What are the GEMs in regards to ICD-9 and ICD-10 codes?

The GEMs were designed to convert current ICD-9-CM codes to applicable ICD-10 codes. A “reverse lookup” of the backward mappings (ICD-10-CM/PCS to ICD-9-CM GEM, looked up by ICD-9-CM code) can be used to convert payment logic or coverage decisions from ICD-9-CM codes to ICD-10 codes.

What does GEMs stand for in coding?

According to the CMS document entitled General Equivalence Mappings: Frequently Asked Questions , “the GEMs are a tool that can be used to convert data from ICD-9-CM to ICD-10-CM and PCS and vice versa. Mapping from ICD-10-CM and PCS codes back to ICD-9-CM codes is referred to as backward mapping.

Are ICD-9 codes still used?

CMS will continue to maintain the ICD-9 code website with the posted files. These are the codes providers (physicians, hospitals, etc.) and suppliers must use when submitting claims to Medicare for payment. These codes form the basis of those used for Section 111 reporting, with some exceptions.

What are GEMs files?

The GEM files are a public domain reference mapping designed to give all sectors of the healthcare industry that use coded data a tool to convert and test systems, link data in long-term clinical studies, develop application-specific mappings, and analyze data collected during the transition period and beyond.

What is ICD-9 and ICD-10 difference?

The biggest difference between the two code structures is that ICD-9 had 14,4000 codes, while ICD-10 contains over 69,823. ICD-10 codes consists of three to seven characters, while ICD-9 contained three to five digits.

When did ICD-9 start?

One year later, WHO advised a series of ICD-9 specifications. Several years later in 1975, ICD-9 was published with its implementation becoming formalized in 1979. During this time, the number of diagnosis codes was expanded upon and the development of a procedural coding system made official headway.