Corporate Compliance

Chargemaster maintenance

Compliance Monitor, September 16, 2005

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.

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