Clinical Classifications Software Refined (CCSR)

The Clinical Classifications Software Refined (CCSR) 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 Refined (CCSR) aggregates International Classification of Diseases, 10th Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) codes into clinically meaningful categories.

  • The CCSR for ICD-10-CM diagnoses balances the retention of the clinical concepts included in the CCS categories under ICD-9-CM and the specificity of ICD-10-CM diagnoses by creating new clinical categories.
  • The CCSR for ICD-10-PCS procedures capitalizes on the taxonomy and specificity of the ICD-10-PCS coding scheme and, where possible, retains the same surgical concepts from prior CCS versions.
The CCSR replaces the beta version of the CCS for ICD-10-CM/PCS. The beta version of the CCS of ICD-10-CM/PCS codes will not be updated for newer codes (ICD-10-CM codes after October 2019 and ICD-10-PCS codes after October 2020).
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The CCSR for ICD-10-CM diagnoses aggregates more than 70,000 ICD-10-CM diagnosis codes into over 530 clinical categories across 21 body systems. Key features of the CCSR for ICD-10-CM include:

  • All ICD-10-CM codes valid from October 2015 to September 2021 are mapped to a clinical category (v2021.1).
  • Some diagnosis codes are cross classified into more than one category because individual ICD-10-CM codes can describe multiple conditions or a condition and a common symptom/manifestation.
  • To facilitate ranking of hospitalizations by clinical conditions, the CCSR for ICD-10-CM includes the assignment of a default CCSR for the principal diagnosis for inpatient data and a default CCSR for the first-listed diagnosis for outpatient data.
The CCSR for ICD-10-CM diagnoses is intended to be used analytically to examine patterns of healthcare in terms of cost, utilization, and outcomes; rank utilization by diagnoses; and risk adjust by clinical condition.

Select for more information on the CCSR for ICD-10-CM diagnoses including the downloadable tool and documentation.
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The CCSR for ICD-10-PCS procedures aggregates more than 80,000 ICD-10-PCS procedure codes into over 320 clinical categories across 31 clinical domains. Key features of the CCSR for ICD-10-PCS include:

  • All ICD-10-PCS codes valid from October 2015 to September 2021 are mapped to a clinical category (v2021.1).
  • Each procedure code is classified into only one CCSR category.
The CCSR for ICD-10-PCS procedures is intended to be used analytically to examine patterns of healthcare in terms of cost, utilization, and outcomes, in addition to perform rank utilization by procedures.

Select for more information on the CCSR for ICD-10-PCS procedures including the downloadable tool and documentation.
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Internet Citation: Clinical Classifications Software Refined (CCSR). Healthcare Cost and Utilization Project (HCUP). November 2020. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/toolssoftware/ccsr/ccs_refined.jsp.
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Last modified 11/30/20