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.

Contents:

• Overview of the Procedure Classes Refined for ICD-10-PCS Tool
• COVID-19-Related Procedure Codes
• User Guide and Other Resources
• Data Elements Required for Input Dataset
• Downloading Information for Tool and Documentation
• Archive for Prior Versions
• For More Information, Comments, or Questions about the Procedure Classes Refined for ICD-10-PCS

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).

Procedure codes related to the introduction or infusion of therapeutics and COVID-19 vaccines that are effective through September 2025 are included in v2025.1 of the Procedure Classes Refined for ICD-10-PCS.

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.

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

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.

Procedure Classes Refined for ICD-10-PCS v2025.1: Fiscal Year 2025, Released November 2024 - valid for ICD 10-PCS procedure codes through September 2025

• Procedure Classes Refined for ICD-10-PCS, v2025.1 (ZIP file, 1.7 MB) released 11/13/24

For convenience, the user documentation for the Procedure Classes Refined for ICD-10-PCS v2025.1 is also provided as separate documents:

• User Guide: Procedure Classes Refined for ICD-10-PCS, v2025.1 (PDF file, 591.6 KB)
• Procedure Classes Refined for ICD-10-PCS Change Log
  • v2024.1 to v2025.1 (Excel file, 715.2 KB)

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.

• Archive for previous versions of the Procedure Classes Refined for ICD-10-PCS and beta versions for ICD-10-PCS

Questions regarding the Procedure Classes Refined for ICD-10-PCS may be directed to HCUP User Support through the following channels:

• Email: hcup@ahrq.gov
• Phone (toll free): 1-866-290-HCUP