Developed to provide a comprehensive review of the chargemaster (CDM) as well as any inventory and pharmacy information to identify those medical devices, radiopharmaceuticals, and pharmaceuticals that are assigned either a pass-through code or packaged C code under the Hospital Outpatient Prospective Payment System. Utilizing the CDM, inventory information, and hospital staff input, HMI assigns the appropriate HCPCS, C codes, and revenue codes for accurate reporting to CMS. The accuracy of the data submitted to CMS is essential in future rate setting for hospitals’ APC procedure payments.
Based on the Client’s need, HMI specialists will perform, either on-site or off-site, a review of the hospital CDM as well as additional inventory/pharmacy files as applicable for line item accuracy of all pass-through and packaged C code assignments for compliance with federal and fiscal intermediary rules and regulations. Preliminary report of findings and queries are prepared for review with department staff.
The final product includes a Comprehensive Report with recommendations for implementation. (An electronic file in Excel format will be provided in the specified Client parameters.) The report will clearly identify the explanation for each recommendation.
Value Added Benefits for this Service:
Comprehensive pass-through and packaged coding update
More knowledgeable staff
Coding and Billing Helpline provided at no additional cost during the term of the contract. Client’s staff may take advantage of this helpful service to answer questions arising from implementation of our recommendations.