REVENEWS
REVENEWS ARCHIVES
How Healthy is your CDM?
With the release this week by CMS of the proposed OPPS rule for 2011 we’re once again reminded how important the chargemaster is in the revenue cycle. If you’re looking for it, it can be found here in all of its “display copy” glory. Look for more details on the proposed rule in the next edition. In the meantime, consider this about your Chargemaster.
The chargemaster of a healthcare facility drives reimbursement for almost every item in a hospital including supplies, devices, medications, services, etc. In a sense, it is an enormous list used to keep track of items that have a distinct charge for patients. Several departments may be responsible for managing the CDM (charge description master) such as the pharmacy, HIM, finance, and even physicians themselves. Other facilities have a centralized department who manages the CDM but who also communicates and interacts with the other departments. It is key to understand that an updated and accurate chargemaster is fundamental to every provider who seeks appropriate reimbursement. It is a sign of a healthy revenue cycle.
The CDM is oftentimes responsible for over 70 percent of a facility’s revenue since its focus is outpatient services/supplies. Although low in cash value, they usually have an extremely high volume. Chargemaster maintenance involves performing an at least an annual review to update the CDM with new or revised CPT/HCPCS codes; reviewing accuracy, validity, and clinical appropriateness for all codes; ensuring compliance with Medicare guidelines; and educating staff in regards to any changes made in a timely fashion.
Changing MS-DRGs, severity-adjusted DRGs, and updated ICD-9 and CPT codes are occurring all the time. Maintaining the chargemaster is a vital responsibility for every healthcare provider; it is crucial that a facility is able to receive adequate and proper reimbursement.
