Reader Question: Charge Master

Question: Im thinking of setting up my charge master to mirror APCs. Is this a good idea? What kind of benefits or risks would be involved?

Wyoming Subscriber

Answer: Unfortunately, there are other payers who will still pay under the current methodology, and you might lose some revenue from those payers if you tailor everything to the APC methodology. For example, pharmacy and central supply items bundled into procedure APCs for Medicare may still be separately identifiable and reimbursable for other payers.

Until other payers move to the APC payment methodology, therefore, you might want to consider maintaining separate billing methodologies for those payers that recognize distinct services and supplies. If you want to bundle, be sure you have enough historical information on how the itemized services and supplies pay when separately identified to ensure that your new bundled charges and payments are not less than you anticipate under your current billing methodology.

- Published on 2000-08-01