Designing and maintaining an effective chargemaster

The chargemaster is the central repository of charges and associated coding information used to develop claims. But this simple description belies the chargemaster's true complexity. The chargemaster's role in the coding process differs from department to department, and not all codes provided on a claim form are necessarily included in the chargemaster, as codes for complex services may need to be developed and reviewed by coding staff. In addition, with the rise of managed care, the chargemaster increasingly is being used to track utilization of supplies and services. To ensure that the chargemaster performs all of its functions effectively, hospitals should appoint a chargemaster coordinator, supported by a chargemaster review team, to oversee the design and maintenance of the chargemaster. Important design issues that should be considered include the principle of "form follows function," static versus dynamic coding, how modifiers should be treated, how charges should be developed, how to incorporate physician fee schedules into the chargemaster, the interface between the chargemaster and cost reports, and how to include statistical information for tracking utilization.