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Unified Medical Language System® (UMLS®)

ICD-10-PCS 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

Notes

Summary of Changes:

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There were no changes to the file formats. The reimbursement map set has been discontinued.

Source-Provided Files: Summary

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Numerous documentation and data files are available at: https://www.cms.gov/Medicare/Coding/ICD10/2017-ICD-10-PCS-and-GEMs.html , including the following:

Documentation and Reference

File Description
pcs_2017.pdf Information about tables indicating meaning of codes for specific character positions; index to codes
GemsTechDoc.pdf GEMs documentation for technical users
pcs_gemguide_2017.pdf GEMs documentation and user guide
icd10pcs_tabular.xsd xml schema document describing tabular xml format
icd10pcs_definitions.xsd xml schema document describing definitions xml format
ICD10OrderFiles.pdf Documentation for the icd10pcs_order_2017.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_order_2017.txt Long and short descriptions
icd10pcs_tables_2017.xml Tabular data


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: icd10pcs_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-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: icd10pcs_tables_YYYY.xml
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: gem_i9pcs.txt

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
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