THE CHARGEMASTER AND ICD-10 RELATIONSHIP Preparing for the - PowerPoint PPT Presentation

May 09, 2023 •262 likes •348 views

THE CHARGEMASTER AND ICD-10 RELATIONSHIP Preparing for the Transition to ICD-10 ICD-10 ICD-10 will affect every aspect of the revenue cycle, including: Encounter Forms/ Charge sheets Order entry system and processes IT System

THE CHARGEMASTER AND ICD-10 RELATIONSHIP Preparing for the Transition to ICD-10
ICD-10 ICD-10 will affect every aspect of the revenue cycle, including:  Encounter Forms/ Charge sheets  Order entry system and processes  IT System  Quality reporting derived from coded data  Financial reports  Other statistical and coding reports
Coding and Charging The new ICD-10 coding system will also affect charges. Charges for services can be either directly or indirectly related to coding.  Outpatient procedure codes are joined directly to charges via the Chargemaster.  Inpatient procedure codes (ICD-10 PCS) have no direct connection to charges.
The Missing Link There is no direct link between inpatient procedure codes and charges. Facilities must implement preventative measures to ensure each procedure coded is charged appropriately.
Chargem aster Exam ple DEPT REVENUE MEDICAID ITEM NUMBER NUMBER DESCRIPTION PRICE HCPCS CODE CODE CODE GL NUMBER 791002 CORONARY ARTERY 92982 481 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 67915 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
The Risk Incomplete and/ or inaccurate charges can have serious consequences.  Increased compliance risk  Inaccurate and/ or missed charges  Could affect Cost-to-charge Ratios  Effects on future payment  Effects on outlier payment  Percentage of charges  Accounting inaccuracies
Questions Who is reviewing your charges? CO CONTAC ACT H HRS 800-329-0365 800-329-0365 www www.HRSc .HRScoding.c oding.com om

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