Clinical Classifications Software Refined (CCSR) for ICD-10-PCS Procedures

The Clinical Classifications Software Refined (CCSR) for ICD-10-PCS procedures 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) for ICD-10-PCS procedures aggregates more than 80,000 ICD-10-PCS procedure codes into over 320 clinically meaningful categories. The CCSR is based on the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS). The categories are organized across 31 clinical domains, which generally follow the structure of the sections in the ICD-10-PCS Code Book.

The CCSR for ICD-10-PCS capitalizes on the taxonomy and specificity of the ICD-10-PCS coding scheme by creating new clinical categories that did not exist in previous versions of the CCS tool and, where possible, retains the same surgical concepts from prior CCS versions. Each ICD-10-PCS code is assigned to a mutually exclusive category. The CCSR is intended to be used analytically to examine patterns of healthcare in terms of cost, utilization, and outcomes, in addition to rank utilization by procedures. At this time, the tool does not include the identification of combinations of different types of ICD-10-PCS codes that define a complex surgical procedure. For example, the seven ICD-10-PCS codes needed to report a Whipple procedure are included in six different CCSR categories.

The CCSR for ICD-10-PCS procedures replaces the beta version of the CCS for ICD-10-PCS. The most substantial difference in the CCSR for ICD-10-PCS procedures compared with the beta versions of the CCS is the enhanced detail available in the revised classification. For example, the CCS for ICD-10-PCS (beta version) had one category (CCS 213) for respiratory intubation and mechanical ventilation. The CCSR for ICD-10-PCS has three categories: mechanical ventilation (ESA003), airway intubation (RES007), and non-invasive ventilation (ESA004).
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The following table provides information on where to find the various resources available for the CCSR tool. The download section includes all of the referenced materials.

Descriptions CCSR Resource
Development of CCSR for procedures User Guide: CCSR for ICD-10-PCS Procedures, Description of the CCSR for ICD-10-PCS and Appendix A
Description of ICD-10-PCS root operations in the medical and surgical chapter User Guide: CCSR for ICD-10-PCS Procedures, Appendix B
Acronyms used in the CCSR for ICD-10-PCS category descriptions User Guide: CCSR for ICD-10-PCS Procedures, Appendix C
 
Technical guidance for applying the CCSR for ICD-10-PCS procedures to administrative data CCSR Resource
System requirements User Guide: CCSR for ICD-10-PCS Procedures, Using the Downloadable CCSR Files, System Requirements
Input files User Guide: CCSR for ICD-10-PCS Procedures, Using the Downloadable CCSR Files, Downloadable Files
Running the SAS program User Guide: CCSR for ICD-10-PCS Procedures, Using the Downloadable CCSR Files, Downloadable Files and Running the SAS Program to Add CCSR Categories to Data
Output file options User Guide: CCSR for ICD-10-PCS Procedures, Using the Downloadable CCSR Files, Flexible File Structure for Outputting the CCSR Categories
 
Additional resources CCSR Resource
List of CCSR 3-character abbreviations by clinical domain Procedure CCSR Reference File, tab Naming_Conventions
Searchable list of CCSR categories Procedure CCSR Reference File, tab CCSR_Categories
Searchable list of ICD-10-PCS procedure codes mapped to CCSR categories Procedure CCSR Reference File, tab PR_to_CCSR_Mapping
Searchable log of changes across versions Procedure CCSR Change Log
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The ZIP folder includes the CSV mapping file, a SAS mapping program, and all of the user documentation. At this time, the CCSR for ICD-10-PCS procedures is only available as a SAS program.

CCSR v2021.1: Fiscal Year 2021, Released December 2020 - valid for ICD 10-PCS procedure codes through September 2021 For convenience, the user documentation for the CCSR v2021.1 is also provided as separate documents:
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Copies of previous versions of the CCSR for ICD-10-PCS procedures tool and the beta versions for ICD-10-PCS are available for users who need to replace or access the old programs and documentation.
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Questions regarding the CCSR 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 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/prccsr.jsp.
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Last modified 11/30/20