I provided education via a webinar on Wednesday, March 5 regarding the latest information on the ICD-10-CM transition. In Medlearn article SE1410 Medicare allowed the use of the General Equivalence Mappings (GEMs) for use just during the transition. I expressed my dismay that Medicare would allow the GEMs for actual coding plus stated my belief that the use of the GEMs would result in error and loss of case mix points.
Medicare has just revised SE1410 to now remove all references to the GEMs and the new grid is attached below.
This means that any episode that crosses over the October 1, 2014 implementation date will need to be coded in ICD-9-CM and ICD-10-CM based on the M0090 date of the OASIS, the ‘from’ date on the episode and the ‘through’ date on the episode. Actual coding processes must be used. This does increase the burden to agencies however it will result in fewer errors and rejections of claims. My real concern was that because the GEMs are not complete codes in some cases and include only 7th character A, the MAC systems would not accept the codes and/or HIPPS codes would be affected.
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