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Record Layout / Sample Data

File Description / Details:

Description: ICD-10-PCS Procedure Codes & Descriptions (over 72, 000 codes)

*ICD-10-PCS Procedure Reimbursement Mapping 

*ICD-10-PCS GEM (General Equivalence Mapping (over 82, 000 codes)

Formats: .xlsx, .mdb, .txt
File Name:

ICD10PCS_20YY_Standard.zip 

ICD10PCS_20YY_Professional.zip

*Professional Version


Record Layout - Standard:
Field Type Size  Description
ICD10PCS Text 8 ICD-10-PCS Code
Status Text 1 ICD10PCS Status:

N - New Code

S - Short Description Revision

R - Long Description Revision

SDesc Text 60 Short ICD-10-PCS Description
LDesc Text 200 Long ICD-10-PCS Description 

Sample ICD-10-PCS Standard File:
 
ICD10PCS SDesc LDesc status
047J0ZZ Dilation of Left External Iliac Artery, Open Approach    
047J34Z Dilate L Ext Iliac Art w Drug-elut Intralum, Perc Dilation of Left External Iliac Artery with Drug-eluting Intraluminal Device, Percutaneous Approach  
047J3DZ Dilation of L Ext Iliac Art with Intralum Dev, Perc Approach Dilation of Left External Iliac Artery with Intraluminal Device, Percutaneous Approach  
047J3ZZ Dilation of Left External Iliac Artery, Perc Approach Dilation of Left External Iliac Artery, Percutaneous Approach  
047J44Z Dilate L Ext Iliac Art w Drug-elut Intralum, Perc Endo Dilation of Left External Iliac Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Approach  
047J4DZ Dilate L Ext Iliac Art w Intralum Dev, Perc Endo Dilation of Left External Iliac Artery with Intraluminal Device, Percutaneous Endoscopic Approach  
047J4ZZ Dilation of Left External Iliac Artery, Perc Endo Approach Dilation of Left External Iliac Artery, Percutaneous Endoscopic Approach  
047K041 Dilate R Fem Art w Drug-elut Intralum, Drug Blln, Open Dilation of Right Femoral Artery with Drug-eluting Intraluminal Device, using Drug-Coated Balloon, Open Approach N
047K04Z Dilation of R Fem Art with Drug-elut Intralum, Open Approach Dilation of Right Femoral Artery with Drug-eluting Intraluminal Device, Open Approach S
047K0D1 Dilate R Fem Art w Intralum Dev, Drug Blln, Open Dilation of Right Femoral Artery with Intraluminal Device, using Drug-Coated Balloon, Open Approach N
047K0DZ Dilation of R Fem Art with Intralum Dev, Open Approach Dilation of Right Femoral Artery with Intraluminal Device, Open Approach S
047K0Z1 Dilation of R Fem Art using Drug Blln, Open Approach Dilation of Right Femoral Artery using Drug-Coated Balloon, Open Approach N

Record Layout - Professional:
Field Type Size  Description
ICD10PCS Text 8 ICD-10-PCS Code
Status Text 1 ICD10PCS Status:

N - New Code

S - Short Description Revision

R - Long Description Revision

*Indicator Text 1

0 - ICD10PCS Code Header, not valid for submission

1 - ICD10PCS Code, valid for submission

SDesc Text 60 Short ICD-10-PCS Description
LDesc Text 200 Long ICD-10-PCS Description 
*ICD9 Number Text 1 Number of ICD9 Procedure Codes codes the ICD10PCS code maps to.  Value 1 through 6

*ICD9_1

Text 6 ICD10PCS to ICD9 Procedure Code Reimbursement Mapping.  First ICD9 Code
*ICD9_2 Text 6 ICD10PCS to ICD9 Procedure Code Reimbursement Mapping.  Second ICD9 Code
*ICD9_3 Text 6 ICD10PCS to ICD9 Procedure Code Reimbursement Mapping.  Third  ICD9 Code
*ICD9_4 Text 6 ICD10PCS to ICD9 Procedure Code Reimbursement Mapping.  Fourth ICD9 Code
*ICD9_5 Text 6 ICD10PCS to ICD9 Procedure Code Reimbursement Mapping.  Fifth  ICD9 Code
*ICD9_6 Text 6 ICD10PCS to ICD9 Procedure Code Reimbursement Mapping.  Sixth ICD9 Code
*Professional File Only


Sample ICD-10-PCS Professional File:

 
ICD10PCS status Indicator SDesc LDesc ICD9_Number ICD9_1 ICD9_2 ICD9_3 ICD9_4 ICD9_5 ICD9_6
02Y
0 Heart and Great Vessels, Transplantation Heart and Great Vessels, Transplantation






02YA0Z0
1 Transplantation of Heart, Allogeneic, Open Approach Transplantation of Heart, Allogeneic, Open Approach 2 37.51 00.93



02YA0Z1
1 Transplantation of Heart, Syngeneic, Open Approach Transplantation of Heart, Syngeneic, Open Approach 2 37.51 00.93



02YA0Z2
1 Transplantation of Heart, Zooplastic, Open Approach Transplantation of Heart, Zooplastic, Open Approach 2 37.51 00.93



031
0 Upper Arteries, Bypass Upper Arteries, Bypass






0312090
1 Bypass Innom Art to R Up Arm Art w Autol Vn, Open Bypass Innominate Artery to Right Upper Arm Artery with Autologous Venous Tissue, Open Approach 1 39.29




0312091
1 Bypass Innom Art to L Up Arm Art w Autol Vn, Open Bypass Innominate Artery to Left Upper Arm Artery with Autologous Venous Tissue, Open Approach 1 39.29




0312092
1 Bypass Innom Art to Bi Up Arm Art w Autol Vn, Open Bypass Innominate Artery to Bilateral Upper Arm Artery with Autologous Venous Tissue, Open Approach 1 39.29




0312093
1 Bypass Innom Art to R Low Arm Art w Autol Vn, Open Bypass Innominate Artery to Right Lower Arm Artery with Autologous Venous Tissue, Open Approach 1 39.29




 

File Description / Details:

Description: *ICD-10-PCS GEM (General Equivalence Mapping (over 82, 000 codes)
Formats: .xlsx, .mdb, .txt
File Name:

I9PCS_20YY_Gem

I10PCS_20YY_Gem


Record Layout:
Field Type Size  Description
I10PCS Text 7 ICD-10-PCS Code
I9P Text 5 ICD-9-CM Volume 3 Procedure
Flags Text 5 Grouping of 5 attributes/flags
Approximate Text 1 Attribute in a GEM that when turned on indicates that the entry is not considered equivalent; 1= Yes /On O = No Off
No Map Text 1 Attribute in a GEM that when turned on indicates that a code in the source system is not linked to any code in the target system; 1= Yes /On O = No Off
Combination Text 1

Attribute in a GEM that when turned on indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system; 1= Yes /On O = No Off

Scenario Text 1 In a combination entry, a collection of codes from the target system containing the necessary codes that when combined as directed will satisfy the equivalent meaning of a code in the source system; 0-9
Choice List Text 1 In a combination entry, a list of one or more codes in the target system from which one code must be chosen to satisfy the equivalent meaning of a code in the source system; 0-9
ICD10DESC Text 255 ICD-10-PCS Description
ICD9DESC Text 255 ICD-9-CM Volume 3 Procedure Code Description
*GEM included in Professional Version 


Sample Gem Files

ICD9 to ICD10PCS:

 
I9P I10PCS Flags Approximate No Map Combination Scenario Choice List ICD10DESC ICD9DESC
00.01 6A751Z4 10000 1 0 0 0 0 Ultrasound Therapy of Head and Neck Vessels, Multiple Therapeutic ultrasound of vessels of head and neck
00.01 6A750Z4 10000 1 0 0 0 0 Ultrasound Therapy of Head and Neck Vessels, Single Therapeutic ultrasound of vessels of head and neck
00.02 6A750Z5 10000 1 0 0 0 0 Ultrasound Therapy of Heart, Single Therapeutic ultrasound of heart
00.02 6A751Z5 10000 1 0 0 0 0 Ultrasound Therapy of Heart, Multiple Therapeutic ultrasound of heart
00.03 6A750Z6 10000 1 0 0 0 0 Ultrasound Therapy of Peripheral Vessels, Single Therapeutic ultrasound of peripheral vascular vessels
00.03 6A751Z6 10000 1 0 0 0 0 Ultrasound Therapy of Peripheral Vessels, Multiple Therapeutic ultrasound of peripheral vascular vessels
00.09 6A751ZZ 10000 1 0 0 0 0 Ultrasound Therapy, Circulatory, Multiple Other therapeutic ultrasound
00.09 6A930ZZ 10000 1 0 0 0 0 Shock Wave Therapy, Musculoskeletal, Single Other therapeutic ultrasound
00.09 6A751Z7 10000 1 0 0 0 0 Ultrasound Therapy of Other Vessels, Multiple Other therapeutic ultrasound
00.09 6A750ZZ 10000 1 0 0 0 0 Ultrasound Therapy, Circulatory, Single Other therapeutic ultrasound
00.09 6A750Z7 10000 1 0 0 0 0 Ultrasound Therapy of Other Vessels, Single Other therapeutic ultrasound
00.09 6A931ZZ 10000 1 0 0 0 0 Shock Wave Therapy, Musculoskeletal, Multiple Other therapeutic ultrasound

ICD10PCS to ICD9:

 
I10PCS I9P Flags Approximate No Map Combination Scenario Choice List ICD10DESC ICD9DESC
00560ZZ 02.14 10000 1 0 0 0 0 Destruction of Cerebral Ventricle, Open Approach Choroid plexectomy
00563ZZ 02.14 10000 1 0 0 0 0 Destruction of Cerebral Ventricle, Percutaneous Approach Choroid plexectomy
00564ZZ 02.14 10000 1 0 0 0 0 Destruction of Cerebral Ventricle, Percutaneous Endoscopic Approach Choroid plexectomy
00570ZZ 01.59 10000 1 0 0 0 0 Destruction of Cerebral Hemisphere, Open Approach Other excision or destruction of lesion or tissue of brain
00573ZZ 01.59 10000 1 0 0 0 0 Destruction of Cerebral Hemisphere, Percutaneous Approach Other excision or destruction of lesion or tissue of brain
00574ZZ 01.59 10000 1 0 0 0 0 Destruction of Cerebral Hemisphere, Percutaneous Endoscopic Approach Other excision or destruction of lesion or tissue of brain
00580ZZ 01.42 10000 1 0 0 0 0 Destruction of Basal Ganglia, Open Approach Operations on globus pallidus
00583ZZ 01.42 10000 1 0 0 0 0 Destruction of Basal Ganglia, Percutaneous Approach Operations on globus pallidus
00584ZZ 01.42 10000 1 0 0 0 0 Destruction of Basal Ganglia, Percutaneous Endoscopic Approach Operations on globus pallidus
00590ZZ 01.41 10000 1 0 0 0 0 Destruction of Thalamus, Open Approach Operations on thalamus
00593ZZ 01.41 10000 1 0 0 0 0 Destruction of Thalamus, Percutaneous Approach Operations on thalamus
00594ZZ 01.41 10000 1 0 0 0 0 Destruction of Thalamus, Percutaneous Endoscopic Approach Operations on thalamus
005A0ZZ 01.41 10000 1 0 0 0 0 Destruction of Hypothalamus, Open Approach Operations on thalamus
005A3ZZ 01.41 10000 1 0 0 0 0 Destruction of Hypothalamus, Percutaneous Approach Operations on thalamus
005A4ZZ 01.41 10000 1 0 0 0 0 Destruction of Hypothalamus, Percutaneous Endoscopic Approach Operations on thalamus

 

09/24/15