The Chargemaster Coding Review provides an analysis and revision of the CDM CPT/HCPCS codes and appropriate modifiers. Every year, the American Medical Association and HCFA revise CPT and HCPCs codes. These codes are used by government payers to determine reimbursement for many ancillary services. If hospitals fail to update their charge masters each year, billing errors can result and significant revenue can be lost. BRHS's CDM Coding Review is specifically designed to alleviate this problem.
BRHS reviews all UB 92 generated revenue, CPT 4, and HCPCs codes for each ancillary department. The review lists all deleted codes and updates all CPT 4/HCPCs codes to comply with current AMA/CMS guidelines. Upgrading of departmental procedure lists to encompass all procedures performed with corresponding codes is also performed. Additionally, an optional financial impact analysis of the recommended code changes can be completed to demonstrate the effect that the code changes will have on reimbursement. The CDM Coding Review incorporates the following:
- A thorough review and analysis is performed of the CDM as it relates to CPT, Revenue, and HCPCs codes
- The review updates all Revenue, CPT, and HCPCs codes using current Medicare and Medicaid guidelines
- It identifies and lists obsolete and incorrect Revenue, CPT, and HCPCs codes
- BRHS personnel meet with all appropriate ancillary departments and identify all procedures that are being performed and are not accounted for
- Reviews all item descriptions for accurate nomenclature
- Recommends changes to coding and billing that will provide optimum and accurate reimbursement
- Identifies trends and deficiencies in Revenue, CPT, and HCPC codes
- Provides documentation that conforms to both federal and state requirements on any recommended changes
- Submits a completely revised CDM report listing all recommendations and changes