Perspectives on Medical Reimbursement Issues
By JR Associates
• Beth Bontemps, MSN, RN, NP, CCS Senior Consultant, JR Associates, Inc.
• Rayellen Gilles, Customer Experience, Wolters Kluwer Law & Business
By October 1, 2013, all U.S. healthcare providers are required to transition from the existing ICD-9 code set to next-generation standards — ICD-10. In preparation, the Centers for Medicare and Medicaid Services (CMS) and Centers for Disease Control (CDC) created the General Equivalence Mappings (GEMs) to ensure that data is consistent, nationwide.
GEMs are intended to serve as a translation dictionary between ICD-9-CM and ICD-10-CM/PCS, but aren’t designed to substitute for their correct application. They should be used to look up relevant codes after a generally equivalent code is located.
Prior to the shift, providers will need to adjust clinical documentation that prepares a medical record for ICD-10 coding. To uncover related issues that may arise with ICD-10 coding and MS-DRG grouping, we examined sample Cardiac Rhythm Management procedure scenarios.
The full whitepaper is available for download directly from Wolters Kluwer:
Impact of ICD-10 on Coding and Reimbursement for Cardiac Rhythm Management Procedures
Would you like to discuss how your organization can prepare for the shift to ICD-10? Contact us anytime to schedule a preliminary consultation.
Republished from Wolters Kluwer