Health Information Management

Don't forget to update your chargemaster

APCs Insider, December 21, 2012

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‘Tis the season to make a list and check it twice. The question is, which list are you checking twice—your holiday shopping list or your chargemaster updates? I vote for the chargemaster.

The holiday list is more fun to update (especially when you can cross things off), but if you don’t update your chargemaster correctly, you won’t be reimbursed correctly. And not just for 2013.
Updating the chargemaster is not just a matter of plugging in new CPT codes. You need to think about what services that CPT code represents.
The AMA continues to combine multiple procedures into one code (think CT of the pelvis and abdomen) and to bundle radiographic guidance into the procedure code. If all you did was change the CPT code without updating the charge to reflect the actual service, you’re losing money.
CMS uses charge data to set future payment rates. If your charges aren’t appropriate (or sufficient to cover the cost of providing services) now, when CMS sets payment rates in two years, it will look at the data and possibly adjust payments downward for everyone.
No one hospital is going to cause a decline in payments, so you might not be so worried about it. However, if a large number of facilities don’t properly update their charges everyone suffers down the line. Don’t risk being a Grinch. Put some thought into what you charge, what those services cost you to provide, and update your chargemaster accordingly.

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