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Context 4 Healthcare, Inc. Can Solve Your GEM of an ICD-10 Problem

  • by Margaret Klasa DC, APN BC
  • Feb 20, 2015, 12:01 PM

Contest_to_Solve_ICD-10_ProblemMost healthcare professionals - from vendors to coders to physicians - are concerned about one aspect of the upcoming, mandated transition to the ICD-10 code set slated for October 1, 2015. A growing consensus across the healthcare industry is that the commonly used General Equivalence Mappings (GEMs) files, published by the Centers for Medicare & Medicaid Services (CMS), are not enough to ensure accurate and appropriate results between ICD-9 and ICD-10 codes. Both in forward and reverse mappings, the GEMs have provided inconsistent crosswalks leading to the conclusion that there is no true crosswalk from ICD-9 to ICD-10 codes. Furthermore, software vendors that solely rely on using the GEMs within their systems often end up displaying pick lists or drop-down menus of codes that are not physician friendly. These ICD-10 system lists are often being populated by IT staff or system administrators, thus leaving clinicians, coders, and intake staff with inadequate ICD-10 choices.

The industry’s concern about the inadequacies of the GEMs was substantiated in a February 10, 2015 FierceHealthIT article titled, “Study: ‘No True Crosswalk’ Exists Between ICD-9 and ICD-10.” In the article, author Susan D. Hall cited a recent study from Vanderbilt University, published in the Journal of the American Informatics Association, involving records from 100 patients that visited the Vanderbilt Adult Primary Care Clinic. The patients’ records were manually coded in both ICD-9-CM and ICD-10-CM, and then compared with GEMs and Reimbursement Mappings (RMs) published by CMS. The analysis found that while the GEM/RMs were consistent with manual encodings more than 80 percent of the time in both directions, a significant number of manual mappings were inconsistent with the GEMs and RMs. According to the research conclusion, the mismatched mappings consisted of only one ICD-9 and one ICD-10 code, and at least half did not match the GEMs due to subtle differences within the same hierarchical category.

Context4 Healthcare can solve your ICD-10 problem. Our ICDTransfomer solution delivers accurate and appropriate ICD-10 codes while eliminating your need to rely on the GEMs. ICDTransformer goes well beyond a simple crosswalk – for example our easy-to use keyword search feature allows users to input the words they know from their experience with ICD-9 in order to return specific ICD-10 codes. In addition, users can enhance the ICDTransformer keyword search by adding the detailed ICD-10 terms they will need – laterality, trimester, stage, etc. Unlike a simple crosswalk or system drop-down menu, ICDTransformer also provides users with the include and exclude codes, code descriptions, and explanatory notes. Now you can use what you know in ICD-9 to get you to the ICD-10 code you want easily.

Read More: Context 4 Healthcare, Inc. Launches Innovative ICDTransformer™ Solution

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