Health Information Management

Mapping or crosswalking?

APCs Insider, March 22, 2013

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Crosswalks are quite in vogue as we prepare for the October 1, 2014 implementation of ICD-10. But do you know what a crosswalk really does?

Crosswalks allow codes to map an ICD-9-CM code to its equivalent code or codes in ICD-10-CM and vice versa. Crosswalks, also known as General Equivalence Maps (GEMS), are not foolproof. You don’t always get a one-to-one match. They are a good starting place and CMS publishes multiple GEMS for converting codes between ICD-10 and ICD-9.   
 
Mapping is something else all together. The primary thing you can use the map for is to compare reimbursement and charges.
 
Remember when the AMA combined the CT of the abdomen and CT of the pelvis into on CPT code? You can use a map to determine how much you charges and were paid for the individual services, so you can accurately price the combined service.
 
Crosswalks help guide you to the new codes, maps help you figure out what you’ll get paid for a service. Crosswalks and maps are both valuable tools, as long as you use them for the right purpose. Remember too that maps and crosswalks are just tools. They won’t code for you and they won’t provide a solid defense against an audit.
 
They’re also not infallible, but they can guide you to new codes or help you set prices for services based on historical data.



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