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What is Aetna’s approach to mapping ICD-9 codes to the ICD-10 codes?

April 26, 2017Aetna approach icd-10 icd-9 Mapping

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What is Aetna’s approach to mapping ICD-9 codes to the ICD-10 codes?

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Mappings between ICD-9 and ICD-10 identify corresponding diagnosis codes between the two code sets.1 CMS has provided General Equivalency Mappings (GEMs) as an approach to define reasonable alternatives for mappings between ICD-9 and ICD-10 codes in both directions. While the GEMS provide guidance and a starting point for crosswalk development, there is currently no industry standard for mapping. We are evaluating the GEMs to determine how they can be applied to our practices, including reviewing common claim scenarios for simulation and modeling.