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Unified Medical Language System (UMLS)

ICD10CM (International Classification of Diseases, Tenth Revision, Clinical Modification) - Source Representation


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:

General Equivalence Mappings (GEMs) have been discontinued for ICD10CM, resulting in the following changes:
Deprecated TTY: XM
Deprecated ATNs:
  • FROMRSAB
  • FROMVSAB
  • MAPSETRSAB
  • MAPSETVERSION
  • MAPSETVSAB
  • MAPSETXRTARGETID
  • MTH_MAPFROMCOMPLEXITY
  • MTH_MAPFROMEXHAUSTIVE
  • MTH_MAPSETCOMPLEXITY
  • MTH_MAPTOCOMPLEXITY
  • MTH_MAPTOEXHAUSTIVE
  • TORSAB
  • TOVSAB
MRMAP, MRSMAP: No entries for ICD10CM

Source-Provided Files: Summary

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

Documentation:
  • icd10OrderFiles.pdf
  • icd10cm_tabular_2019.pdf

Data:
  • icd10cm_order_2019.txt
  • icd10cm_tabular_2019.xml
The tabluar xml file aligns with the order file, and redundant data is not processed.

Source-Provided Files: Details

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

file:icd10cm_tabular_<YYYY>.xml



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
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 MRSAT.ATN = NOTE

file: icd10cm_order_<YYYY>.txt



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)