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Unified Medical Language System® (UMLS®)

2012AA ICD-10-PCS Source Information




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

Notes

Summary of Changes:

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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 an 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: Summary

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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

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_index_2012.xml Table file in xml
icd10pcs_order_2012.txt Long and short descriptions
reimb_map_pr_2012.txt ICD-10-CM to ICD-9-CM reimbursement mappings

Not Included

All data from the order and mappings files is represented in the Metathesaurus.  Selected tags from the xml file are not processed at this time, including <explanation> and <includes>.

Source-Provided Files: Details

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The following is a list of elements available for ICD-10-PCS data:

file:gem_i9pcs.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-PCS code (target)
7
7
13
MRMAP.RRF.TOID
MRMAP.RRF.TOEXPR
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:gem_pcsi9.txt

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Field
Length
Begin
End
Representation
ICD-10-PCS Code (source)
7
1
7
MRMAP.RRF.FROMID
MRMAP.RRF.FROMEXPR
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:icd10pcs_index_2012.xml

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This file is parsed to extract data for codes at each level of the table, as well as information in the "<definition>" tag.

Tag
Representation
<axis> Letter or number of each character of code:  concatenated to create MRCONSO.CODE, MRCONSO.SCUI for TTY = HX, MTH_HX, PX

Description for the value:  concatenated, using "@" as a subfield separator to create MRCONSO.STR for TTY = HX, MTH_HX, PX
<definition>
MRSAT.ATN = ADDED_MEANING

file:icd10pcs_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-PCS code. Dots are not included.
MRCONSO.CODE
MRCONSO.SCUI
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.
Determines TTY:  "0" for "HS" or "HT"; "1" for "AB" or "PT"
16
1
Blank
N/A
17
60
Short description
MRCONSO.STR
TTY = AB or HS, based on value in character position 15
77
1
Blank
N/A
78
Up to
300
Long description
MRCONSO.STR
TTY = HT or PT, based on value in character position 15


file:reimb_map_pr_2012.txt

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Field Name Length Begin
End
Representation
ICD-10-PCS Code
8
1
8
MRMAP.RRF.FROMID
MRMAP.RRF.FROMEXPR
Decimal point added as appropriate
Number of ICD-9-CM codes 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"