An accurate, updated, compliant Charge Description Master (CDM) is extremely important as it is the heart of any health care system’s revenue cycle. What is a CDM you ask? It is simply a master catalog of procedures, supplies, medications, and other services provided at a facility. CDM’s come in many different sizes and configurations but they all contain the necessary information to produce patient charges. The CDM allows the health care system to capture charges, almost in real time. Without a stringent CDM maintenance process the health care system may not receive accurate reimbursement because of lost charges, incorrect charges, outdated pricing, and non-compliant billing practices.In our experience, the ancillary systems, such as a LIS (Laboratory Information System) or a RIS (Radiology Information System), are frequently overlooked in the CDM maintenance process. Ancillary systems are commonly maintained within the clinical department with limited communication with the CDM team. These systems are set up to capture the clinical procedures performed within a department and this data, when the system is set up correctly, gets translated into a patient charge. For the patient charge to occur the charge from the ancillary system needs to be communicated to the main billing system. This communication usually occurs in the form of a mnemonic. The mnemonic may be the CDM number, an order number, test number, or any other unique alpha or numeric identifier that is linked to the CDM in the billing system. If the mnemonic is not in the CDM, the charge from the ancillary system does no know where to go and may drop into a “black hole” and become a lost charge.
It is extremely important that clinical department involves the CDM team whenever changes are made to the ancillary system. Anytime a new mnemonic or CDM is built in the ancillary system it must be communicated with the CDM so the appropriate update can occur and effective communication can happen between the two systems. Is it is a good idea to regularly perform a “check-up” between the two systems. If possible, obtain an excel download of all tests in the ancillary system that includes the communication link to the billing system. Then, obtain an excel download of the CDM with the same information. Perform a check by doing a ‘lookup’ into the ancillary download from the CDM and vice versa, matching on the mnemonic or other linkage. If any items show up as “N/A”, that means they are not set up in either the ancillary system or the billing system. This is a quick and easy way to identify any breakdown in charging with regards to ancillary systems. In the end, these few extra steps will save a lot of work on the back end and dramatically decrease the chances of incurring lost charges.