Update Your Charge Master To Avoid Financial Losses

Were all your HCPCS codes entered in your charge master by Jan. 1, 2001? If not, youre losing money. The best way to tackle the task of updating your charge master is to break it down by department and then initially add only the procedures you do regularly.

Caral Edelberg, CPC, CCS-P, president of Medical Management Resources Inc., an emergency medicine coding company based in Jacksonville, Fla., says that adding the charges is the single most important thing a facility needs to do right now, and unfortunately not everyone is ready.

Before [Jan. 1, 2001] you could bill for just an evaluation and management (E/M) level and you could bundle all of your other itemized services under one code for the total charge, Edelberg explains. So lets say I have an E/M level, a laceration repair, a fracture and some additional services. Some facilities are itemizing them all under the E/M level, which is one big charge, and they identify them as a multiple units. That is not the best way to do it because once you reach your APC payment rate everything else above that amount gets written off.

As of Jan. 1, 2001, you have to bill for the laceration repair with its charge, the orthopedic service with its charge, and the E/M with its charge to get paid for each of the services rendered. Despite the level of importance surrounding this, a lot of hospitals havent modified their charge masters.

Develop a Detailed Charge Master

Id say about 70 percent of the hospitals we talk to havent developed their detailed charge masters yet, Edelberg says. They havent put the HCPCS codes for the procedures on their charge masters, nor do they intend to. These facilities still dont understand they arent getting paid for these services after Jan. 1, and thats a big emergency.

Other experts agree, and see this as a critical situation for institutions. Its not that the facilities dont just have charges, but they dont have anything in their charge master that reflects the supplies and the products that are being used, adds Nancy Hirschl, CCS, vice president of professional services for Pyramid Coding Services, a clinical data management company in Seal Beach, Calif., that provides coding support, quality monitoring for compliance, and APC training and education. Every hospital needs to do an assessment, in all departments. Work with central supply and purchasing and identify line by line every device, supply and piece of equipment that the facility is using and include that in their charge master. They need to update their charge master, and we are talking about a major overhaul.

Make it Your First Priority

Why havent facilities added these charges if the financial impact [...]

- Published on 2001-01-01