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Unified Medical Language System® (UMLS®)

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




Skip to: Notes, Summary of Changes, Summary of Source-Provided Files, Source-Provided File Details

Notes

  • 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 publically.  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. 
  • Additional files and documentation are downloaded from http://www.cms.gov/Medicare/Coding/ICD10/2012-ICD-10-CM-and-GEMs.html.
  • 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|||||

Summary of Changes:

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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)

Source-Provided Files: Summary

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The following are files used for Metathesaurus source processing.

Documentation and Reference

File Name Description
GemsTechDoc.pdf
GEMs guide for technical users
Dxgem_guide_2012.pdf Diagnosis Code Set General Equivalence Mappings Documentation and User's Guide
Gems2012UpdateSummary.pdf
GEMs update summary
reimb_map_guide_2012.pdf ICD-10-CM/PCS to ICD-9-CM Reimbursement Mappings Documentation and User's Guide
ICD10OrderFiles.pdf
Documentation for icd10cm_order_2012.txt

Data Files

File Name Description
MRCONSO.TREF Concepts, atoms and descriptors
MRDOC.TREF Documentation for abbreviated values
MRREL.TREF Relationships
MRSAB.TREF Source metadata
MRSAT.TREF Attributes
icd10cm_order_2012.txt Code descriptions in Tabular Order
2012_I10gem.txt ICD-10-CM to ICD-9-CM General Equivalence Mappings (GEMs)
2012_I9gem.txt ICD-9-CM to ICD-10-CM General Equivalence Mappings (GEMs)
reimb_map_dx_2012.txt ICD-10-CM to ICD-9-CM reimbursement mappings

Not included: All information from the ICD-10-CM TREF data files and from the mapping files is included in the UMLS representation.

Certain fields and files may not be directly processed because they contain redundant data.

Source-Provided Files: Details

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Details on format of input files and representation of source data.

file:MRCONSO.TREF

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# Field Name Description Representation
1
AUI
Atom Unique Identifier
not populated
2
STR
Name associated with an atom
MRCONSO.RRF.STR
3
CUI
Concept Unique Identifier
not populated
4
DUI
Descriptor Unique Identifier
MRCONSO.RRF.CODE, MRCONSO.RRF.SDUI
5
TTY
Term Type
MRCONSO.RRF.TTY

file:MRDOC.TREF

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File not directly used

file:MRREL.TREF

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# Field Name Description Representation
1
RUI
Relationship Unique Identifier
not populated
2
UI1
Unique Identifier of the first element
MRREL.RRF.UI1
3
STYPE1
Name of the column in MRCONSO.TREF that contains the identifier used for the first element
MRREL.RRF.STYPE1
4
REL
Relationship
Always "PAR"; used to create the hierarchy in MRHIER.RRF and PAR/CHD/SIB relationships in MRREL.RRF
5
RELA
Relationships attribute
not populated
6
UI2
Unique Identifier of the second element
MRREL.RRF.UI2
7
STYPE2
Name of the column in MRCONSO.TREF that contains the identifier used for the second element MRREL.RRF.STYPE2

file:MRSAB.TREF

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Not directly used


file:MRSAT.TREF

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# Field Name Description Representation
1
ATUI
Attribute Unique Identifier
not populated
2
UI
Unique Identifier of the thing to which the attribute is attached
MRSAT.RRF.UI
3
STYPE
Type of identifier used in the UI field MRSAT.RRF.STYPE
4
ATN
Attribute name
MRSAT.RRF.ATN for attributes other than DEFINITION
5
ATV
Attribute value
MRSAT.RRF.ATV for attributes other than DEFINITION
MRDEF.DEF for DEFINITIONS


file: icd10cm_order_2012.txt

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Character
Position
Length Description Representation
1
5
Order number, right justified, zero filled.
MRSAT.ATN = ORDER_NO
6
1
Blank
N/A
7
7
ICD-10-CM or ICD-10-PCS code. Dots are not included.
Not directly processed (extracted from MRCONSO.RRF)
14
1
Blank
N/A
15
1
0 if the code is a “header” – not valid for submission on a UB04.
1 if the code is valid for submission on a UB04.
Not directly processed (extracted from MRCONSO.RRF;  determines TTY:  "0" for HT; "1" for "PT"
16
1
Blank
N/A
17
60
Short description
Not directly processed (extracted from MRCONSO.RRF;  TTY = AB)
77
1
Blank
N/A
78
Up to
300
Long description
Not directly processed (extracted from MRCONSO.RRF;  TTY = PT or TTY = HT)


file: 2012_I10gem.txt

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Field
Length
Begin
End
Representation
ICD-10-CM Code (source)
7
1
7
MRMAP.RRF.FROMID
MRMAP.RRF.FROMEXPR
Decimal point added as appropriate
filler
1
8
8
not used
ICD-9-CM Code (target)
5
9
13
MRMAP.RRF.TOID
MRMAP.RRF.TOEXPR
Decimal point added as appropriate
filler
1
14
14
not used
Approximate flag
1
15
15
Value of 1 (indicates the entry is not equivalent):
MRMAP.RRF.REL=RO
MRMAP.REL.RELA=approximately_mapped_to

Value of 0: 
MRMAP.RRF.REL=SY
MRMAP.RRF.RELA=mapped_to
No map flag
1
16
16
Value of 1:
MRMAP.RRF.REL=XR
Combination flag
1
17
17
Value of "1" indicates that more than one code is required.  This is implied in MRMAP.RRF by non-zero values in MAPSUBSETID.
Scenario
1
18
18
MRMAP.RRF.MAPSUBSETID (first subfield, before the ":")
Anything with the same FROMEXPR and MAPSUBSETID values should be "OR'd" together
Choice list
1
19
19
MRMAP.RRF.MAPSUBSETID (second subfield, after the ":")
Anything with the same FROMEXPR and MAPSUBSETID values should be "OR'd" together

file: 2012_I9gem.txt

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Field
Length Begin
End
Representation
ICD-9-CM Code (source)
5
1
5
MRMAP.RRF.FROMID
MRMAP.RRF.FROMEXPR
Decimal point added as appropriate
filler
1
6
6
not used
ICD-10-CM code (target)
7
7
13
MRMAP.RRF.TOID
MRMAP.RRF.TOEXPR
Decimal point added as appropriate
filler
1
14
14
not used
Approximate flag
1
15
15
Value of 1 (indicates the entry is not equivalent):
MRMAP.RRF.REL=RO
MRMAP.REL.RELA=approximately_mapped_to

Value of 0: 
MRMAP.RRF.REL=SY
MRMAP.RRF.RELA=mapped_to
No map flag
1
16
16
Value of 1:
MRMAP.RRF.REL=XR
Combination flag
1
17
17
Value of "1" indicates that more than one code is required.  This is implied in MRMAP.RRF by non-zero values in MAPSUBSETID.
Scenario
1
18
18
MRMAP.RRF.MAPSUBSETID (first subfield, before the ":")
Anything with the same FROMEXPR and MAPSUBSETID values should be "OR'd" together
Choice
1
19
19
MRMAP.RRF.MAPSUBSETID (second subfield, after the ":")
Anything with the same FROMEXPR and MAPSUBSETID values should be "OR'd" together


file: reimb_map_dx_2012.txt

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Field Name Length Begin
End
Representation
ICD-10-CM Code
8
1
8
MRMAP.RRF.FROMID
MRMAP.RRF.FROMEXPR
Decimal point added as appropriate
Number of ICD-9-CM mapped to
1
9
9
not used
1st ICD-9-CM code mapped to
6
10
15
Used in MRMAP.RRF.TOEXPR; if multiple ICD-9-CM codes are included, they are concatenated with "AND"
2nd ICD-9-CM code mapped to 6
16
21
Used in MRMAP.RRF.TOEXPR; if multiple ICD-9-CM codes are included, they are concatenated with "AND"
3rd ICD-9-CM code mapped to 6
22
27
Used in MRMAP.RRF.TOEXPR; if multiple ICD-9-CM codes are included, they are concatenated with "AND"
4th ICD-9-CM code mapped to 6
28
33
Used in MRMAP.RRF.TOEXPR; if multiple ICD-9-CM codes are included, they are concatenated with "AND"
5th ICD-9-CM code mapped to 6
34
39
Used in MRMAP.RRF.TOEXPR; if multiple ICD-9-CM codes are included, they are concatenated with "AND"