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Overview

The Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses is a classification system developed by the Agency for Healthcare Research and Quality (AHRQ) — see the official documentation. It groups more than 70,000 ICD-10-CM diagnosis codes into 550+ clinically meaningful categories across 22 body systems. This allows diagnoses to be organized into two hierarchical levels of CCSR categorization that are easier to interpret, analyze, and visualize — for example, grouping all tumor-related diagnosis codes under a single neoplasms category.

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Applications

Metriport enriches FHIR Conditions by including both descriptive CCSR categories and broader body systems, maximizing flexibility for categorization and analytics.

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Key Considerations

A single ICD-10-CM code may map to multiple CCSR categories when it represents more than one clinical concept. Each CCSR code consists of:
  • A three-letter prefix representing a body system or condition category (e.g., END for endocrine disorders).
  • A three-digit numeric suffix representing a specific category within that body system (e.g., END002 → Diabetes mellitus without complication).

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CCSR Body System Categories

Taken from the CCSR User Guide.
Three-character AbbreviationICD-10-CM Body System (largely aligned with chapters in the ICD- 10-CM Code Book)
BLDDiseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
CIRDiseases of the circulatory system
DENDental diseases
DIGDiseases of the digestive system
EARDiseases of the ear and mastoid process
ENDEndocrine, nutritional, and metabolic diseases
EXTExternal causes of morbidity
EYEDiseases of the eye and adnexa
FACFactors influencing health status and contact with health services
GENDiseases of the genitourinary system
INFCertain infectious and parasitic diseases
INJInjury, poisoning and certain other consequences of external causes
MALCongenital malformations, deformations and chromosomal abnormalities
MBDMental, behavioral, and neurodevelopmental disorders
MUSDiseases of the musculoskeletal system and connective tissue
NEONeoplasms
NVSDiseases of the nervous system
PNLCertain conditions originating in the perinatal period
PRGPregnancy, childbirth, and the puerperium
RSPDiseases of the respiratory system
SKNDiseases of the skin and subcutaneous tissue
SYMSymptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified

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Where can I find it in Metriport’s patient record?

CCSR codes are found in Condition resources under the code.coding array. CCSR body systems are found in Condition resources under the category array. 
{
    ...,
    "resourceType": "Condition",
    "code": {
        "text": "Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral",
        "coding": [
            {
                "system": "https://hcup-us.ahrq.gov/toolssoftware/ccsr/ccs_refined.jsp",
                "code": "END003",
                "display": "Diabetes mellitus with complication"
            },
            {
                "system": "https://hcup-us.ahrq.gov/toolssoftware/ccsr/ccs_refined.jsp",
                "code": "END005",
                "display": "Diabetes mellitus, Type 2"
            },
            {
                "system": "https://hcup-us.ahrq.gov/toolssoftware/ccsr/ccs_refined.jsp",
                "code": "EYE005",
                "display": "Retinal and vitreous conditions"
            },
            ...
        ]
    },
    "category": [
        {
            "coding": [
                {
                    "system": "https://hcup-us.ahrq.gov/toolssoftware/ccsr/ccs_refined.jsp",
                    "code": "END",
                    "display": "Endocrine, nutritional, and metabolic diseases"
                }
            ],
        },
        {
            "coding": [
                {
                    "system": "https://hcup-us.ahrq.gov/toolssoftware/ccsr/ccs_refined.jsp",
                    "code": "EYE",
                    "display": "Diseases of the eye and adnexa"
                }
            ],
        },
        ...
    ],
    ...
}