Chargemaster maintenance
Compliance Monitor, September 16, 2005
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
Q: How often should the chargemaster (CDM) be maintained?
A: I recommend that it be an ongoing process, but it should be done at least quarterly, because CMS provides us with quarterly OPPS updates. I have seen facilities that only update their CDM annually and several that only update every three years-it amazes me. I recently saw one facility that hadn't updated their CDM since 1998!
You need to have a formal process, so if you get a new charge request, you have a standardized process in place. Somebody from finance needs to be looking at reimbursement ramifications, somebody should be looking at the pricing, somebody should be looking at proper HCPCS or CPT code assignment, as well as mapping to the proper revenue code.
If clients state they can't update their CDM on an ongoing basis, I tell them to do it at least quarterly so they're not missing revenue opportunities or opening themselves up to potential compliance risks.
This question was answered by Arlene F. Baril, MS, RHIA, vice president of HIM & Software Services for United Audit Systems, Inc. based in Cincinnati, OH.
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- HIPAA Q&A: Level of encryption needed for email
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- OB services: Coding inside and outside of the package
- QA:Coding multiple initial infusions
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- HIPAA Q&A: Level of encryption needed for email
- CMS has reformulated payments for some bilateral procedures
- Q&A: Follow CMS' coding guidelines when using modifier -25
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- Cohesive History and Physical Requirements
- Searched