Stream: terminology
Topic: CCSR and CCS
Brendan Keeler (Aug 11 2021 at 17:46):
Looking to list the CCSR for ICD-10-CM Diagnoses, CCSR for ICD-10-PCS Procedures, and CCS for Services and Procedures in our terminology server. I don't see a canonical URI for these here: https://www.hl7.org/fhir/terminologies-systems.html
I was planning on using these: https://www.hcup-us.ahrq.gov/toolssoftware/ccs_svcsproc/ccssvcproc.jsp
https://www.hcup-us.ahrq.gov/toolssoftware/ccsr/dxccsr.jsp
Brendan Keeler (Aug 11 2021 at 17:46):
https://www.hcup-us.ahrq.gov/toolssoftware/ccsr/prccsr.jsp
Brendan Keeler (Aug 11 2021 at 17:47):
Is there a good way to determine a canonical URI to list?
Eric Haas (Aug 11 2021 at 20:34):
ICD-10-PCS = http://www.cms.gov/Medicare/Coding/ICD10
ICD-10-CM = http://hl7.org/fhir/sid/icd-10-cm
Eric Haas (Aug 11 2021 at 20:37):
look here: https://terminology.hl7.org/1.0.0//codesystems.html
Brendan Keeler (Aug 12 2021 at 17:48):
Those are ICD-10-CM and ICD-10-PCS, but I am asking about the CCS codesystem
May Terry (Aug 19 2021 at 13:54):
The request is interesting and one that I'd like some guidance on as well.
If we were to start with the definitions in the code system scope and noted by HL7 Vocab (https://www.hl7.org/fhir/codesystem.html#scope), then CCSR is not exactly a code system but a reorganization (as a taxonomy) of an existing code system for a specific use case - in this case AHRQ for for healthcare cost and utilization. Like Elixhauser (another AHRQ grouping of ICD10CM codes), CCSR is updated each year in line with the ICD10CM FY releases, but in itself does not define new codes or concepts. Given this understanding, CCSR is closer to a value set, which vocab has defined as "specifies a set of codes drawn from one or more code systems, intended for use in a particular context."
But then...what would be the best practice in FHIR's handling of taxonomies, or possibly ontologies based on existing code systems?
Is the guidance to build a value set or identify it as a code system? Code system is structurally more elegant for taxonomies, but value set seems truer to the intent.
Michael Lawley (Aug 19 2021 at 22:44):
Given that CCSR creates its own alternate hierarchical structure, then this could be represented (with new, dedicated properties) as a CodeSystem supplement. For example, you could define new properties ccsrParent and ccsrAncestor (as well as defining a ValueSet that captured just the codes that make up CCSR).
Robert McClure (Aug 25 2021 at 12:41):
I agree with @Michael Lawley that of the alternatives, representing this as a code system supplement fits more use cases then representing this as a value set - which I do agree with @May Terry, is technically an option. The reason it fits better is that we should be able to do all the code system operations using the supplement hierarchy properties but I'd be interested in @Michael Lawley's confirmation that ontoserver could do this.
Michael Lawley (Aug 31 2021 at 11:55):
Well, they would just be properties - they have no special status (e.g., would not be used to determine $subsumes or is-a or :below or similar. However, as long as your ccsrAncestor values were the transitive closure of the ccsrParent values, then you could use them in ValueSet.compose.include.filter to define ValueSets using these alternate hierarchies.
Last updated: Apr 12 2022 at 19:14 UTC
