http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/FAQ-09-04-2014.pdf
The GEMs are a tool you can use to convert data from
ICD-9-CM to ICD-10-CM and ICD-10-PCS and vice versa. The GEMs are also known as crosswalks as they provide important information linking codes of one system with codes in the other system. The GEMs are a comprehensive translation dictionary that can be used to accurately and effectively translate any ICD-9-CM-based data, including data for: ™™ Tracking quality; ™™ Recording morbidity/mortality; ™™ Calculating reimbursement; or Converting any ICD-9-CM-based application to ICD-10-CM/PCS such as: Payment systems; Payment and coverage edits; Risk adjustment logic; Quality measures; and A variety of research applications involving trend data. Mapping from ICD-10-CM and ICD-10-PCS codes back to ICD-9-CM codes is known as backward mapping. Mapping from ICD-9-CM codes to ICD-10-CM and ICD-10-PCS codes is known as forward mapping. The GEMs are complete in their description of all the mapping possibilities as well as when there are new concepts in ICD-10 that are not found in ICD-9-CM. All ICD-9-CM codes and all ICD-10-CM/PCS codes are included in the collective GEMs: ™™ All ICD-10-CM codes are in the ICD-10-CM to ICD-9-CM GEMs; ™™ All ICD-9-CM Diagnosis Codes are in the ICD-9-CM to ICD-10-CM GEMs; ™™ All ICD-10-PCS codes are in the ICD-10-PCS to ICD-9-CM GEMs; and ™™ All ICD-9-CM Procedure Codes are in the ICD-9-CM to ICD-10-PCS GEMs. https://www.aapc.com/icd-10/conversion-mapping.aspx
The below tutorial explains ICD-9 to ICD-10 conversion and mapping. For help with converting codes, refer to our online ICD-10 code conversion tool, see our ICD-9 to ICD-10 crosswalks by specialty, or consider our ICD-10 mapping services. One of the identified benefits for the United States' transition from ICD-9 to ICD-10 is because of the increased level of specificity offered by the ICD-10 code format. This specificity will benefit patients and doctors (by giving more detailed diagnosis and treatment information), payers (by more accurately defining services) and international organizations that monitor worldwide disease. However, all of this increased specificity comes at a price—the codes are becoming more complex. In ICD-9-CM, codes are three to five digits. The first digit is either numeric or alpha (the letters E or V only) and all other digits are numeric. In ICD-10-CM, however, codes can be up to seven digits. The first digit is always alpha (it can be any letter except U), the second digit is always numeric, and the remaining five digits can be any combination. The following example shows an ICD-10-CM code for chronic gout due to renal impairment, left shoulder, without tophus. The corresponding ICD-9-CM code would have been 274.02, which only indicates gouty arthropathy. As you can see, the ICD-10-CM code contains much more information. Mapping Some ICD-9-CM codes map easily to ICD-10 in a simple one-to-one conversion. For example, the ICD-9-CM code 733.6 (Tietze's Syndrome) maps directly to the ICD-10-CM code M94.0. (An exact map does not always mean the codes match in detail.) Other codes will require additional information to map for possible solutions. For example, the ICD-9-CM code 649.51 (spotting complicating pregnancy) requires information about weeks in pregnancy to map. There are three options: O26.851 (spotting complicating pregnancy, first trimester), O26.852 (spotting complicating pregnancy, second trimester), and O26.853 (spotting complicating pregnancy, third trimester). http://news.aapc.com/index.php/2014/07/official-date-for-icd-10-implementation-annThe
U.S. Department of Health and Human Services (HHS) issued a rule Aug. 4 finalizing Oct. 1, 2015 as the new compliance date for healthcare providers, health plans, and healthcare clearinghouses to transition to ICD-10, the tenth revision of the International Classification of Diseases. This deadline allows providers, insurance companies, and others in the healthcare industry time to ramp up their operations to ensure their systems and business processes are ready to go on Oct. 1, 2015. The anticipated announcement is consistent with speculation the date would be moved back by exactly one year, as the original mandate was scheduled for Oct. 1, 2014. “We’re very pleased HHS issued the official ICD-10 implementation date. We look forward to helping the industry continue to progress with testing and improving coder productivity. The finalization of the date provides clear incentive to improve physician documentation,” said Rhonda Buckholtz, CPC, CPMA, CPC-I, vice president of ICD-10 Training and Education at AAPC. Stay Tuned AAPC will follow up with more information on the steps organizations should now take to prepare for ICD-10 implementation. To stay up-to-date with the latest ICD-10 announcements, subscribe to our RSS feed or follow us on Twitter ounced/ http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/index.htmlPhysician Fee Schedule
CY 2015 Physician Fee Schedule Proposed Rule with Comment Period The CY 2015 PFS proposed rule with comment period was placed on display at the Federal Register on July 3, 2014. In this major proposed rule, we propose RVUs for CY 2015 and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. In addition to policies affecting the calculation of payment rates, this proposed rule proposes potentially misvalued codes, adding procedures to the telehealth list, a process for added transparency in development of payment rates, and provisions relating to implementation of separate payment for chronic care management services. In addition the rule includes proposals and updates related to the ambulance fee schedule regulations, the Physician Compare Website, the Physician Quality Reporting System, the Medicare Shared Savings Program and the Value-Based Payment Modifier and the Physician Feedback Program. |