PMMC CDM Coding Review.

Prevent unnecessary denials due to improper billing of codes with a CDM coding review. A CDM coding analysis utilizes the latest coding guidelines and compares it to your current chargemaster. This ensures you are billing the correct codes to minimize denials.

Learn more about a CDM coding review today!

Correct CPT/HCPCS Coding

The consulting team will work to identify missing reimbursable CPT/HCPCS codes, evaluate the accuracy of the codes to their description as well as validate the relevant CPT/HCPC to Revenue Code combinations for each clinical department.

Correct Revenue Coding

The consulting team will work to identify missing chargemaster revenue codes, determine the accuracy of the codes to their line item description and the alignment of the revenue codes to listed CPT/HCPS codes.   Efforts will also include an assessment of the correct revenue codes being assigned to implants and other carve-outs to insure proper billing and reimbursement from managed care payers.

Correct Modifiers

The consulting team will work to identify all items with required modifiers that may be missing from the chargemaster (CDM) and evaluate if the assigned modifier is accurate.

Compliance and Pricing Evaluation

The consulting team will make recommendations for regulatory compliance standards and will work to identify all items that should be deleted because they have not been used in the past 24 months. As it relates to chargemaster pricing, the review will identify zero-priced items as well those with same code or description but have different prices.

Training and Ongoing Support

The consulting team can provide department directors with sessions highlighting the importance of accurate CDM maintenance and the regulatory steps that must be followed to stay in compliance with all third-party payers. These sessions can also include educational programs for procedural modeling and coding accuracy. At the conclusion of the chargemaster review, a written report with recommendations will be provided. The recommendations will include steps for maintaining the ongoing integrity of the CDM. Ongoing support can also include establishing a process for reviewing and maintaining the CDM on an ongoing basis.