> ## Documentation Index
> Fetch the complete documentation index at: https://docs.metriport.com/llms.txt
> Use this file to discover all available pages before exploring further.

# CCSR

> Learn about Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses.

## 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](https://hcup-us.ahrq.gov/toolssoftware/ccsr/dxccsr.jsp). 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.

## Applications

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

## 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*).

## CCSR Body System Categories

Taken from the CCSR [User Guide](https://hcup-us.ahrq.gov/toolssoftware/ccsr/DXCCSR-User-Guide-v2025-1.pdf).

| Three-character Abbreviation | ICD-10-CM Body System (largely aligned with chapters in the ICD- 10-CM Code Book) |
| :- | :- |
| `BLD` | Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism |
| `CIR` | Diseases of the circulatory system |
| `DEN` | Dental diseases |
| `DIG` | Diseases of the digestive system |
| `EAR` | Diseases of the ear and mastoid process |
| `END` | Endocrine, nutritional, and metabolic diseases |
| `EXT` | External causes of morbidity |
| `EYE` | Diseases of the eye and adnexa |
| `FAC` | Factors influencing health status and contact with health services |
| `GEN` | Diseases of the genitourinary system |
| `INF` | Certain infectious and parasitic diseases |
| `INJ` | Injury, poisoning and certain other consequences of external causes |
| `MAL` | Congenital malformations, deformations and chromosomal abnormalities |
| `MBD` | Mental, behavioral, and neurodevelopmental disorders |
| `MUS` | Diseases of the musculoskeletal system and connective tissue |
| `NEO` | Neoplasms |
| `NVS` | Diseases of the nervous system |
| `PNL` | Certain conditions originating in the perinatal period |
| `PRG` | Pregnancy, childbirth, and the puerperium |
| `RSP` | Diseases of the respiratory system |
| `SKN` | Diseases of the skin and subcutaneous tissue |
| `SYM` | Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified |

## 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.

```json theme={null}
{
    ...,
    "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"
                }
            ],
        },
        ...
    ],
    ...
}
```


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