Claims and Coding

The Centers for Medicare & Medicaid Services (CMS) has made available the 2011 versions of the ICD-10-CM and ICD-10-PCS crosswalks, also known as general equivalence mappings (GEMs), on the ICD-10 portion of its Web site ( A quick reference guide, a “What's New” summary, compliance timelines, and a user- and reimbursement-procedures guide are also downloadable.

According to CMS, “ICD-10 codes must be used on all HIPAA transactions, including outpatient claims with dates of service, and inpatient claims with dates of discharge on and after Oct. 1, 2013. Otherwise, your claims and other transactions may be rejected, and you will need to resubmit them with the ICD-10 codes. This could result in delays and may impact your reimbursements, so it is important to start now to prepare for the changeover to ICD-10 codes. This change does not affect CPT coding for outpatient procedures.”

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