Wiki Chargemaster coding

[mitchellde]

In the facility the coders are responsible for the 10000 thru 69999 and everything else goes thru the chargemaster. It is not so much that these other non-coders are "coding" per se, it is that they are entering charge codes or scanning bar codes that go to the chargemaster and pulls the CPT and HCPC II codes to the claim. It could be that you have a chargemaster error, you need to maybe talk to your CDM person and find out what codes are being pulled.

 

[kevbshields]

I agree, this sounds like a chargemaster issue, not a "coding" issue.

The diagnosis on orders, that's something that cannot be circumvented. Unfortunately, this is the quality of coding for a lot of practices. In the past I've even seen where providers always ordered for the "same" diagnosis code, even when indications were different.

Although your hospital assumes some part of the risk for that, ultimately it is the ordering physician who is responsible for the accuracy of those orders.

Regardless, the CDM might be a problem. Certainly some provider education needs to go on--although I'd venture to say such practices are rampant(?) throughout our hospital networks.