Hospital Chargemaster Reviews

We have a dedicated team of experts with more than 27 years experience available to evaluate your hospital’s Charge Description Master (CDM), make the necessary corrections and provide education for the hospital staff that will enable them to maintain the chargemaster correctly based on the latest CPT-4, HCPCS Level II guidelines and Medicare OPPS regulations.

If you would like a free CDM analysis which will provide you information on whether your current CDM needs a complete review, a limited update or nothing needed at all then please contact us so we may provide to you the information we will need to perform this analysis.

ACS consultants begin the complete CDM review and update process with an extensive review of selected outpatient accounts, outpatient claim rejections and corresponding billing forms such as the UB-04, itemized statement and electronic claims summary. These documents present the total picture of an episode of care, beginning from the point of order and continuing through billing and reimbursement.

To help the hospital update its CDM and comply with the coding and billing requirements critical to optimal reimbursement, a complete analysis with an assessment of outpatient coding is available. The "scope of work" for a complete review consists of the following elements:

  • Complete CDM Review for accuracy of CPT/HCPCS codes, revenue codes, charge analysis, HCPCS description, modifiers and billable/non-billable services.
  • Staff Education for OPPS Updates
  • Check accuracy of coding & billing practices in individual departments.
  • Check the transfer accuracy of Chargemaster driven charges to the claim.
  • Identifies erroneous or missing codes
  • Review the aspects of the chargemaster that affect reimbursement and data quality.
  • Core-based Statistical Area (CBSA) Charge Analysis for every line item with an assigned CPT or HCPCS code.
  • Peer Charge Comparison of 5 to 8 Hospitals of your choice
  • Medicare Fee Charge Analysis will be provided for every line item with an assigned CPT or HCPCS code. Compares Medicare fee schedules with the chargemaster charges.
  • Deletes obsolete items and recommends correct codes
  • Review the flow of data in the hospital for ancillary services.
  • Verify accuracy to department charge sheets.
  • Conduct department head interviews and staff education
  • Review devices for appropriate HCPCS level II code assignment and revenue code assignment.
  • Review the supply and device chargemaster to identify accurate HCPCS Level II codes and revenue code assignment
  • Provide chart review along with the corresponding billing information.
  • Provide education to the staff members responsible for the chargemaster, coders and department leaders.
  • Provide a summary exit conference for hospital leadership