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Unified Medical Language System® (UMLS®)

ICD-10-CM Source Information

This page lists specific source data elements and provides information on their representation in the UMLS Metathesaurus.

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

Summary of Changes:

Note: ICD10CM_2017_2016_10_19 is a minor update to correct an omission in processing ICD10CM_2017. A small number of atoms, relationships and the "NOTE" attribute were missing in 2017AA. The changes listed here are in comparison to ICD10CM_2016.
  • The reimbursement mappings have been discontinued
  • Previously, the UMLS received and processed files submitted in TREF (Terminology Representation and Exchange Format). For 2017AA, a publicly available xml file was processed for tabular data.
  • Deprecated ATN. The following data is not included in the tabular xml data:
    • ALT_SORT_CODE

Source-Provided Files: Summary

The following files are downloaded and processed from //www.cdc.gov/nchs/icd/icd10cm.htm:

Documentation:
  • icd10OrderFiles-508.pdf
  • icd10cm_tabular_2017-508.pdf
  • GemsTec5hDoc_2017.pdf

Data:
  • 2017_I10gem.txt
  • 2017_I9gem.txt
  • icd10cm_order_2017.txt
  • icd10cm_tabular_2017.xml
The tabluar xml file aligns with the order file, and redundant data is not processed.

Source-Provided Files: Details

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

file:icd10cm_tabular_<YYYY>.xml

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The ICD-10-CM tabular data is represented as "chapter," "section," and "diag" elements:
note type Description Representation
name
id (section attribute)
MRCONSO.CODE, SDUI
chapter: TTY = HT
diag: TTY = HT if there are children; TTY = PT if leaf node
inclusionTerm MRCONSO.STR; TTY = ET
includes MRCONSO.STR; TTY = ET
desc MRCONSO.STR
sevenChrDef extension indicates that a seventh character is to be assigned to codes in a subcategory The extension char is appended to the subcategory name value to assign the MRCONSO.CODE, SDUI; The tag value is appended to the desc value to create MRCONSO.STR
includes
excludes1 A pure excludes, meaning "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. MRSAT.ATN = EXCLUDES1
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. MRSAT.EXCLUDES2
codeFirst 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. "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. MRSAT.CODE_FIRST
useAdditionalCode 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. MRSAT.ATN = USE_ADDITIONAL
codeAlso 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. MRSAT.ATN = CODE_ALSO
notes

file: icd10cm_order_<YYYY>.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 icd10cm_tabular_<YYYY>.xml)
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 icd10cm_tabular_<YYYY>.xml; determines TTY: "0" for HT; "1" for "PT"
16 1 Blank N/A
17 60 Short description MRCONSO.STR; TTY = AB
77 1 Blank N/A
78 Up to
300
Long description Not directly processed (extracted from icd10cm_tabular_<YYYY>.xml; TTY = PT or TTY = HT)


file: <YYYY>_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 1919
MRMAP.RRF.MAPSUBSETID (second subfield, after the ":")
Anything with the same FROMEXPR and MAPSUBSETID values should be "OR'd" together

file: <YYYY>_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