Gearing Up For ICD-10 - Superbills July 17, 2015

Gearing Up for ICD-10

Tips on Planning for New Superbills

Plans for transition to ICD-10 have been in the making for several years now, and though thousands of articles
have been published on getting ready for ICD-10 implementation, most of them are very broad in their scope.
One item sometimes overlooked is the use of new superbills in the physician office setting. The recent move to
electronic health records (EHR, EMR) by many providers has eliminated the need for paper superbills. There are,
however, a few practices that have not yet adopted the use of EHR systems and continue to utilize paper
superbills in their practice. It is those practices that have some decisions to make regarding their paper superbills.

Due to the increase in the number of possible diagnosis codes, the most important thing physicians can do is be
realistic about their documentation, and analyze what they really use in ICD-9 as a starting point. Your superbill
may contain 100 ICD-9 codes, which now translate to 2,500 possible ICD-10 codes. But how many of those ICD-9 codes
do you really use in documenting in your day-to-day practice? Paring down your code selection to only those necessary
will help you in designing a usable form for providers to use. If you are unable to reduce the number of codes for your
specialty, multiple page superbills may become necessary to provide all of the necessary codes as an option depending
on how many codes you need in your practice. You should keep that in mind when designing your new superbill.

One way to reduce the number of ICD-10 codes that you will be listing on your new superbills is to run your Diagnosis
Usage Report to analyze the top codes you use today which may not be exactly what is on your current superbill. Look at
the frequency of use over the course of a year and if 50 of those codes make up 80% of your ICD-9 volume, turn to the
General Equivalence Mappings (GEMs)to help you find crosswalks for those codes and then create a mock-up of your
superbill using the new ICD-10 codes instead of the ICD-9 codes. Be sure to allow plenty of space on your new superbill
for write-in diagnoses since there will certainly be codes not listed that will need to be written in by the provider.
By the time you have 75 – 100 of your most used codes on your superbill, MOST specialties will have a superbill that helps
you code 80%, or more of your daily visits with a minimal amount of write-in codes.

Some specialties (orthopedic surgery, for example) will be forced to create much larger superbills, unless they limit their
practice to a specific body part. But the basic premise is the same. However, because of the specificity of ICD-10, you'll
be forced to change your documentation style, or be unable to find codes for some conditions. Remember that anatomy and
laterality are key in ICD-10, along with dominance (mostly for neurological conditions). Your documentation should indicate
right vs. left along with whether the patient is right or left hand dominant. You might have been able to find a code for
"right arm fracture in the past, but now you'll need to document the bone(s) involved, including the area of the bone involved.

Whatever approach you plan to take to create superbills in ICD-10, the time to start is now. October 1, 2015 will be here before you
know it. Practices will always have the choice to continue using their old ICD-9 superbill and converting to ICD-10 during the claim
creation process. Practices that wish to change, however, should take the time now in order to allow you and us the necessary time to
make any changes needed in your documentation, and help you better understand the differences in ICD-10 language and rules. We have
provided a link to the CMS website which has the official guidelines that you will follow in making changes to your superbill. The
following link will take you to CMS.gov and the 2015 ICD-10-CM and GEMs.
http://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-CM-and-GEMs.html

When you have decided how your new superbill needs to look for your system, contact our support team at 800-248-4298 to discuss pricing
and to schedule the changes to your superbill to allow ICD-10 documentation. Don’t wait until the October 1 deadline, contact our office today.


Your DuxWare Support Team