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The Importance of Entering Correct Medical Codes to A Hospital Chargemaster

Posted By Giovanna Stahl
medical coding company

Many healthcare facilities utilize a hospital charge description master, or hospital chargemaster (CDM), for billing patients and health insurance companies. When a chargemaster isn’t performing as it should, it negatively affects the overall healthcare experience. Accurate coding is important and must be documented precisely as it represents every healthcare service provided to the patient. Due to the constant updates of the medical coding classification system, occasional mistakes are made. It is recommended that healthcare providers work with professional international medical coding companies to ensure that the correct codes are entered into the hospital chargemaster so patients receive the proper health services needed to live a quality life.

When it comes to health service costs, healthcare facilities around the world are working on becoming more transparent. Professional medical coders play a significant role as they act as the bridge between the hospitals and patients or payers by sending accurate codes to the chargemaster, which then processes the claims made. Medical coding companies, like ECLAT Health Solutions, make it their mission to remain up-to-date with every change in the medical coding classification system so that health care providers can focus on providing quality patient care and that patients and payers are billed accordingly. To help you understand the importance of entering correct medical codes into a hospital chargemaster, we have provided more information below.

What is a Chargemaster?

A chargemaster, otherwise known as a Charge Description Master (CDM) or hospital chargemaster, is a vital component of the healthcare revenue cycle. A chargemaster serves as a medium between a healthcare facility and for billing their patients and insurance companies. This system contains a list of all the billable services and/or items to a patient or the patient’s insurance company. Examples of what a chargemaster may track include various medical procedures, diagnostic tests, medicine prescribed, and non-physician services. The data collected from a chargemaster can be used to track service volume, revenue, and costs.

Why Medical Codes Must Be Entered Accurately

When hospitals begin their billing process, a chargemaster uses charge captures to close the gap between the hospital and the patient. For example, after a patient receives the services they need, medical providers make note of the service in the patient’s medical record. From there, professional medical coders assign codes so that claims can be accurately submitted to payers. The charges are then used to bill or create claims for patients. If there are any coding mistakes in this process, it can affect everything that relies on the chargemaster. This includes data the chargemaster retrieves as well as the claims and bills sent to patients and insurance companies. To make sure that the CDM is working efficiently, it is reviewed annually for any additional service lines that have been added, which ensures the correct Healthcare Common Procedure Coding System (HCPCS)/Current Procedural Terminology (CPT) codes are associated with the appropriate service description.

How to Correct Codes in the Chargemaster

Those in charge of their health facility’s chargemaster must enter correct medical codes because any errors could result in a lower quality of patient healthcare services. It is possible for errors to arise from what is captured in the Order Entry System (EHR) and what is being reported in the chargemaster. If your chargemaster has any inaccuracies, it can result in issues with payment, claim rejections, and compliance violations.

Typical examples of code errors include:

  • Assigning a non-billable or nonexistent code
  • Missing or inaccurate HCPS code is entered when a specific code is available
  • Assigning the wrong type of code. (for  example, using CPT code when an HCPS code is necessary for Medicare billing)
  • Missing HCPS codes for separately paid drugs

It is imperative that chargemaster staff members coordinate with providers to ensure correct coding so that the chances of errors are reduced. This includes verifying the line-item descriptions match up with CPT/HCPCS and revenue codes. If codes do not represent the service provided by the hospital, then those codes need to be changed immediately.

ECLAT Health Solutions is Northern Virginia’s Top Medical Coding Company

Oftentimes healthcare providers balance a variety of duties on their plates and are spread too thin. With the addition of inputting accurate medical codes and making sure they are correct, it can take more time than health providers can spare. ECLAT Health Solutions provides the best medical coding services in the Washington DC metro area that will reduce the chances of coding and billing errors and upcoding occurrences. Our team of highly-trained medical coders is professional and dedicated to helping providers increase their coding accuracy and provide solutions to improving areas of inefficiency. Contact us to speak with one of our medical coding specialists today!

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