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Clinical Classifications Software (CCS) for ICD-10-PCS (beta version)
The CCS is one of the HCUP tools that can be applied to HCUP and other similar databases. These tools are created by AHRQ through a Federal-State-Industry partnership.
 
Note: The U.S. transitioned to the International Classification of Diseases, 10th Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) coding scheme on October 1, 2015. The HCUP tools for International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) should only be used with data for discharges before 10/1/15.

The HCUP tools were translated to ICD-10-CM/PCS prior to the availability of ICD-10-CM/PCS-coded data. The translated tools are considered in beta version, until a refined version of the tool can be developed. Preliminary findings suggest some unexpected discontinuities between the tools based on ICD-9-CM and the beta version of tools based on ICD-10-CM/PCS. See the ICD-10-CM/PCS Resources page for details. The tools will continue to undergo refinements over the next several years. You are advised to visit this page regularly to download and apply the most recent version of the HCUP tools for your data throughout your research process.
 
Clinical Classifications Software (CCS) for ICD-10-PCS (beta version)

The Clinical Classifications Software (CCS) for ICD-10-PCS (beta version) is one in a family of databases and software tools developed as part of the Healthcare Cost and Utilization Project (HCUP), a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ). HCUP databases, tools, and software inform decision making at the national, State, and community levels.

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The Clinical Classifications Software (CCS) for ICD-10-PCS (beta version) is a procedure categorization scheme that can be employed in many types of projects analyzing data on procedures. CCS is based on the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS), a uniform and standardized coding system for procedures. The ICD-10-PCS's multitude of codes—more than 77,000 procedure codes—are collapsed into a manageable number of clinically meaningful categories that are sometimes more useful for presenting descriptive statistics than are individual ICD-10-PCS codes. It is based on the CCS for ICD-9-CM procedures and attempts to map ICD-10-PCS codes into the same categories.

The CCS can be used to identify populations for procedure-specific studies or to develop statistical reports about relatively specific procedures. It can be a useful way to categorize procedures when exploring data and can serve as a tool for reporting statistical information on hospitalizations.

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Development History of the CCS for ICD-10-PCS Procedures (beta version)

In preparation for the October 2015 implementation of ICD-10-PCS, the procedure CCS tool from HCUP were converted to the new coding system. The initial mapping was completed by linking ICD-10-PCS codes to the CCS for ICD-9-CM classification assignments via the General Equivalence Mappings (GEMs) available from the Centers for Medicare & Medicaid Services (CMS) Web site (see https://www.cms.gov/Medicare/Coding/ICD10/index.html for more information on GEMS). No dually coded data were available at the time the CCS categories were translated to ICD-10-PCS. The translation was based on forward and backward mapping using the GEMs.

These initial GEMs were reviewed by credentialed coders trained in both ICD-9-CM and ICD-10-PCS to ensure the validity of the map for use in formulating the CCS categories. Two coders each made a CCS assignment for each code based n the GEMs. When the coders did not initially map a code to the same CCS category, the team reviewed the discrepancies and came to consensus for the CCS assignment, with the help of a third coder if necessary. Initial maps were completed in September 2011. The accuracy of the initial assessment was verified by reviewing a 20 percent sample of the coding assignments.

In 2013, reverse mapping validation of 100 percent of the ICD-10-PCS procedure CCS assignments was conducted to verify the accuracy of mapping of the beta version of the CCS.

Preliminary findings suggest some unexpected discontinuities between the tools based on ICD-9-CM procedures and the beta version of tools based on ICD-10-PCS. Ongoing analyses are being conducted now that ICD-10-PCS-coded data is available. A fully refined version of the CCS for ICD-10-PCS procedures that capitalizes on the specificity and structure built into the ICD-10-PCS coding scheme is in development.

Procedure Codes

The ICD-10-PCS coding scheme contains over 77,000 procedure codes, and does not follow the conventions or structure of the ICD-9-CM coding scheme (which had only 3,900 codes). The following table summarizes the differences between ICD-9-CM and ICD-10-PCS procedure codes. See the ICD-10-CM/PCS Resources page for details and examples.
ICD-9-CM ICD-10-PCS
3,900 codes 77,000 codes
Chapters organized by body system Multiaxial structure to chapters
3–4 numeric characters with decimals after two characters 7 characters must be used. Each character can be alpha or numeric. No decimals are included.
Includes combination codes in which procedures that typically are performed together are combined into one procedure code Does not include combination codes; may require multiple codes to capture what a surgeon considers a single procedure.
May contain diagnostic information (i.e., diagnoses and procedures may be linked) Does not contain diagnostic information (i.e., diagnoses and procedures are not linked)
Generic terms for body parts and devices Specific terms for body parts and devices
Lacks descriptions of methodology and approach Provides detailed descriptions of methodology and approach

CCS for ICD-10-PCS Procedure Categories (beta version)

The beta versions of the CCS for ICD-10-PCS procedures contain 223 mutually exclusive categories. Eight CCS procedure categories that are found in the CCS for ICD-9-CM procedures could not be populated with any ICD-10-PCS codes and the new structure of ICD-10-PCS codes also warranted the revision of the labels for some CCS procedure categories. See the ICD-10-CM/PCS Resources page for details. Revised labels can be found below.

Revised CCS PCS labels (PDF file, 81 KB).

Every effort was made to translate the CCS system to ICD-10-PCS without making changes to the CCS categories for procedures. However, because of the new structure and expanded code availability in PCS this was difficult. In ICD-10-PCS each component of the major procedure is reported separately (this includes the surgical approach, surgical closure, etc.). This is a significant change for reporting procedures that affects not only the CCS for the procedure but also the volume of codes. In ICD-10-PCS four procedure codes may be reported, whereas only one is reported in ICD-9-CM for a single operative session. For example, ICD-9-CM code 52.7, Radical pancreaticoduodenectomy (Whipple procedure) is reported as one operative session where numerous surgical components are performed. However, in ICD-10-PCS each component of the procedure is reported with a separate code. Below are the available coding options to be selected based on the medical record documentation for the encounter. One code from each of the four categories (root operation plus body system) would be selected to fully report the procedure in ICD-10-PCS.

Bypass GI System (select one)
0D1607A Bypass Stomach to Jejunum with Autologous Tissue Substitute, Open Approach CCS 94 Other OR upper GI therapeutic procedures
0D160JA Bypass Stomach to Jejunum with Synthetic Substitute, Open Approach CCS 94 Other OR upper GI therapeutic procedures
0D160KA Bypass Stomach to Jejunum with Nonautologous Tissue Substitute, Open Approach CCS 94 Other OR upper GI therapeutic procedures
0D160ZA Bypass Stomach to Jejunum, Open Approach CCS 94 Other OR upper GI therapeutic procedures
Resection GI System
0DT90ZZ Resection of Duodenum, Open Approach CCS 75 Small bowel resection
Bypass Hepatobiliary System (select one)
0F190Z3 Bypass Common Bile Duct to Duodenum, Open Approach CCS 99 Other OR gastrointestinal therapeutic procedures
0F1G0ZC Bypass Pancreas to Large Intestine, Open Approaches CCS 99 Other OR gastrointestinal therapeutic procedures
Resection Hepatobiliary System
0FTG0ZZ Resection of Pancreas, Open Approach CCS 99 Other OR gastrointestinal therapeutic procedures
Abbreviations: CCS, Clinical Classifications Software; OR, operating room; GI, gastrointestinal.

ICD-9-CM CCS 99, Other OR gastrointestinal therapeutic procedures, is populated with only one code for a Whipple procedure; however, in ICD-10-PCS, CCS 94 will be populated with one code for the GI Bypass component, CCS 75 will be populated with one code for the GI Resection component, and CCS 99 will be populated with two possible codes for the Hepatobliary Bypass and Resection components. A total of four CCS categories will be activated in ICD-10-PCS for the Whipple procedure. Additionally, because of the added specificity in ICD-10-PCS, two of the gastrointestinal components of the Whipple procedure are now reported at a greater level of specificity (CCS 94 and 75) than is allowed in ICD-9-CM.

Many of the CCS categories represent single procedures; however, some procedures that occur infrequently are grouped according to three dimensions: (1) the relevant body system, (2) whether they are used for diagnostic or therapeutic purposes, and (3) whether they are considered operating room or nonoperating room procedures, according to Medicare Severity–Diagnosis Related Groups (MS-DRG) definitions.

Multilevel Tool

Because of the increased specificity of ICD-10-PCS procedures and the differences between the two procedure coding schemes (ICD-9-CM and ICD-10-PCS), it was not possible to translate most multilevel categories to ICD-10-PCS within the current structure. The exceptions are the first- and second-level multilevel categories. These categories work with ICD-10-PCS structure and have been added to the beta version of the CCS for ICD-10-PCS tool file (columns 5–8). The specificity of categories increases with the higher levels, such that second-level categories are more specific than first-level categories. The first-level categories are identified by one whole digit (1–16), whereas the second-level categories include one decimal point.


Multilevel CCS category Description Single-level CCS used to map
7 Operations on the cardiovascular system 43-63
7.1 Heart valve procedures 43

The beta versions of the CCS for ICD-10-PCS tool files are located in the Downloading Information for the CCS for ICD-10-PCS Tool section below.

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System Requirements

In order to use the beta versions of the CCS for ICD-10-PCS files, you will need a program (such as WinZip®) that will allow you to decompress or "unzip" files. You will also need approximately 15 megabytes of disk space available on your hard drive to accommodate all of the CCS for ICD-10-PCS files (beta version).

Required Data Elements

The beta versions of the CCS tool files for ICD-10-PCS require procedure codes (ICD-10-PCS) with no embedded periods on the input data.

File Layout

The beta versions of the ICD-10-PCS tool file (CSV) are composed of eight fields separated by commas. The files are organized as follows:
  • Field 1: Procedure Code
  • Field 2: CCS Category
  • Field 3: Code Description
  • Field 4: CCS Category Description
  • Field 5: Multi-level 1 Category
  • Field 6: Multi-level 1 Category Description
  • Field 7: Multi-level 2 Category
  • Field 8: Multi-level 2 Category Description

"Unzipping" Files

There is a downloadable self-extracting zipped file, called ccs_pr_icd10pcs_2019.1.zip. Users are advised to:
  1. Create a subdirectory (or folder) called CCS on your hard drive (e.g., C:\CCS)
  2. Download and save ccs_pr_icd10pcs_2019.1.zip to this subdirectory
  3. Using WinZip (or comparable program), double click the zip file to expand the file

The zipped file will unzip (expand for normal use) the following file: ccs_pr_icd10pcs_2019.1.csv. Note that the original files ccs_pr_icd10pcs_2019.1.zip) will remain intact.

Using Translation File

The translation file translates specific ICD-10-PCS codes into CCS categories. Your use of the file will depend on the software system being utilized. For example, if you are using SAS, you can adapt the translation to create a SAS PROC FORMAT. If you are working with SPSS, you can adapt the translation into VALUE LABELS or into a series of recodes.

Representation of ICD-10-PCS Procedure Codes

In practice, ICD-10-PCS procedures are represented as seven-character codes. All seven characters must be specified in order for the code to be valid. Each character in the seven-character code represents an aspect of the procedure. ICD-10-PCS procedure codes do not contain implicit or explicit decimals.


Procedure ICD-10-PCS Procedure code Alphanumeric code
Division of Brain, Open Approach 00800ZZ '00800ZZ'
Repair Right Thumb Phalanx, Open Approach 0PQR0ZZ '0PQR0ZZ'

For proper handling of procedure codes:

  • Leading zeroes must be preserved; they are significant.

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Note: The beta versions of the CCS procedure tools were updated in FY 2019 with new codes.

Shift-click from this Web page: Click on each of the file names to automatically download the files for the beta version of the CCS for ICD-10-PCS. Alternately, click on the following links with the right mouse button and select "Save Link As" (Google Chrome) or "Save Target As" (Internet Explorer) to download the ZIP folder to your computer. After downloading the files, extract the ZIP file contents by double clicking on the ZIP folder. The ZIP folder includes the Tool, a load program, and instructions for applying the Tool to your data using the load program. Additionally, the HCUP Tools Loading Tutorial, part of the HCUP Online Tutorials Series, provides step-by-step instructions for downloading, applying, and verifying HCUP Tools.

CCS for ICD-10-PCS (beta version) Information

CCS Category Names (Full Labels) (PDF file, 161 KB).

ASCII CCS for ICD-10-PCS files (beta version) for use with user analytic software (i.e., SAS, STATA, or SPSS)

CCS Version 2019.1 (beta version): Fiscal Year 2019, Updated October 2018 - valid for ICD-10-PCS codes through September 2019

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Copies of previous beta versions of the CCS for ICD-10-PCS procedures are available for users who need to replace or access the old programs.


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Questions regarding the CCS may be directed to HCUP User Support through the following channels:


Phone (toll free): 1-866-290-HCUP.

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Internet Citation: Clinical Classifications Software (CCS) for ICD-10-PCS (beta version). Healthcare Cost and Utilization Project (HCUP). September 2019. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/toolssoftware/ccs10/ccs10.jsp.
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Last modified 9/4/19