Our Charge Master Review focuses on compliance with all Government Regulations, and includes accuracy and reimbursement issues as well. This Review encompasses CPT/HCPCS codes, Revenue Center codes, Line Item Descriptions, Modifiers, Panels, and Charge Explosions. During the Review process, we will also conduct a Medicare Fee Schedule Analysis, and when appropriate, an APC Charge Analysis. In addition to the Charge Master, we will also review a sample of medical records procedures medical records, UB-04s, and Detail Bills, in order to insure accuracy in coding and billing claims. While on-site, we will also conduct interviews with Department Managers and key staff personnel, as well as provide them with information and/or an educational session(s). The total project is conducted both off-site and on-site at your facility, and a resolution session will be held to discuss our findings and initial recommendations. A comprehensive, written report will be submitted after the project is completed.

A Charge Master Review may include all departments, or one (1) or more specific departments, at the client’s discretion.

• Assure the Accuracy of the CPT/HCPCS Codes
• Assure the Accuracy of Revenue Center Code Assignments
• Assure that Line Item Descriptions match the CPT Codes exactly
• Assure that the use of Modifiers is correct
• Verify the proper utilization of NCCI Edits
• Validate the utilization of Charge Explosions
• Assure Billing is accurate and at optimum levels
• Assure Compliance standards are being met
• Identify services that do not have a Line Item
• Conduct a Medicare Fee and APC Charge Analysis

• CPT and HCPCS Code Validation
• Revenue Center Code Validation
• Line Item Description Validation
• The Use of Modifiers
• The Utilization of NCCI Edits
• Accuracy of Panels
• Pass-Through Codes
• Device Code Edits
• The Use of Charge Explosions
• Medicare Fee Schedule Analysis
• APC Charge Analysis
• Diagnostic Medical Records Review
• UB-04 Compliance
• Detail Bill Compliance
• Reimbursement
• Interviews with Department Managers
• Educational Sessions to Departments
• Opening Meeting
• Resolution Session
• Off-Site, Desk, Reviews
• Comprehensive, Written Report

• Laboratory
• Radiology
• Cath Lab
• Oncology
• Emergency Room
• Recovery Room
• Rehabilitation
  . Physical Therapy
  . Occupational Therapy
  . Speech Therapy

• Cardiac Rehabilitation
• Cardiology
• Respiratory Therapy
• IV Therapy
• EKG
• Pharmacy
• Supply
• Observation