Procedure Classes Refined for ICD-10-PCS

The Procedure Classes Refined for the ICD-10-PCS 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 Procedure Classes Refined for ICD-10-PCS facilitates health services research by allowing the researcher to readily determine (1) whether a procedure is diagnostic or therapeutic and (2) whether a procedure is expected to be performed in an operating room. The Procedure Classes Refined for ICD-10-PCS assigns all ICD-10-PCS procedure codes to one of four categories:

  • Minor Diagnostic—Nonoperating room procedures that are diagnostic (e.g. B244ZZZ, Ultrasonography of Right Heart)
  • Minor Therapeutic—Nonoperating room procedures that are therapeutic (e.g. 02HQ33Z, Insertion of Infusion Device into Right Pulmonary Artery, Percutaneous Approach)
  • Major Diagnostic—Procedures that are considered operating room procedures that are performed for diagnostic reasons (e.g. 02BV0ZX, Excision of Superior Vena Cava, Open Approach, Diagnostic)
  • Major Therapeutic—Procedures that are considered operating room procedures that are performed for therapeutic reasons (e.g. 0210093, Bypass Coronary Artery, One Site from Coronary Artery with Autologous Venous Tissue, Open Approach).
The Procedure Classes was originally developed using ICD-9-CM procedure codes. The software was translated into ICD-10-PCS prior to the availability of ICD-10-PCS-coded data and released as a beta version. Once ICD-10-PCS-coded data became available, the beta version was evaluated by clinical experts. The recommended modifications (implemented in v2021.2) transition the software tool out of its beta status and into the Procedure Classes Refined for ICD-10-PCS.

The Procedure Classes Refined for ICD-10-PCS is updated annually to coincide with fiscal year updates to the ICD-10-PCS coding system and retains procedure codes valid from the start of ICD-10-PCS in October 2015. For this reason, it is advisable to always use the most recent version of the tool (it is not recommended to use the beta versions of the tool).
 
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The following table provides information on where to find the various resources available for the Procedure Classes Refined for ICD-10-PCS tool. The download section includes all of the referenced materials.

Descriptions Procedure Classes Refined for ICD-10-PCS Resource
Development of Procedure Classes Refined for ICD-10-PCS User Guide: Procedure Classes Refined for ICD-10-PCS, Description of the Procedure Classes Refined for ICD-10-PCS and Appendix A
 
Technical guidance for applying the Procedure Classes Refined for ICD-10-PCS to administrative data Procedure Classes Refined for ICD-10-PCS Resource
System requirements User Guide: Procedure Classes Refined for ICD-10-PCS, Using the Downloadable Procedure Classes Refined for ICD-10-PCS Files, System Requirements
Input files User Guide: Procedure Classes Refined for ICD-10-PCS, Using the Downloadable Procedure Classes Refined for ICD-10-PCS Files, Downloadable Files and Data Elements Required for Input Dataset
Running the SAS program User Guide: Procedure Classes Refined for ICD-10-PCS, Using the Downloadable Procedure Classes Refined for ICD-10-PCS Files, Downloadable Files and Running the SAS Program to Add Surgery Flags to Data
 
Additional resources Procedure Classes Refined for ICD-10-PCS Resource
Searchable log of changes across versions Procedure Classes Refined for ICD-10-PCS Change Log

 
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The input dataset must contain an array of ICD-10-PCS procedure codes without decimals. These data elements are required for the assignment of the Procedure Classes Refined for ICD-10-PCS.

Required Input Data Element

Data Element Name in Program Purpose How to Modify the Data Element Name Used in the Program Data Element Name in HCUP Databases
PR1-PRn where n is the dimension of the procedure array Array of ICD-10-PCS procedures used to assign procedure classes Specify prefix for PR array using macro statement %LET PRPREFIX= I10_PR1-I10_PRn in all HCUP databases starting in data year 2016
 
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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 Procedure Classes Refined for ICD-10-PCS is only available as a SAS program.

Procedure Classes Refined for ICD-10-PCS v2021.2: Fiscal Year 2021, Released March 2021 - valid for ICD-10-PCS procedure codes through September 2021
For convenience, the user documentation for the Procedure Classes Refined for ICD-10-PCS v2021.2 is also provided as separate documents:
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Copies of previous versions of the Procedure Classes Refined for ICD-10-PCS 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 Procedure Classes Refined for ICD-10-PCS may be directed to HCUP User Support through the following channels:

 
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Internet Citation: Procedure Classes Refined for ICD-10-PCS. Healthcare Cost and Utilization Project (HCUP). March 2020. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/toolssoftware/procedureicd10/procedure_icd10.jsp.
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Last modified 3/19/20