Using GEMs for ICD-10 Preparation

GEMs and ICD-10 HISOctober 1, 2015 is the deadline put in place by the Centers for Medicare & Medicaid Services (CMS) for switching to the ICD-10 standard for medical coding.  The impending switch is an issue that many healthcare practitioners need to devote some time and effort to so that they will be able to adapt to it by this deadline.  

GEMs, or General Equivalence Mappings, allow medical firms to have a crosswalk between the older ICD-9 codes and the new ICD-10 codes so that they can increase their efficiency when considering how to prepare for ICD-10 conversion.  In order to maximize the value that your practice receives from these GEMs, you must keep a few important concerns in mind.

One of the initial steps when considering how to prepare for ICD-10 conversion through GEMs is what particular kind of GEM is right for your needs.  GEM tools are used by a wide range of medical professionals, including medical researchers, coders, and software vendors when they are creating their products.  There are also GEMs in place that go backwards from ICD-10-CM and ICD-10-PCS codes to allow users more flexibility in how they look up the code information that they require.  This backwards mapping will not only help firms considering how to prepare for ICD-10, it will also make conducting research on historic trends at your practice much easier.

Your next step is to begin the process of utilizing GEMs to help you with your switch.  Keep in mind that using GEMS is not a substitute for learning the new ICD-10 codes.  The GEMs are used much in the same way as one would use a dictionary that translates between languages.  They are helpful tools for quick fixes on how to speak certain words of a language, but to become truly fluent you need to study the language itself instead of looking up these individual words.  The same concept holds true with medical codes.  Having said that, there are several reasons why GEMs do provide valuable assistance for medical practitioners still getting used to the new ICD-10 coding:

  • ICD-10 codes are much more detailed.  For example, ICD-9-CM has 3,878 codes while the ICD-10-CM has 68,000 codes.  The ICD-9 codes are limited to five characters while the ICD-10 codes expand to seven character positions. 
  • Certain types of ICD-10-CM codes do not have any corresponding ICD-9-CM codes, which may cause confusion in converting medical records
  • The ICD-10 codes are much more specific so a single ICD-9-CM code may have two or three or more corresponding ICD-10-CM codes.

Quality medical coding is a crucial element of an efficient practice.  If your practice is concerned about how to prepare for ICD-10 conversion with the deadline less than 14 months away, we at Healthcare Information Services, L.L.C. are happy to help.  We can help you with the use of GEMs and other important tools that can help you smoothly make the switch to the new ICD-10 requirements for medical coding. 

Image courtesy of: twobee/