The functions of the Charge Description Master (CDM) include producing an itemized statement of services received by a patient during a healthcare encounter, assigning charges to services and supplies, monitoring the cost of care, and providing cost accounting data to financial systems. Most errors are not the result of inaccurate CDM but rather a disconnected charging process. As the CFO of Healthcare Hospital, you are tasked with finding ways to prevent the following areas of common charging and coding errors. Address the following situations in your facility.

2. The following table is a sample of a section of the CDM for your hospital. After and audit you determine that for inpatient procedures, coders use ICD-10-PCS codes but the CDM uses CPT or HCPCS codes to determine charges for procedures. There is no link in the CDM between CPT or HCPCS codes and ICD-10-PCS codes. What should you do to correct this?

b. The billing department employees do not have systems in place to check for inaccurate charges. What procedures should be put in place to correct this?

c. The laboratory department CPT codes for tests are hard-coded into the laboratory electronic system and sent directly to the claim form, by-passing the CDM. What should be done to correct this?

3. Managing the Revenue cycle process: Explain why revenue cycle management is important and what the role for HIM professionals is in the process. Use a minimum of 3 sentences

 

DEPT ITEM NUMBER NUMBER REVENUE MEDICAID 791002 DESCRIPTION CORONARY ARTERY PRICE HCPCS CODE 92982 CODE 481 CODE GL NUMBER 92982TC 761 DILATION $1,550.00 0800.4601 791000 761 INJECTION, CARDIAC CATH $ 220.00 93540 481 93540TC 0800.4601 761001 NURSING FAC CARE, 99307 636 7610 761 SUBSEQ $ 75.00 0800.4601 761002 HOME VISIT, NEW PATIENT 99341 636 7610 761 $ 80.00 0800 4601 761003 761 REPAIR EYELID DEFECT $ 110.00 57915 636 7610 0800.4601 810003 761 REPAIR EYELID DEFECT $ 550.00 (67916 272 7610 0800.4601 810004 REMOVAL OF KIDNEY 50080 272 7610 761 STONE $ 390.00 0800.4601 810050 761 DECALCIFY TISSUE $2.065.00 88311 272 7610 0800.4601 810061 CHROMOSOME COUNT, 88285 272 7610 761 ADDITIONAL $ 275.00 0800 4601 810072 ASSAY OF FREE 84439 622 7610 761 THYROXINE $ 159.00 0800 4601 810080 ASSAY OF THYROID 84442 272 7610 761 ACTIVITY $7,064.00 0800.4601 791004 ASSAY THYROID STIM 84443 272 7610 761 HORMONE $ 650.00 0800.4601