ICD-10 Superbill: Will superbills survive ICD-10 implementation?

Carl Natale
by Carl Natale

If you're looking for something that will make work easier as an ICD-10 compliant medical practice, you can find your most used ICD-9 codes and translate them to ICD-10.

And maybe you can take that ICD-10 preparation a step further.

During the the ICD-10 Implementation Strategies for Physicians National Provider Call by staff members at the Centers for Medicare & Medicaid Services (CMS), Daniel Duvall, medical officer for the CMS Hospital and Ambulatory Policy Group, suggested that medical practices create an ICD-10 version of the superbill.

Jen Searfoss, an attorney who represents individual and group health care providers and integrated health systems, doesn't see the superbill being preserved.

"Unless you can make the superbill really, really long," says Searfoss. "It's going to have to be one of those 11x14 sheets, nobody's going to be able to find it."

Just how long could it be? Gayl Kirkpatrick, solution sales executive for 3M HIS Consulting Services, has an example from one hospital her team consulted. "We took a two-page superbill in ICD-9 and translated that into ICD-10," Kirkpatrick said. "It became a 48-page superbill."

A less drastic example has ICD-10 inflating a superbill from two pages to nine pages. That's still a significant growth in paperwork. That should be enough to question just how useful superbills will be?

"Do you know anyone in your organization moving through a 48-page superbill?" asked Kirkpatrick.

You may need to take a second crack at it and pare down the available diagnoses. Or make them more broad. "Are you going to have a superbill that only has the high-level codes?" asks Searfoss.

Adding pages or decreasing specificity could be the medical coding equivalent of shuffling deck chairs on the Titantic. Clinicians may need a different tool. Will ICd-10 make the superbill obsolete?