The Hospital Chargemaster Guide can help hospitals update and maintain an accurate charge description master (CDM). This guide is organized by ancillary service department and provides detailed guidelines for achieving optimal reimbursement and department-specific information for efficient auditing.
Key Features and Benefits
Optum Edge—Improve the chargemaster update, maintenance, and charge capture processes. All of your chargemaster-related information and guidance are consolidated into a one-source document, described in easy-to-understand terms.
Optum Edge—APC payment status indicators. Determine how each code will be reimbursed under APCs, a fee schedule, or other payment methodology.
Relevant CPT®/HCPCS Level II and revenue code crosswalks for each clinical department. Takes the guesswork out of assigning revenue codes to each line item on your chargemaster.
Step-by-step process review guidelines. Improve accuracy and billing of chargemaster-related items and services and establish processes for reviewing and maintaining the CDM on an ongoing basis.
Organized by ancillary service department. Easily review the CDM for coding, billing, reimbursement, and clinical accuracy. It also helps you to identify items and procedures that need to be added, deleted, or revised on the CDM.
CCI and OCE edits and fraud alerts. Reduce the potential for rejections. Identifies department-specific CCI edits, OCE edits, and fraud alerts to help hospitals stay in compliance with Medicare guidelines and claims processing edits.
Exclusive, time-saving tools. Templates are provided with recommendations on procedure codes and descriptions for radiology, laboratory, and other clinical areas. It is a useful tool for mapping revenue codes and CPT®/HCPCS Level II codes in radiology, laboratory, and other ancillary service areas.
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CPT® is a registered trademark of the American Medical Association