ICD10 CM General Equivalence Mappings GEMs Coordination Maintenance

ICD-10 -CM General Equivalence Mappings (GEMs) Coordination & Maintenance Committee Meeting September 28, 2007 CMS Headquarters—Baltimore

Codes are. . . n the currency of data transactions n n monitor health status of a defined population track trends in disease and treatment optimize delivery of healthcare govern reimbursement 2

Code Mapping & I-10 Implementation n Mappings will be used to n n convert and test systems link data in long-term clinical studies develop application-specific mappings analyze data collected during transition period and beyond 3

an attempt to translate equivalent meaning from Code Mapping is. . . n n source to target one source system code linked to one or more target system codes 4

“ equivalent meaning” meaning. . . “an attempt to translate equivalent meaning from source to target” n heavily dependent on the purpose of the map n n clinical mapping focuses on all possible meanings contained in source system code reimbursement mapping focuses on equivalent payment 5

if the differences were not significant, no incentive Different is Good n to change n clinical equivalent not possible in many cases 6

ICD-10 -CM General Equivalence Mappings n n Presents all reasonable correspondences between the two code sets Consists of two general equivalence mappings (GEMs) n n n ICD-9 -CM to ICD-10 -CM to ICD-9 -CM Each file contains code pairs—one code from each set n n Source or target system code may be used more than once Additional information specified using flags 7

Presents All Reasonable Correspondences: All-inclusive 8

Presents All Reasonable Correspondences: Rule-based 9

Consists of Two GEM Files: I-9 to I-10 and I-10 to I-9 I-10 + flags 6822 L 03311 1 0 0 6822 L 03312 1 0 0 6822 L 03313 1 0 0 6822 L 03314 1 0 0 6822 L 03315 1 0 0 6822 L 03316 1 0 0 6822 L 03317 1 0 0 6822 L 03319 1 0 0 6822 L 03321 1 0 0. . . I-10 I-9 + flags O 045 O 045 63500 63502 63600 63601 63602 63700 63702 10000 10000 10

Additional Information Specified in Flags n Read as 1=On, 0=Off n Three different flags n n n Approximate No Map Combination 11

Approximate Flag 1 “On” = Approximate 12

No Map Flag 1 “On” = No Map 13

Combination Flag 1 “On” = Combination 14

Diagnosis GEMs User’s Guide 15

GEMs User’s Guide: Intro to Mappings 16

GEMs User’s Guide: How to Use GEM Files 17

GEMs User’s Guide: Glossary 18

GEMs User’s Guide: File and Format Info 19

Documentation and User’s Guide n Posted on NCHS website with GEM files n n http: //www. cdc. gov/nchs/about/otheract/icd 9/icd 10 cm. htm Revised as needed based on industry response 20