Crosswalking,’ also known as ‘mapping,’ is the translating of one code to another. Its purpose is to ease transitioning from the old coding to the new system. While it is not a perfect solution, nor a substitute for mastering ICD-10, it is useful in bridging the coding gap for the short term until the implementation deadline is reached.
The National Center for Health Statistics (NCHS) has created mapping files, called “General Equivalence Mappings” (GEMs) for diagnosis codes, while the Centers for Medicare and Medicaid Services (CMS) have created GEMs for procedure codes. According to the American Academy of Professional Coders (AAPC), these GEMs are designed to provide a way to convert existing ICD-9 codes to their equivalent ICD-10 codes(s), as well as analyze data.
Some benefits of crosswalking:
More than half of the ICD-9 current superbill codes are designated as either ‘unspecified’ or ‘not otherwise specified’ so their continued use within the ICD-10 framework will only serve to defeat the purpose of specificity and accuracy behind the new system. Utilizing crosswalking will help you and your staff to become accustomed to the differences between the two coding systems during the transition period, such as with developing new superbills and other forms.
Crosswalking’s limitations:
Crosswalking cannot match code for code exactly due to the changes in concepts and structure of the ICD-10 system. Crosswalking is intended for the short term as a temporary way to bridge the learning gap between the initial and full implementation.
GEMs examples for help with transition:
Below are listed several examples from the American Medical Association fact sheet on crosswalking from ICD-9 to ICD-10. The AMA also reports that once the compliance deadline is past, the CMS will discontinue revisions to the GEMs files, eventually making them obsolete.
1. Exact One-to-One Match
|
ICD-9 Diagnosis Code |
ICD-10 Diagnosis Code |
|
1570 Malignant neoplasm of head of pancreas |
C250 Malignant neoplasm of head of pancreas |
2. Approximate One-to-One Match with One Choice
|
ICD-9 Diagnosis Code |
ICD-10 Diagnosis Code |
|
1574 Malignant neoplasm of islets of Langerhans |
C254 Malignant neoplasm of endocrine pancreas |
3. Approximate One-to-One Match with Multiple Choices
|
ICD-9 Diagnosis Code |
ICD-10 Diagnosis Code |
|
4169 Chronic pulmonary heart disease, unspecified |
I279 Pulmonary heart disease, unspecified |
|
4169 Chronic pulmonary heart disease, unspecified |
I2781 Cor pulmonale (chronic) |
4. One-to-One Match – (one ICD-10 code to multiple ICD-9 codes)
|
ICD-9 Diagnosis Code |
ICD-10 Diagnosis Code |
|
5375 Gastroptosis |
K3189 Other diseases of stomach and duodenum |
|
53789 Other specified disorders of stomach and duodenum |
K3189 Other diseases of stomach and duodenum |
5. One-to-Many Match with Multiple Scenarios
|
ICD-9 Diagnosis Code |
ICD-10 Diagnosis Codes |
|
|
80010 Closed fracture of vault of skull with cerebral laceration and contusion, with state of consciousness unspecified |
S020xxA Fracture of vault of skull, initial encounter for closed fracture |
|
|
S06339A Contusion and laceration of cerebrum, unspecified, with loss of consciousness of unspeciduration, initial encounter |
||
6. Research and reports
As part of your medical duties, you may need to generate reports of patient data including either ICD-9 of ICD-10 coding. Understanding crosswalking is essential to determine and accurately report on patient data within the transition period. Whether you move from ICD-9 to ICD-10 or backward will depend on how much data is in which time frame. Depending on the time period, research that is based upon or otherwise uses diagnostic codes will also need to do crosswalking with research data.
For further assistance with your practice’s ICD-10 transition questions and other billing concerns , contact M-Scribe Technologies, LLC – a recognized leader in the medical billing, coding and auditing fields.
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