Understanding GEMs attributes

GEMs (General Equivalance Mapping) are direction and has either forward mapping or backward mapping. The source system determines the map’s direction. Target system should never be used for mapping direction.

Example for Forward mapping

In ICD 9 procedure code 843.  Revision Of Amputation Stump will have long list of below procedure codes in the ICD 10 PCS (Procedure coding system).
0HQBXZZ Repair Right Upper arm Skin, External Approach
0HQCXZZ Repair Left Upper arm Skin, External Approach
0HQDXZZ Repair Right Lower arm Skin, External Approach
0HQEXZZ Repair Left Upper arm Skin, External Approach

Source System

Target System
Mapping direction
ICD 9 CM (procedure classification)
ICD 10 PCS the newer procedure codes
Forward

Source System

Target System
Mapping direction
ICD 10 CM, the newer code set
ICD 9 CM (disease classification) the older set
backward


Understand GEMs Attributes

There are different attributes which are used while mappling ICD 9 or ICD 10 codes. For example, 10000,11000, 10112, 10111 etc. But, many of us have less clarification how to interpret these attributes.
719.41          M25511          10000
719.41         M25512           10000
719.41         M25519           10000
In the above example, the attributes are 10000. The first digit “1” here signifies the mapping is an approximate match for the code.
When the first digit is “0” then the mapping is considered as identical or equivalent for the target code.
Now when we code diabetes we have to use combination codes along with diabetes. Here the attributes will differ as well.
25092 E1165  10112
25092  E118   10111
Now, in the above example, the third digit is very important here. If the third digit is “1” then it indicates that a combination of target codes is necessary for a complete translation of the source code.



Column 1
Column 2
Column 3
Source Code
Target Code
Attributes
Approximate [FLAG]
No Map [FLAG]
Combination [FLAG]
Scenario
Choice List
1 = Yes/On
0 = No/Off
1 = Yes/On
0 = No/Off
1 = Yes/On
0 = No/Off
0-9
0-9
Example (ICD-10-CM to ICD-9-CM [disease classification] GEM)
B3741
1122
1
0
0
0
0
Example (ICD-9-CM [disease classification] to ICD-10-CM GEM)
V6441
No Dx
1
1
0
0
0


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1 comments:

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31 October 2016 at 08:50 delete

The source of information that you have posted about mapping and coding is really useful. We have able to learn a lot of useful techniques from it that is essential to use in all the aspects of the GEMS attributes.

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