GEMs: Buyers Beware-CROSSWALK AND TRANSLATION TOOLS CAN BRING UNEXPECTED RISKS

摘要

WHEN IT COMES to converting superbills and claims from ICD-9-CM to ICD-10-CM, many healthcare providers believe that general equivalence mappings (GEMs) offer a cost effective and simple solution. The ability to purchase relatively cheap automated mappings of specialties' top codes contributes to this sense of security. The mappings are often marketed using terms such as "translation tools" or "crosswalks." Mappings are useful tools, but it is important that healthcare providers are also advised of the tools'limitations. Mapping simply provides a linkage between a code in one set and its closest equivalent in the other code set without consideration of context or specific patient encounter information, whereas coding involves assigning the most appropriate code based on health record documentation, knowledge of other codes in the medical record, and applicable coding guidelines.