Coding compliance and integrity are of utmost importance to the revenue cycle, especially during this time of increased governmental scrutiny and auditing. Medical records coding as well as the charge description master (CDM), or chargemaster, codes should be reviewed regularly to identify and correct any potential issues and ensure codes are current and being utilized appropriately. CDM reviews involve a line by line review of all services provided to ensure that all proper CPT/HCPCS codes, modifiers, revenue codes and descriptions accurately reflect services performed. Compliant bills can then be submitted for proper reimbursement.
We offer detailed coding audits of inpatient and outpatient records, among other financial improvement services.
- Hospitals receive specific feedback on each audited record.
- The process provides suggested changes and financial impact of any DRG or ambulatory payment classification (APC) changes.
- Staff receives education on relevant topics based on audit results.
- CDM review services identify invalid or deleted CPT codes and other discrepancies.
- An onsite line-by-line review of the CDM with each respective department ensures that each code is being utilized in a compliant manner and identifies all items and services that can and should be charged.
- The changes identified during these sessions can be uploaded to the CDM file, resulting in a current, compliant and comprehensive CDM.