Observational Health Data Sciences and Informatics

ICD10PCS, often spelled “ICD-10-PCS”, is a vocabulary in the USA for coding hospital-based medical procedures. It is currently implemented as a standard vocabulary, with OMOP-generated hierarchical relations to Procedure concepts from SNOMED CT vocabulary and other relationships mimicking SNOMED CT's internal model.

ICD10PCS concepts have up to 7 levels of hierarchy with transition to next level of being represented by addition of one alphanumeric character to parent code. Only the leaf-level concepts are allowed to being used in clinical setting and are Standard concepts. Hierarchical levels 1 through 6 are always Classification concepts.

Classes for concepts in ICD10PCS vocabulary are either 'ICD10PCS' for leaf-level concepts and 'ICD10PCS hierarchy' for others.

Currently all concepts from ICD10PCS vocabulary belong to Procedure domain. Some of them may relate to taking Measurements or administering Drugs in clinical setting, but rely on other coding systems to specify important details (results of measurements or exact drug and dose that was administered). ICD10PCS concepts themselves still represent only the nature of actions performed by provider.

Leaf-level ICD10PCS concepts have custom relationships to SNOMED CT concepts. ICD10PCS procedures have attribute-value relationships built following SNOMED CT conventions to various SNOMED CT concepts that serve as attributes for concepts in procedure subhierarchy. Following the attribute assignment, multiple hierarchical relationships are built to SNOMED concepts, closest in meaning to ICD10PCS concepts themselves.

Due to differences in concept building between two vocabularies, complete match on attributes and meaning is never guaranteed even when concept names sound alike. Because of this, equivalence mappings are never built and all concepts remain Standard.

Internal ICD10PCS hierarchy is straightforward with each concept always having one immediate ancestor. Leaf-level concepts also have multiple hierarchical relations to SNOMED CT concepts from procedure subhierarchy as terminal descendants.