In late May, CMS published a new presentation that explains how to use General Equivalence Mappings (GEMs). Find the presentation here. The presentation provides a high-level overview of forwards and backwards mapping between ICD-10 and ICD-9, both for procedures and diagnoses. Most people understand this concept and the need for it. What people seem to have questions about is how the GEM flags work.

The GEM flags are used to provide coders with insight about the quality and or accuracy of the mapping. The five-digit flags provide coders with a great deal of information. For this purpose of this post, we'll example the first three digits of the flag code. An upcoming post will detail the meaning of the fourth- and fifth-digit fields, which require a more lengthy explanation.
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Detailed clinical documentation is the heart of ICD-10 coding. ICD-10 holds the promise of increased specificity within its coding, but the documentation needs to support the increased specificity. Posts on several ICD-10 message boards have indicated a quick and simple way to access the quality of the clinical documentation at their organizations, and the value of the idea is worth repeating here.

As coders begin to learning to use ICD-10, they should apply their new knowledge by coding a cross section of existing clinical documentation using the ICD-10 code set. Such an exercise will provide a quick assessment of the organization's shortcomings within its clinical documentation.
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CMS recently posted a summary report about its ICD-9-CM Coordination and Maintenance Committee meeting. The committee reviews requested changes to the ICD-9 code set, as well as the development and implementation of the ICD-10 code set. Highlights of the issues discussed during the meeting include:

Code Update Freeze – CMS discussed the need to freeze updates to ICD-9-CM and ICD-10 prior to the implementation of ICD-10. Several meeting attendees supported a freeze, but had yet to formulate clear opinions as to when the freeze should begin and if the freeze should apply to both ICD-9-CM codes as well as ICD-10-CM and ICD-10-PCS codes. Meeting participants agreed to discuss the issue in more depth at the next Committee meeting in September.
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