Charge Master Review
When was the last time your hospital performed a thorough evaluation of the charge master for structure, codes, descriptions, and prices? If it’s been a year or two, there are likely CPT and HCPCS coding changes that haven’t been properly implemented. If it’s been three or more years you may have line items structured in ways that must now be bundled to comply with National Correct Coding Initiative (NCCI) edits. It’s possible that 50-60% of the charge items you maintain have zero volume.
It doesn’t take long for a charge master to get out of shape. If you are not certain what your charge master contains, then your organization is already at risk for lost charges, fraudulent billing practices, and Medicare compliance violations.
Our Charge Master Review is the best line of defense against an aging or overlooked charge master. CPI Experts will take the guesswork out of charge master evaluation by providing the painstaking analysis required to comply with Medicare guidelines. Our experts will:
- Ensure complete and accurate HCPCS/CPT and revenue code assignments
- Establish Medicare-compliant and optimal charge structures
- Remove unused charge codes
- Evaluate use of modifiers, linked codes, and pass-throughs to ensure proper billing and allowable reimbursement
- Identify sources of lost charges
- Highlight coding and compliance opportunities
- Instill “CDM awareness” among staff and department heads
In this era of reduced reimbursement and heightened regulation, shouldn’t your hospital be in the best shape possible to avoid risk and capture every opportunity?