Policy and procedure for updating charge master
Not all services can be coded using the CDM; more complex cases, such as surgeries and ED encounters, must be coded by HIM Staff.The Revenue Integrity Department, and the CDM coordinator, with the assistance of the clinical department manager, the patient financial services office(billing), and the HIM department.These services are identified by the department performing the service. Charges are automatically posted on the UB-04 form through the billing system, without hospital coder involvement. the code is already built into the system not entered manually.Codes entered in the system by the coder are said to be directly coded or soft coded.Evaluate 4 digit of revenue code to ensure accuracy.Review for more appropriate revenue code assignment.This hospital determines its standard charges for patient services with the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient's bill.These are the baseline rates for services provided at this hospital.
CMS also issued final rules this week on fiscal year (FY) 2019 Medicare payments and policies for the Skilled Nursing Facility (SNF) PPS, Inpatient Psychiatric Facility (IPF) PPS, Inpatient Rehabilitation Facility (IRF) PPS, and the Hospice Wage Index and Payment Rate Update.Ensure all outpatient services have a corresponding code and monitor for duplication of services. Allocate resources to the process.(done internal or external, # employees/ hours needed to complete review.Review departmental charge tickets to ensure codes correlate to CDM. Establish the communication mechanism for the team. Conduct interviews and review line item, per department. Finalize changes to the CDM and report to the appropriate department.staff registers patient -getting demographics, insurance and creating account.services are documented by clinicians involved in patient care.Review sample UB-04 form prospectively, and remittance advice notices retrospectively, to verify information. (department notified when services in CDM are updated). Charges entered into system by the departments involved.revenue codes assigned via chargemaster when the charge is entered. corrected and resubmitted or an appeal may be done.statement mailed to patient for their responsibility.which is true about the chargemaster:a services can't be coded using the chargemasterb it must be updated when coding changes occur.c A comprehensice review is recommended every year.d A department review should be performed monthly.Codes entered for the services rendered either by CDM or coders.coding staff (or outpatient dept) assigns dx codes.
Also maybe the information management service, the compliance department.