cdm maintenance questions and answers with verifie
the cdm may also be called
the cdm requires regular maintenance to ensure acc
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Cdm Maintenance Questions And
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The CDM may also be called? - ANSWER✔✔ -Service Master
-Price List
-Charge List
-Service item Master
The CDM requires regular maintenance to ensure accuracy in charges reported
and reimbursement received. The following should be considered when creating a
plan for CDM Maintenance: - ANSWER✔✔ -Purpose
-Risks
-Process
-Responsible Parties
Purpose - ANSWER✔✔ -Appropriate CDM maintenance assures submission of
claims that are accurate and compliant, which in turn renders reimbursement
that appropriately reflects the care provided to the patient.
-The CDM allows the organization to capture charges as they occur, almost in real
time.
-Without a well maintained CDM, the facility would not receive complete and
proper reimbursement.
Frequency - ANSWER✔✔ -It is critical that the CDM is regularly updated.
-Yearly updates are necessary to capture annual changes in CPT and HCPCS codes.
-If the organization provides new services, these must be added to the CDM.
, Risks - ANSWER✔✔ -Maintenance of the CDM is very critical to minimize risk of
compliance violations for the organization.
-An out-of date chargemaster can result in incorrect billing and submission of
noncompliant claims.
-Consistent submission of or large volumes of noncompliant claims leaves an
organization at an increased risk of audit.
-One wrong or outdated CPT code can continue to be reported when linked or
mapped to a specific charge code, perpetuation errors on multiple claims.
-This would certainly cause overpayment, underpayment, or claims rejections
which could result in fines or penalties.
Risks (additionally) - ANSWER✔✔ -Lack of proper maintenance of the CDM can
translate into lost charges, leading to less than the total reimbursement the
organization is appropriately entitled to.
Process - ANSWER✔✔ -To ensure complete capture of all billable charges, review
cannot be limited to analysis of the charge description and coding alone.
-Periodic line-by-line review of all CPT and HCPCS codes and their associated
charges and revenue code mapping increases the accuracy of each claim
submitted for reimbursement.
Responsible Parties - ANSWER✔✔ -although oversight of the CDM as a complete
system may be managed by a single individual or team, appropriate maintenance
requires collaboration with all departments across the organization that create
charges through the chargemaster.
-Because the CDM collect information on all the goods and services an
organization provides to its patients, it is important to solicit input from ancillary
departments knowledgeable of services and charges.
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