Digital image transmission typically optimizes source coding, channel coding, and modulation separately, limiting how source representations adapt to channel impairments. We propose SemQAM, a joint semantic-channel coding and modulation scheme for generative image transmission converting source to modulated symbols, such as standard QAM symbols. Channel impairments create two challenges: they can corrupt the latent representation at the receiver, and this corruption can compound through autoregressive coding, degrading reconstruction quality. First, SemQAM represents latent features with vector quantization (VQ), maps each VQ index to a QAM symbol, and updates the codeword corresponding to the detected symbol so that channel impairments directly affect codebook learning. Moreover, SemQAM uses the conditional expectation of received codewords to approximate the receiver reconstruction and reduce error propagation during autoregressive coding. SemQAM supports multiple SNRs and CBRs in a unified model, while also supporting conventional source coding through SemQAM-C. Experiments show that (i) under the same LDPC and QAM settings, SemQAM-C outperforms OneDC in LPIPS and DISTS with substantially lower complexity, showing that the unified model retains competitive capability for source coding. (ii) Compared with this separated counterpart, SemQAM reduces channel uses by 18.57% at matched LPIPS and outperforms the compared JSCC methods, demonstrating the benefit of joint coding.

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