AHA Coding Clinic® for HCPCS - 2001 Quarter 2
The chargemaster
BY DANELLE KELLY R.N., CPC, CPC-H D J KELLY & ASSOCIATES, INC. SCHAUMBURG, ILLINOIS Chargemaster, Charge Description Master, CDM, they all refer to the “list” of your facility’s billable items. Every hospital has one. Every hospital at one time or another has gone through a dreaded computer conversion, (when you change from one system to another) and every hospital should update their CDM on a quarterly basis for OPPS pass - through items and yearly for the other departments. Does yours? So, how is the CDM set up? Each department in your hospital is assigned to...
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Article Overview
This article explains what a hospital chargemaster is, how it is structured, and how it supports billing operations across departments. It covers broad topics such as charge description master maintenance, mapping to revenue codes, interaction with CPT and HCPCS-related items, use of modifiers, and review/audit considerations tied to outpatient billing processes. The article is relevant to hospital coders, chargemaster analysts, revenue cycle staff, HIM personnel, and finance teams.
Why This Topic Matters
Chargemaster structure affects how facility charges are organized, reviewed, and routed through billing systems. Understanding the operational concepts discussed here can help teams evaluate CDM completeness, consistency, and maintenance practices.
Article Sections
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Chargemaster basics and structure
Introduces the chargemaster concept and describes how hospital items are organized by department and internal numbering. It also discusses general maintenance timing and the role of different facility departments in the process.
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Charge review, coding, and revenue mapping
Covers the workflow used to evaluate new items, including code assignment, pricing, and mapping to revenue codes. It also notes how billing records and reporting support audits and inventory-style review.
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Annual updates and quarterly outpatient changes
Describes how chargemaster updates may align with annual code-set changes and outpatient prospective payment system updates. The section focuses on broad timing and operational maintenance considerations.
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Review questions for chargemaster accuracy
Presents general questions used to assess whether the chargemaster is complete, current, and aligned with departmental usage. The discussion includes broad checks for descriptions, mapping, and pricing consistency.
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Hardcoded and softcoded items
Explains the distinction between items built into the chargemaster and items assigned through other facility processes. It also addresses description formatting and consistency for sorting and internal review.
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Repeat procedures and modifiers
Discusses how repeat services may be handled in outpatient settings and how modifiers may be associated with repeat testing workflows. The section focuses on operational setup concepts rather than specific coding decisions.
What You Will Learn
- What a hospital chargemaster is and how it is organized
- How facility departments and internal numbering schemes support charge capture
- How chargemaster items are reviewed, priced, and mapped within billing workflows
- Why chargemaster maintenance and periodic updates matter
- How hospitals think about modifiers and repeat-service setup in the chargemaster
- What general review questions are used to assess chargemaster completeness and consistency
Who Should Read This
- Hospital coders
- HIM staff
- Chargemaster analysts
- Revenue cycle professionals
- Hospital finance staff
- Billing and compliance teams
Codes Discussed
Modifiers Discussed
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