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Researchers Link ICD-10 Shift to Financial Losses



The transition from ICD-9 to ICD-10 coding led to significant information loss at one oncology clinic, says a researcher who found that 39 ICD-9-CM codes with information loss accounted for 2.9% of total Medicaid reimbursements and 5.3% of the organization's billing charges.



2 comments on "Researchers Link ICD-10 Shift to Financial Losses"
Dan Toren (3/18/2014 at 2:32 PM)

Great questions Susie. From 3M website:"How 3M became the ICD-10 leader Under contract with the Centers for Medicare and Medicaid Services (CMS), 3M designed and developed the ICD-10 Procedure Coding System (ICD-10 PCS) and the General Equivalence Mappings (GEMs). 3M also completed the initial conversion of the CMS MS-DRGs to ICD-10." Disclaimer: we have nothing to do with 3M. However, anticipating the angst of October 1st, we've developed and recently released an app that may help alleviate the anxiety related to the ICD-10 implementation - ICD10Doc. And yes, we have actually used GEM for mapping between ICD-9 and ICD-10. ICDDoc.com is intended especially for the small practices that don't have the support or budgets of a hospital HIM department. You can check it out at http://icd10doc.com Your feedback would be much appreciated Thanks Dan
Susie/Internal Medicine Practice Administrator (3/17/2014 at 10:54 AM)

I am still trying to figure out why there is the switch to ICD-10 in the first place. Real facts, not just government or insurance company public statements. Who wrote/created the GEMs? Is this evidence based medicine? When the author states that the maps may be wrong, most practices simply don't have the time or knowledge to create new algorithms. Is this tool for oncology only? Is this "map" ubiquitously used by Medicare and Commercial insurance companies? In other words, are they sharing the same GEMs? Any assistance would be greatly appreciated. Thank you in advance.