Department CDM Update Internal Evaluation
This evaluation helps you assess where your facility is in the annual CDM Update process.
Department CDM Update Internal Evaluation
(Send to all Department Representatives involved in your annual CDM update process)
Points Quality/Frequency (as applicable)
5 Excellent 0 Not applicable
____ 1. Orientation to /overview of the hospital’s annual CDM update process
____ 2. Support from hospital leadership (ex. for allocation of time, resources needed, assistance needed, etc.)
_____ 3. Explanation from Charge Management /Revenue Cycle leadership why you or your department was involved in the annual CDM update process
_____ 4. Communication of assigned annual update tasks and responsibilities
_____ 5. Communication of due dates for annual update activities assigned to your area
_____ 6. Availability of time to perform requested annual update activities
_____ 7. Access to necessary and complete resources and reference information for assigned annual CDM update tasks
_____ 8. Guidance/assistance with data changes or charge capture impacted by regulatory or payment system changes
_____ 9. Education and guidance on coding changes for your service area (new codes, code changes, deleted codes, HCPCS vs. CPT-4®, changes to charge usage/structure due to code changes, etc.)
_____ 10. Education/guidance on payment or pricing indicators or edits (eg. OPPS Status Indicators, I/OCE edits, MPFS Payment Indicators, HCPCS Pricing Indicators, etc.), and how they impact CDM annual updates
____ 11. Tools, forms, reports or other mechanisms used for performing annual CDM revisions (e.g. what to do and in what format)
_____ 12. Instructions for submission of annual CDM changes (guidance on tools, forms, research requirements, fields to complete, due date, who to call for help, etc.)
_____ 13. Instructions and information on impact to charge protocol, charge capture processes, and/or tools due to annual changes
_____ 14. Availability of Hospital/Corporate standards, policies, and procedures to support decisions for CDM revisions & usage
_____ 15. Clear communications on areas pending Medicare (CMS) clarification and why data changes may be delayed.
_____ 16. Input on information systems problems or functionality updates to support the required charge data changes in the current environment (not in a future upgrade or HIS system)
_____ 17. Input on pricing rules, parameters, guidelines and market comparisons or pricing standards for your area’s services/items
_____ 18. Clear direction about charges that require ‘hard coding’ of CPT-4® codes in the Charge Master file vs those coded by HIM/Medical Record Coding
_____ 19. Instructions and suggested methodology for post implementation quality control of annual CDM changes for assurance of correct data entry
_____ 20. Overall quality, guidance and support from Charge Management / Revenue Cycle (e.g. your contact people who help with annual Charge Master revisions).
__________ Total Score
Annual CDM Update Evaluation Scoring
100-95 A The Health System appears to be doing a very good job with the annual CDM update process.
94-85 B The Health System has developed an annual CDM update process and appears to follow an organized approach. However, there appears to be room for improvement.
84-75 C The Health System has initiated a program for annual CDM updates, but appears to need to expand its efforts and/or performance.
74-65 D The Health System has some key elements of an effective annual CDM updates program, but there appears to be significant need for improvement. There may be potential for compliance and/or revenue risks.
< =65 F Needs Immediate Improvement – Your hospital appears to be at high risk for lost reimbursement and/or compliance problems associated with what appears to be inadequate annual CDM update processes.
Optional Contact Information: Name/E-mail /Phone
Thank you for participating in this Evaluation. The Charge Management/ Revenue Cycle team will share plans for improvements or any concerns you’ve expressed. Please immediately reach out to our team for any charge-related compliance issues or urgent matters. Your input is important to us.