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

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the chargemaster and icd 10 relationship
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THE CHARGEMASTER AND ICD-10 RELATIONSHIP Preparing for the - - PowerPoint PPT Presentation

May 09, 2023 262 likes •350 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

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SLIDE 1

THE CHARGEMASTER AND ICD-10 RELATIONSHIP

Preparing for the Transition to ICD-10

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SLIDE 2

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
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SLIDE 3

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.

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SLIDE 4

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.

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SLIDE 5

Chargem aster Exam ple

ITEM NUMBER DEPT NUMBER DESCRIPTION PRICE HCPCS CODE REVENUE CODE MEDICAID CODE GL NUMBER

791002 761 CORONARY ARTERY DILATION 1,550.00 $ 92982 481 92982TC 0800.4601 791000 761 INJECTION, CARDIAC CATH 220.00 $ 93540 481 93540TC 0800.4601 761001 761 NURSING FAC CARE, SUBSEQ 75.00 $ 99307 636 7610 0800.4601 761002 761 HOME VISIT, NEW PATIENT 80.00 $ 99341 636 7610 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 761 REMOVAL OF KIDNEY STONE 390.00 $ 50080 272 7610 0800.4601 810050 761 DECALCIFY TISSUE 2,065.00 $ 88311 272 7610 0800.4601 810061 761 CHROMOSOME COUNT, ADDITIONAL 275.00 $ 88285 272 7610 0800.4601 810072 761 ASSAY OF FREE THYROXINE 159.00 $ 84439 622 7610 0800.4601 810080 761 ASSAY OF THYROID ACTIVITY 7,064.00 $ 84442 272 7610 0800.4601 791004 761 ASSAY THYROID STIM HORMONE 650.00 $ 84443 272 7610 0800.4601

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SLIDE 6

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
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SLIDE 7

Questions

Who is reviewing your charges? CO CONTAC ACT H HRS 800-329-0365 800-329-0365 www www.HRSc .HRScoding.c

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