William A. Kramer and Assoc., Inc.
Financial Management Solutions for
Small and Medium Sized Hospitals
CHARGE MASTER REVIEW PROTOCOL
Step 1
Match the current charge master with the revenue and usage report, via computer sorting and file linking. Determine if the charge master contains items that are no longer used.
Step 2
Match the charge master to the most current CPT-4 code listing, via computer sorting and file linking Determine if the charge master contains any deleted or out of date codes. Compare the official CPT-4 description to the hospital's description to assure the CPT-4 codes are assigned correctly.
Step 3
Match the UB Codes to the charge master to determine if there are any out of date codes.
STEP 4
Via dialogue with the Business Office Manager and the billing personnel, determine if any charge master items are causing billing problems or rejections.
Step 5
Via dialogue with the Corporate Compliance Manager, determine if there are items being billed that may be in violation with Medicare billing regulations.
Step 6
Segment the charge master into departments. Assign each segment to the manager – or agreed upon designee – responsible for the departmental charges.
Step 7
Meet with each of the managers to discuss their concerns about the charge master and complete the following list of functions:
 | Review deleted CPT-4 Codes and assign new CPT and APC codes. |
| Review items without CPT-4 Codes that should have codes and assign them with related APC codes. |
| Review the complete list of CPT-4 Codes for that department to determine if services are being provided, but neither billed nor reimbursed.
Review the list of UB Codes to determine correct assignment.
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| Review for duplicate charges. Where duplicate charges are required, such as the same procedure charge in both the emergency room and surgery, assure the charge is uniform. |
| Review G/L routing codes to assure revenue is going to the correct account. |
| Assist in the development of new charge tickets to assure the charge master updates carry forth to the billing process.
Review charge master after input to assure completion of the project.
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Establish a working group to manage the charge master in the future. To assure that this kind of review will not be necessary in the future.
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