Several healthcare industry groups collaborated to develop the General Equivalence Mapping (GEM) system to aid in making the transition from ICD-9 to ICD-10 less cumbersome. This system, which aims to more closely match each ICD-9 Code with its ICD-10 counterpart, does not work on a one-to-one crosswalk basis.
Connect Back Office features the ICD GEMS tool, accessed from the File menu. Use this tool anytime to search for and enter an ICD-9 code to populate a list of potential ICD-10 code mappings.
The following errors warrant use of the ICD GEMS tool to determine the correct code:
- An error appears stating, "Payer/Plan requires ICD-9" or "Payer/Plan requires ICD-10". This error occurs when the primary plan on the claim is set to send diagnosis codes in the other format. For example, the plan is set to send ICD-10 codes and the codes entered are ICD-9, or vice versa. Diagnosis Codes options are set in the Plan: [ID] > Claims tab.
An error appears stating, "ICD-9 is not associated with [CPT/ASA code]". This error occurs when the ICD-9 code entered is not associated with the Procedure (CPT) code. This would occur only if the Enable CPT/ASA to ICD-9 GEMs option is unchecked in the Practice: [ID] > Miscellaneous tab.
