Introduction to New Functionality ICD9 to ICD10 Mapping This document contains an overview of new functionality in Blue Step. Table of Contents Diagnosis ICD9 to ICD10 GEM Report... 1 Diagnosis Form... 5 Helpful Hints on Correcting Issues... 8 Disclaimer... 9 Diagnosis ICD9 to ICD10 GEM Report Residents>Reports A new report has been created allowing users to see the CMS General Equivalence Mapping (GEM) that is found on the CMS web site, to help crosswalk existing ICD9 codes to the new ICD10 list of codes as has been mandated for October 1 of this year. The report allows all Active Residents with active ICD-9 codes, for which no ICD-10 code has yet been added, to allow you to perform this crosswalk. 1
This report will display the existing active ICD-9 code in the left-hand column, and then display the ICD-9 to ICD-10 GEM crosswalk in the right-hand column so that you see what available codes you can select from as you proceed. ICD-10 GEM codes displayed with a tilde (~) indicate an approximate match where an exact crosswalk isn t possible. Review of the possible matches and selection of the correct ICD10 can only occur from a clinical knowledge of the resident and their specific illness or condition. 2
Single ICD-10 GEM codes displayed with no tilde (~) indicate a one-to-one match with the associated ICD9. ICD-10 GEM codes with multiple crosswalk options listed, or labelled Combo, indicate a combination code where the existing ICD9 crosswalks to more than one ICD-10 code. 3
To perform the ICD9 to ICD10 crosswalk for each existing active diagnosis, click SELECT next to the desired ICD9 code. This will take you to the Diagnosis Form which is shown in the next section of this documentation. You will want to select each listed resident ICD9 diagnosis in the left-hand column to perform the crosswalk and entry of the clinically appropriate desired ICD-10 code(s). 4
Diagnosis Form The Diagnosis form now includes an ICD-10 Diagnosis lookup field. Note: The ICD10 field will be a non-required field, by default, until two weeks prior to the ICD-10 implementation date. The ICD-9 Diagnosis lookup field, however, will continue to be a required field until the ICD-10 implementation date of October 1, 2015. The CMS GEM file has been uploaded into the software and is being presented in this screen to allow users to crosswalk the ICD9 code to the new ICD10 equivalent on each resident diagnosis. The ICD-9 code you selected from the Diagnosis ICD9 to ICD10 GEM report will be displayed in the ICD 9 Diagnosis lookup field. Click the GEM button to activate the crosswalk function and display the associated ICD10 codes. 5
The associated code(s) will display the same options noted on the Diagnosis ICD9 to ICD10 GEM report. Below is an example of an ICD9 code that only has one suggested match in the ICD10 list. Click on the desired clinically appropriate ICD-10 code from the GEM display, and the code will automatically populate the ICD-10 Diagnosis lookup field 6
More than one ICD-10 code can be selected for a single ICD-9 code, in the case of a COMBO code, by selecting the option to Save and add to combo code Note: The clinician performing the crosswalk of ICD9 to ICD10 diagnosis codes may not want to select this option if there is only one listed code in the suggested crosswalk. That would create an error in their matching that is not consistent with the CMS crosswalk file. If the SAVE AND ADD TO COMBO CODE option is selected, the ICD-10 Diagnosis lookup field will open for another selection. The GEM file will display for easy selection of the other associated code(s) that are matched to the original ICD9 you are working with. 7
Helpful Hints on Correcting Issues If a user selects the option to Save and add to combo code and then cancels the entry without selecting any of the additional ICD-10 code(s) listed in the crosswalk, the ICD-9 will still show the COMBO designation in the list of active diagnoses, but it will be a single entry and therefore incomplete. This can be corrected by following the steps below: Edit the diagnosis entry Select the option to DC this diagnosis and then select Archive/Void Re-enter the ICD-9 code and suggested ICD-10 code. Diagnosis will then display as No Combo 8
Disclaimer The GEM report and GEM tool provided are based on the General Equivalency Mapping (GEM) files published by CMS, and are not intended to be used as an ICD-10 conversion tool. Keep in mind that while many ICD9 codes crosswalk directly to single codes in ICD10, a clinical determination should be made to determine which ICD10 code or codes should be selected from the GEM list. It is a good practice to always review the suggested crosswalk codes against the resident known illnesses and conditions before selecting them. 9