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Unified Medical Language System® (UMLS®)

2012AA ICD-10-PCS Source Information



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

VSAB: ICD10PCS_2012

Summary of Changes

The released file format has changed:

  • The "table" file is no longer released.  The table information is now released in xml.  The xml includes "definitions," which are explanations describing the 3rd character of the code.  The meaning of the 3rd character is dependent on the value of the 1st character, e.g. the meaning of "J" is different if the first character is "0," "1" or "G":
0WJ|Visually and/or manually exploring a body part 
0XJ|Visually and/or manually exploring a body part 
0YJ|Visually and/or manually exploring a body part 
10J|Visually and/or manually exploring a body part
GZJ|Application of specialized light treatments to improve functioning or well-being
  • Instead of a "long description" form, there is a file called "icd10pcs_order_2012.txt" which includes the long descriptions, codes, and also a short description, as well as an "order" field.  In addition to the 7-character codes, this file also contains 3-character codes.

The above format changes affect Metathesaurus source processing as follows:

New TTYs:

  • AB - Abbreviation (short form)
  • HS - Short form of hierarchical term
  • HX - Expanded form of 3-7 character codes.  These were previously HT
  • MTH_HX - Top two levels (previously MTH_HT) created by appending "procedure"

New ATNs:  

  • ADDED_MEANING - Additional descriptive information about a header term
  • ORDER_NO - Order number from the icd10pcs_*_order.txt file

New REL/RELAs:

  • SY/expanded_form_of  REL/RELAs connect additional TTYs:  AB --> PT -->PX, HS --> HT --> HX

Missing TTYs:

  • MTH_HT:  changed to MTH_HX

Changed TTYs:

  • As noted above, some things that were HT are now HX, and MTH_HT is now MTH_HX to create a TTY structure parallel to the PT/PX assignments. HT is now only used to represent the "long description" of the 3-character (header) codes.

Source Provided Files:

Numerous documentation and data files are available at:  http://www.cms.gov/Medicare/Coding/ICD10/2012-ICD-10-PCS.html, including the following:

Documentation and Reference

File Description
pcs_2012.pdf Tables indicating meaning for codes for specific character positions; index to codes
Gems2012UpdateSummary.pdf Summary of General Equivalence Mappings (GEMs) updates and public comment
GemsTechDoc.pdf
GEMs documentation for technical users
PCS_2012_guidelines.pdf PCS coding conventions and guidelines
pcs_gemguide_2012.pdf GEMs documentation and user guide
icd10pcs_tabular.xsd xml schema document describing xml format
pcs_whats_new_2012.pdf Summary of updates and changes for 2012
reimb_map_guide_2012.pdf Reimbursement mappings documentation and user guide
ICD10OrderFiles.pdf
Documentation for the icd10pcs_order_2012.txt file

Data files

Data
File Description
gem_i9pcs.txt ICD-9-CM to ICD-10-PCS General Equivalence Mappings (GEMs)
gem_pcsi9.txt ICD-10-PCS to ICD-9-CM GEMs
icd10pcs_order_2012.txt Long and short descriptions
reimb_map_pr_2012.txt ICD-10-CM to ICD-9-CM reimbursement mappings
icd10pcs_index_2012.xml
Table file in xml


Identifiers:

Identifiers are assigned as follows:
  • CODE: 3 or 7-digit code from icd10pcs_order_YYYY.txt, or assembled code from icd10pcs_index_YYYY.xml
  • SAUI:  Not applicable
  • SCUI:  3 or 7-digit code from icd10pcs_order_YYYY.txt, or assembled code from icd10pcs_index_YYYY.xml
  • SDUI: tag = Not applicable

Atoms (MRCONSO):

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Term Type Origin
AB
CODE: 7-digit code from icd10pcs_order_YYYY.txt (character positions 7-13)
STR: Short description from icd10pcs_order_YYYY.txt (character positions 6-76)
SCUI: 7-digit code from icd10pcs_order_YYYY.txt (character positions 7-13)
SUPPRESS = "Y"

Note:  AB atoms are created when character position 15 = "1", indicating that the code is valid for submission on a UB04
HS
CODE: 3-digit code from icd10pcs_order_YYYY.txt (character positions 7-13)
STR: Short description from icd10pcs_order_YYYY.txt (character positions 6-76)
SCUI: 3-digit code from icd10pcs_order_YYYY.txt (character positions 7-13)
SUPPRESS = "Y"

Note:  HS atoms are created when character position 15 = "0", indicating that the code is a "header" -- not valid for submission on a UB04
HT
CODE: 3-digit code from icd10pcs_order_YYYY.txt (character positions 7-13)
STR: Short description from icd10pcs_order_YYYY.txt (character positions 6-76)
SCUI: 3-digit code from icd10pcs_order_YYYY.txt (character positions 7-13)

Note:  HS atoms are created when character position 15 = "0", indicating that the code is a "header" -- not valid for submission on a UB04
HX
CODE:  assembled from values icd10pcs_index_YYYY.xml
STR:  assembled from values in icd10pcs_index_YYYY.xml, using "@" as a subfield separator
SCUI: assembled from values icd10pcs_index_YYYY.xml

TTY = "HX" atoms are created for levels 2-6
MTH_HX
CODE:  assembled from values icd10pcs_index_YYYY.xml
STR:  assembled from values in icd10pcs_index_YYYY.xml, using "@" as a subfield separator;  the string "(Therapy)" or "(Procedure)" is appended as appropriate
SCUI: assembled from values icd10pcs_index_YYYY.xml

TTY = "MTH_HT" atoms are created for levels 1-2
PT
CODE: 7-digit code from icd10pcs_order_YYYY.txt (character positions 7-13)
STR: Long description from icd10pcs_order_YYYY.txt (character positions 78 - end)
SCUI: 7-digit code from icd10pcs_order_YYYY.txt (character positions 7-13)
SUPPRESS = "Y"

Note:  PT atoms are created when character position 15 = "1", indicating that the code is valid for submission on a UB04
PX
CODE:  assembled from values icd10pcs_index_YYYY.xml
STR:  assembled from values in icd10pcs_index_YYYY.xml, using "@" as a subfield separator
SCUI: assembled from values icd10pcs_index_YYYY.xml

TTY = "PX" atoms are created for level 7
XM
This data is added during Metathesaurus source processing

Attributes (MRSAT):

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Attribute Name Origin
ADDED_MEANING
Additional descriptive information about a header term extracted from <definition> tag in icd10pcs_index_YYYY.xml
ORDER_NO
Order number from icd10pcs_order_YYYY.txt (character positions 1-5)
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
MAPSETTYPE
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
SOS
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
XMAP
This data is added during Metathesaurus source processing
XMAPFROM
This data is added during Metathesaurus source processing
XMAPTO
This data is added during Metathesaurus source processing

Definitions (MRDEF):

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Additional descriptive information about a header term extracted from <definition> tag in icd10pcs_index_YYYY.xml is included in MRSAT.RRF with ATN = "ADDED_MEANING"


Relationships (MRREL):

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REL RELA
Inverse RELA
ORIGIN
SY
expanded_form_of
has_expanded_form
Connect AB and PT descriptions
Connect PT and PX descriptions
Connect HS and HT descriptions
Connect HT and HX descriptions

Mappings (MRMAP):

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Three Mapsets ("XM" atoms, along with associated attributes and mappings), are included for ICD-10-PCS. 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 codes.  For clarity, decimals are added appropriately to the MRMAP.RRF representation, e.g. "3929' is converted to "39.29" as a TOID.

Field Value/Origin (GEMs)
Value/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 = "NoPCS"
RQ
RELA
approximately_mapped_to where approximate flag = "1"
mapped_to where approxmiate flag = "0"
null (empty) where target value = "NoPCS"
mapped_to