Massachusetts Medical Society: ICD-10 Implementation: Adjusting Encounter Forms and Superbills

ICD-10 Implementation: Adjusting Encounter Forms and Superbills

From the May 2015 edition of Vital Signs

The implementation date for ICD-10, October 1, 2015, is rapidly approaching. We often get questions from practices about how to adjust their processes, and adjusting encounter forms and superbills is one specific concern that is often raised.

In general, most practices have fine-tuned their forms, electronically or on paper, to maximize efficiency. All of the key services and procedures are outlined so that physicians can easily select what services they have pro- vided for a patient and the associated diagnosis codes. I often hear things like, “it is going to take five pages to convert my current form onto an ICD-10 optimized form.”

My general response to this is to know your data and consider the following key steps:

Know Your Data:  Conduct a quick analysis to determine the top 10 to 20 ICD-9 codes used by your practice and what percent of your total volume these codes represent. If any of these codes represent a small percentage of the volume, then elimination of these codes on the encounter form or superbill may be a reasonable idea.

Map Top Codes:  Take the top codes you’ve identified and correlate them to the associated ICD-10 codes. In some cases, it may be a one-to-one match, in other cases it may be a one-to- multiple match. This may be one factor in helping you streamline what really needs to be on the ICD-10- optimized form. If a “not necessary, but nice to have” code results in a one-to-multiple mapping and uses a lot of real estate, consider eliminating it on the updated form.

Determine True Necessity:  Once you have correlated the codes and understand the volume of patients the codes apply to, as well as the frequency in which the codes are used, you can evaluate which codes are truly necessary for the bulk of your work.

Most practices are able to refine their lists to the essentials and create a form (electronic or paper-based) that makes sense for their daily processes.

Be sure to allocate time and resources to this process in advance of the October deadline. Additionally, allocating extra time for input from physicians and other practice staff will ultimately ensure easier adoption of the new forms and a smoother operational transition.

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