CODE
Alternative sort code
CODE_ALSO
Instructs that 2 codes may be required to fully describe a condition but the sequencing of the two codes is discretionary, depending on the severity of the conditions and the reason for the encounter.
CODE_FIRST
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code.
MTH_CODE_FIRST Plain text version of "CODE_FIRST" attribute value.
EXCLUDES1
A pure excludes. It means "NOT CODED HERE!" Indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. Used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
MTH_EXCLUDES1
Plain text version of "EXCLUDES1" attribute value.
EXCLUDES2
Represents "Not included here". Indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When an Excludes2 note appears under a code it is acceptable to use both the code and the excluded code together.
MTH_EXCLUDES2
Plain text version of "EXCLUDES2" attribute value.
NOTE
Note
ORDER_NO
Order number (from icd10cm_order_2014.txt)
SOS
This data is added during Metathesaurus source processing
USE_ADDITIONAL
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/ manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
FROMRSAB
This data is added during Metathesaurus source processing
FROMVSAB
This data is added during Metathesaurus source processing
MAPSETRSAB
This data is added during Metathesaurus source processing
MAPSETVERSION
This data is added during Metathesaurus source processing
MAPSETVSAB
This data is added during Metathesaurus source processing
MAPSETXRTARGETID
This data is added during Metathesaurus source processing
MTH_MAPFROMCOMPLEXITY
This data is added during Metathesaurus source processing
MTH_MAPFROMEXHAUSTIVE
This data is added during Metathesaurus source processing
MTH_MAPSETCOMPLEXITY This data is added during Metathesaurus source processing
MTH_MAPTOCOMPLEXITY This data is added during Metathesaurus source processing
MTH_MAPTOEXHAUSTIVE This data is added during Metathesaurus source processing
TORSAB
This data is added during Metathesaurus source processing
TOVSAB
This data is added during Metathesaurus source processing



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
Connect short forms (TTY = "AB") to their preferred form (TTY = PT")

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. style="font-size: 22pt; font-family: Calibri; color: black;">
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