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Box 2—Examples of single-level CCS procedure categoriesDescriptionICD-9-CM procedure CCS categorycodes used to mapHeart valve procedures 3500 3501 3502 3503 3504 3510 433511 3512 3513 3514 3520 35213522 3523 3524 3525 3526 35273528 3596 3599Coronary artery bypass graft(CABG)3610 3611 3612 3613 3614 36153616 3617 3619 362 363 36313632 363944ICD-9-CM codes for the single-level procedure CCS categories are presented inAppendix B. The ICD-9-CM code assignments to each category are viewable in theaccompanying executable files that provide the crosswalk from ICD-9-CM procedurecodes to single-level CCS categories.Labels for the single-level CCS procedures are available in Appendix B1.Multi-level CCSThe multi-level CCS is a hierarchical system and is defined using both single-level CCSgroupings and ICD-9-CM codes. There are four levels in the multi-level diagnosis CCSand three levels in the multi-level procedure CCS. The first of the four levels in the multileveldiagnosis CCS is broken into 17 categories. Similarly, the first of the three levels inthe multi-level procedure CCS is also broken into 17 categories. These 17 categoriesbroadly group the single-level CCS and ICD-9-CM codes into 17 body systems (e.g.,“Diseases of the Circulatory System”). Note that multi-level CCS categories arecomprised of single-level CCS categories or ICD-9-CM codes. Construction of multilevelCCS requires that ICD-9-CM codes first be assigned to single-level CCS.Diagnosis CodesThe specificity of categories increases with the higher levels, such that second-levelcategories are more specific than first-level categories, third-level categories are morespecific than second-level categories, and fourth-level categories are more specific thanthird-level categories.The first-level categories are identified by one whole digit (1-17), second-level categoriesinclude 1 decimal point, third-level categories have 2 decimal places and fourth levelcategories have 3 decimal places.Box 3 provides an example of multi-level CCS for diagnoses, showing how single-levelCCS category 99 (from single-level CCS example in Box 1) is further subdivided into themore specific levels in the multi-level system.HCUP CCS 6/16/2004 6
Box 3—Examples of multi-level CCS diagnosis categoriesMulti-level CCScategoryDescription ICD-9-CM diagnoses usedto mapSingle-level CCS used tomap7 Diseases ofthecirculatorysystem-- 96 97 98 99 100 101 102103 104 105 106 107108 109 110 111 112113 114 115 116 117118 119 120 1217.1 Hypertension -- 98 997.1.1 Essential-- 98hypertension7.1.2 Hypertension-- 99withcomplicationsandsecondaryhypertension7.1.2.1 Hypertensiveheart and/orrenal disease40200 40201 40210 4021140290 40291 4030 4030040301 4031 40310 403114039 40390 40391 404040400 40401 40402 404034041 40410 40411 4041240413 4049 40490 4049140492 40493--7.1.2.2 Otherhypertensivecomplications4010 40501 40509 4051140519 40591 40599 4372--ICD-9-CM codes for the multi-level diagnosis CCS categories are presented in AppendixC.Labels for the multi-level CCS diagnoses are available in Appendix C1.Procedure CodesThere are only three levels in the multi-level procedure CCS. The specificity of theprocedure categories increases with the higher levels, such that second-level categoriesare more specific than first-level categories and third-level categories are more specificthan second-level categories.The first-level categories are identified by one whole digit (1-17), second-level categoriesinclude 1 decimal point, and third-level categories have 2 decimal places.HCUP CCS 6/16/2004 7
Page 1 and 2: HCUP Methods Series
Page 3 and 4: Table of ContentsABSTRACT………
Page 5 and 6: INTRODUCTION TO THE CLINICAL CLASSI
Page 7: All codes in the diagnosis section
Page 11 and 12: ICD-9-CM codes requiring special tr
Page 13 and 14: 1. Create a subdirectory (or folder
Page 15 and 16: Example—Procedure codesMulti-leve
Page 17 and 18: REFERENCESAgency for Health Care Po
Page 19 and 20: 45 Maintenance chemotherapy; radiot
Page 21 and 22: 139 Gastroduodenal ulcer (except he
Page 23 and 24: 237 Complication of device; implant
Page 25 and 26: 43 Heart valve procedures44 Coronar
Page 27 and 28: 135 Forceps; vacuum; and breech del
Page 29 and 30: 229 Nonoperative removal of foreign
Page 31 and 32: 2.7 Cancer of ovary and other femal
Page 33 and 34: 5.2.2 Substance-related mental diso
Page 35 and 36: 7.2.4.3 Other acute and subacute fo
Page 37 and 38: 9.4 Upper gastrointestinal disorder
Page 39 and 40: 10.1.8.1 Hematuria10.1.8.2 Retentio
Page 41 and 42: 12.1 Skin and subcutaneous tissue i
Page 43 and 44: 16.2.4.2 Fracture of ankle16.2.4.3
Page 45 and 46: Appendix 4Multi-Level CCS - Procedu
Page 47 and 48: 7.5 Diagnostic cardiac catheterizat
Page 49 and 50: 9.31 Other OR gastrointestinal ther
Page 51 and 52: 14.10.5 Other lower extremity amput
Page 53: 16.31 Ophthalmologic and otologic d

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