AHA Coding Clinic® for HCPCS - 2002 Quarter 3
Updating your chargemaster: Part II
by Danelle Kelly, r.n., cpc, cpch DJ Kelly & Associates, Inc. Schaumburg, IL In Part II of this article we will assume you have selected your consultant and are now ready to perform the chargemaster review. Memos will have been sent to each department informing them of the review, the days the consultant will be onsite, the length of time needed for each department’s meeting and what they need to bring to that meeting. A paper copy of the on screen descriptions of each chargeable item is very useful as the descriptions in the Charge Description Master...
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Article Overview
This piece explains how hospitals can organize a chargemaster review after selecting a consultant, work with departments on charge descriptions and pricing consistency, and validate updates before and after implementation. It also discusses the importance of aligning chargemaster content with coding, revenue reporting, and outpatient claims review processes. The article is aimed at hospital coding, billing, CDM maintenance, and revenue cycle staff who support ongoing chargemaster maintenance and outpatient claim accuracy.
Why This Topic Matters
Chargemaster accuracy affects charge capture, coding consistency, outpatient billing, and claim quality. The article is relevant to organizations trying to reduce errors, improve department coordination, and keep CDM maintenance current with coding and reimbursement-related changes.
Article Sections
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Chargemaster review workflow with departments
Describes the setup for the review process, including departmental meetings, preparation materials, and coordination with a consultant. It focuses on how the review is organized rather than on specific coding outcomes.
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Evaluating departmental charge items and coding alignment
Covers the review of individual charge items within departments, including comparison of charge descriptions, pricing consistency, and identification of unused or missing items. It also addresses how departments may approach coding and charge capture issues during the review.
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Special review areas and maintenance considerations
Discusses broader CDM maintenance topics such as radiology-related services, revenue code coordination, modifier assignments, and final review steps. It also notes the use of supporting reference materials during updates.
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Post-update APC claims review
Explains the follow-up review performed after chargemaster changes are made, including sampling outpatient accounts and comparing billing records to claim output. The section emphasizes using this review to identify data and reporting issues.
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Ongoing monitoring and claim accuracy
Summarizes the need for continuous review as coding and charge changes occur over time. It highlights the relationship between ongoing maintenance and cleaner claim processing.
What You Will Learn
- How a chargemaster review is typically organized after a consultant is selected
- What departments should prepare for a chargemaster or CDM review
- How charge descriptions, pricing, and department charge items are evaluated
- What types of maintenance issues may be considered during chargemaster updates
- How outpatient claims review can be used after chargemaster changes
- Why ongoing monitoring is important for charge capture and claim accuracy
Who Should Read This
- Hospital coders
- CDM maintenance staff
- Revenue cycle teams
- Billing staff
- Hospital department managers
- Outpatient charge capture staff
- Compliance and reimbursement staff
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