Implementing a Charge Data Master (CDM)

In the Commure Pro system, the Admin > Institution > Charge Capture > Update Charges/Modifiers option contains the comprehensive set of charge codes that is used by the organization. However, if your organization is comprised of multiple locations (facilities), and each of those locations has historically used its own (different) set of charge codes, you might use a Charge Data Master (CDM). Or in another example, your organization might use a CDM if they have historically used different charge codes for different billing areas. The Commure Pro CDM feature maps the disparate lists of charge codes (for either locations or billing areas), to the single organization-wide comprehensive list that is stored in the Commure Pro system (via the Update Charges/Modifiers option). Please note that the CDM can be used to map charge codes for either different locations (referred to as a “location-based CDM”), or different billing areas (referred to as a “billing area-based CDM”), but not both at the same time. In this document, the list of codes in the Commure Pro Update Charges/Modifiers option are referred to as “CPT codes,” while the codes used for the different locations or billing areas are referred to as “CDM codes.” Often, the charges captured in the various locations or billing areas are routed to multiple billing systems, depending on the location or billing area where the services are provided and the business relationship that the organization has with the physicians in that location or billing area. The charges that are captured in Commure Pro can include both professional and technical services. When a CDM is used, the Commure Pro system can send the appropriate professional or technical CDM codes used at a given location/billing area to the appropriate billing system that is responsible for processing that location’s/billing area’s charges. Several different business models can be accommodated, as in the examples below. Let’s look at an example where different charge codes are used at different locations. For simplicity, the term “hospital” below equates to any large multi-facility organization that is using the Commure Pro Charge Capture system.

• Services are provided in one or more locations that are owned by the hospital, where the physicians are salaried by the hospital.
  • Professional charges are entered by physicians. These receivables are owned by the hospital and are routed to the hospital’s billing system(s).
  • Technical charges for services provided by the locations (such as room preparation, nurse exams, or immunizations administered by nurses) are entered by nurses or medical assistants. These receivables are also owned by the hospital and are routed to the hospital’s billing system(s).
• Services are provided in one or more locations that are owned by the hospital. The physicians are salaried by a physician organization (PO), which is leasing space in the locations for their physicians to practice.
  • Professional charges are entered by physicians. These receivables are owned by the PO and are routed to the PO’s billing system.
  • Technical charges for services provided by the locations (such as room preparation, nurse exams, or immunizations administered by nurses) are entered by nurses or medical assistants. These receivables are owned by the hospital and are routed to the hospital’s billing system(s).
• Services are provided in one or more locations that are owned by a PO, where the physicians are salaried by the PO. Each location has its own charge codes and billing system.
  • Professional charges are entered by physicians. These receivables are owned by the PO and are routed to the PO’s billing system for that location.
  • There are no charges for technical services. In addition to routing the charges to different billing systems, a CDM can be used to “explode” a single charge captured in Commure Pro into two or more CDM charges (to account for both the professional and technical components). The professional and technical CDM charges are then routed to the appropriate billing systems. Whether or not a charge is “exploded” depends on the contents of the CDM and whether a supervising physician was present for that service. See How Does the CDM Work? for more information.

When a CDM is implemented in the Commure Pro system, the CDM codes are displayed next to the standard CPT codes in the Charges display option on the Patient List tab (or in the Patient Data Display). They can also be displayed in the Holding Bin, Search, and Worklist options. This enables billers to verify that the correct CDM code(s) will be sent to the billing system.

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Availability of the CDM Feature on Web versus Handheld Platforms

Once the CDM feature is configured, charges entered on any platform (web, Android, or Apple) are evaluated when determining whether or not to retrieve a CDM code. The handheld charges are evaluated when they are submitted to the server.

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Using a CDM with Other Charge Capture Features

A CDM can be used in conjunction with the features below, as long as the Supervising MD Present and Rendering Provider charge headers are enabled for the users who are entering the charges, which in turn enables the system to retrieve the correct CDM codes.

• Automated Code Entry. If a charge is generated by Automated Code Entry, and that charge is mapped in the CDM, and the transaction meets all of the criteria for applying CDM codes, then the appropriate CDM codes are retrieved. See Configuring Automated Code Entry.
• Batch Charge Entry. When a provider applies a charge code to a batch of patient visits, the appropriate CDM codes will be retrieved for each transaction in the batch, if the charge code is mapped in the CDM, and the transaction meets all of the criteria for applying CDM codes. See Configuring Batch Charge Entry.
• Custom Charge Capture Screens. If a charge is generated by a Custom Charge Capture Screen, and that charge is mapped in the CDM, and the transaction meets all of the criteria for applying CDM codes, then the appropriate CDM codes are retrieved. See Configuring Custom Charge Capture Screens.
• Hold for Review. The Hold for Review feature can be used in conjunction with a CDM. Upon submitting a charge transaction that is held for review, the appropriate CDM codes will be retrieved for the transaction, if the charge code is mapped in the CDM, and the transaction meets all of the criteria for applying CDM codes. See Configuring the Hold for Review Workflow.
• PQRS. When the PQRS feature is implemented, each time a provider submits a charge transaction, it is evaluated to determine if it fits the quality reporting criteria, and if so, the provider is then prompted to answer a series of clinical metrics questions. The questions do not interfere with a CDM, or vice versa. If the charge codes entered by the provider are mapped in the CDM, and if the transaction meets all of the criteria for applying CDM codes, then the appropriate CDM codes are retrieved. See Configuring PQRS/MIPS.
• RVU Management. This feature can be used in conjunction with a CDM. Both features work in tandem and do not interfere/conflict in any way. See Configuring RVU Management.
• Selection of NDC Codes. When a provider enters a charge code that has NDC codes mapped to it, specifies the appropriate drug and NDC code, and then submits the transaction, the appropriate CDM codes will be retrieved, if the charge code is mapped in the CDM, and if the transaction meets all of the criteria for applying CDM codes. See Configuring the Selection of NDC Codes During Charge Capture.

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How Does the CDM Work?

When determining whether to retrieve a CDM code, the system evaluates the charge transaction. Charge transactions that are entered on both the web and handheld platforms are evaluated (the handheld charges are evaluated when they are submitted to the server). The values in the following fields are reviewed: the Supervising MD Present header, the Role (nurse, provider, etc.) of the person listed in the Rendering Provider header, and either the patient Location (the facility and nursing unit listed on the visit) or the Billing Area on the charge transaction.

• The combination of either the patient Location and the Rendering Provider’s user Role, or the Billing Area and the Rendering Provider’s user Role, for a given CPT code determines whether a CDM code is retrieved at all:
  • If the combination of Location and Role, or Billing Area and Role, are listed in the CDM Preferences table, then for the CPT code listed on the charge transaction, the system searches for the matching CDM code for that patient Location or Billing Area.
  • If the combination of Location and Role, or Billing Area and Role, are not listed in the CDM Preferences table, then the system does not search for a CDM code.
• The value of the Supervising MD Present header for a given CPT code determines how many CDM codes are retrieved:
  • If the value is No for a CPT code, then only the technical CDM code for that Location or Billing Area is retrieved.
  • If the value is Yes for a CPT code, then both the professional and the technical CDM code for that Location or Billing Area are retrieved.

If the system is not able to find a CDM code in the CDM file when the rules above dictate that it should, the charge transaction is sent to the Holding Bin with either a Missing Technical CDM or Missing Professional CDM error.

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Steps for Configuring a CDM

There are several steps involved in configuring the system to use a CDM:

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Mapping CPT Codes to CDM Codes

Each row in the CDM maps a CPT code to one or more professional or technical CDM codes, and also maps each CPT code to the CDM code(s) that are used for a given location or billing area. For example:

• If a CPT code needs to be mapped to a CDM code, then the CPT code might be listed in the CDM as follows:

• If a CPT code needs to “explode” into two CDM codes (for the professional and technical services), then that CPT code must be listed twice in the CDM: one row maps the CPT to a professional CDM code, and the other row maps the same CPT to a technical CDM code. For example:

• If a CPT code has CDM codes for several different locations/billing areas (but not all locations/billing areas), then the rows for that CPT code must be repeated for each location/billing area (see also Special Notes about the Facility and Nursing Unit Columns:). For example, if a CPT code were used at two out of four locations/billing areas, and that CPT also needed to explode as described in the first bullet, this would increase the number of rows to four:

If you added separate CPT codes to the Commure Pro charge code list for technical E & M charges (such as 99211T, 99213T, and 99215T), make sure that these CPT codes also have mappings to CDM codes (see Creating New Charge Codes for more information). There are several different ways you can load your CPT to CDM mappings into the system. You can load them in bulk or individually. Once loaded, you can then edit, delete, or export them as well. See When to Use the CDM Preferences Option versus the Manage CDM Option for more information.

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When to Use the CDM Preferences Option versus the Manage CDM Option

In order for the Commure Pro system to be able to retrieve the right CDM codes under the correct circumstances, you must map the CPT codes to the CDM codes. There several features available for working with the mappings in bulk or individually. All of the bulk management features are located in the CDM Preferences option, while all of the features for working with individual mappings are located in the Manage CDM option:

• The CDM Preferences option contains these options:
  • Import: Import some or all of the mappings in bulk from a text file. This is a useful tool during initial implementation of the Commure Pro system or when you otherwise need to add many new mappings at once (for example, when your organization acquires a new facility). See Importing/Exporting CDM Mappings in Bulk.
  • Export: Export some or all of the mappings in bulk to a text file. The exported file can then be imported into a different system.
  • Clear CDM: Clear (delete) some or all of the mappings in bulk. See also Sample Scenarios for Making Bulk Changes to Mappings
• The Manage CDM option contains these options:
  • Add CDM: Add new mappings, one by one. This option is commonly used after initial implementation, for cases where you just want to add a few new mappings. See Adding a New CDM Mapping.
  • Edit: Edit an individual mapping, pre or post implementation. See Editing or Deleting a CDM Mapping.
  • Delete: Delete an individual mapping, pre or post implementation. See Editing or Deleting a CDM Mapping. See also Sample Scenarios for Making Individual Changes to Mappings.

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Sample Scenarios for Making Bulk Changes to Mappings

When first implementing the Commure Pro system, the quickest way to load the CDM mappings into your system is to import them in bulk. Most likely you will load them initially into a test environment so that you can test them prior to implementation. Keep in mind that a CDM import file maps CPT codes to CDM codes, for one or more locations or billing areas. When importing a new CDM file into a test or production system that already has mappings in place, you should consider the following:

• If a CPT code is already mapped in the system, and the new CDM file has one or more rows for that same CPT code, some or all of those existing mappings may be overwritten when you import the new file.
• If a CPT code is already mapped in the system, and the new CDM file does not have any rows for that CPT code, the existing mappings will not be removed when you import the new file. With the above considerations in mind, before performing a new import into a test or production system that already has mappings in place, you may find it helpful to review the CPT codes that are currently mapped via the Manage CDM option (see Viewing the Current List of CDM Mappings).

While testing during the initial implementation phase, if you find that you have to make frequent large-scale changes to your CDM mappings, it may be easiest to use an Export - Clear - Import strategy. This allows you to clean the slate and start fresh with each import. In this scenario, you would use the CDM Preferences option to:

1. Export all of the current CDM mappings in your test environment to a text file.
2. Clear all of the current mappings from the test system.
3. Make the desired changes to the exported CDM file.
4. Import the changed CDM file back into the test environment. In another example, let’s say you have imported a complete set of CDM mappings for OP Clinics A, B, and C. However, prior to implementation, you decide that you do not want to use the CDM mappings for OP Clinic C after all. In this example, you could use the Clear function to delete all of the mappings for OP Clinic C in bulk (rather than manually deleting what could possibly be hundreds of entries one by one, using the Manage CDM option).
5. In the Manage CDM option, review all of the mappings for OP Clinic C, to confirm that in fact you want to remove all of those rows.
6. In CDM Preferences option, use the Clear option to delete the entries for only OP Clinic C. The mappings for OP Clinic C are removed, while the mappings for OP Clinic A and B remain in place.

And finally, once you have perfected the CDM mappings in your test environment, you can export them to a text file and then import that same file into your production system.

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Sample Scenarios for Making Individual Changes to Mappings

If you have already loaded the majority or all of your CDM mappings into a test or production system and now you just want to make a few changes to fine-tune them, you can use the Manage CDM option to add, edit, or delete a few entries. For example, if you just need to add one or two new mappings, you can use the Add CDM button in the Manage CDM option to add those entries. Or, let’s say CPT 12345 was mapped to CDM 11111 for the OP Clinic A location, but starting on 01/01/13 you want it to be mapped to CDM 22222. In this example, you would use the Manage CDM option to:

1. Edit the row where CPT 12345 is mapped to CDM 11111 for OP Clinic A and enter an expiration date of 12/31/12 on this mapping.
2. Add a new row that maps CPT 12345 to CDM 22222 for OP Clinic A, specifying an effective date of
   01/01/13. Now, any charges for CPT 12345 in OP Clinic A with a service date on or before 12/31/12 will generate CDM 11111, and any with a service date on or after 01/01/13 will generate CDM 22222.

Or in a final example, let’s say CPT 12345 was mapped to CDM 11111, and effective as of right now, you do not want it to be mapped to anything at all, for a specific set of locations (OP Clinic A and OP Clinic B). However, you want to leave the mappings for CPT 12345 in place for OP Clinic C. In this example you would use the Manage CDM option to:

1. Delete the rows for CPT 12345 in OP Clinic A and OP Clinic B.
2. Leave the row for CPT 12345 in OP Clinic C untouched. The mappings for CPT 12345 in OP Clinic A and OP Clinic B are removed, while the mappings for CPT 12345 in OP Clinic C remain in place.

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Importing/Exporting CDM Mappings in Bulk

You can load all or some of your CDM mappings in bulk using the Import feature. This feature is helpful during initial implementation, or when you otherwise need to add many new mappings at once (for example, when your organization acquires a new facility). Once you have a set of mappings loaded into your system (whether via importing or manually adding them individually), you can then later export them to a file. The most likely usage of the Export feature is that you might import an initial CDM file into a test or production environment so that you can test it or use it for a while, export it to a file, possibly make some modifications, and then import it back into the same Commure Pro system, or to a different Commure Pro system (such as a test or production environment). See Defining the Roles and Locations for the CDM. When exporting a CDM file, the system creates a text file that uses a comma separated values format (with a .txt extension). The content and format of the file is described in Format for the CDM Import/Export File. When importing, your source file must use this same format.

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Format for the CDM Import/Export File

When exporting the CDM mappings, the system creates a text file that uses a comma separated values format (with a .txt extension). When importing, Commure Pro recommends that you use this same comma separated .txt format. If necessary, you can edit the exported file using a text editor, save it in the same .txt format, and then re-import it. Each row in the file must contain a value in the columns that are listed as required in the table below, each column’s contents must be enclosed in double quotes, and each column must be separated by a comma. If you prefer to edit the file in Microsoft Excel®, please be sure to save it as a comma delimited file (with a .csv extension). In addition, when working in Excel, you do not have to enclose items in double quotes.

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Steps for Importing/Exporting CDM Mappings

Instructions for importing or exporting the CDM mappings are listed below. To import a file containing your CDM mapping information:

1. Select Admin > Institution > Charge Capture > Custom Charge Capture Screens > CDM Preferences.
2. In the CDM Upload section, click the Browse button to search for the file that contains the CDM, and then select the file.
3. Click the Import icon The file is imported. The filename, date and time imported, and the person who imported it are all recorded and displayed on the screen.

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To export the mappings that currently exist in your system to a spreadsheet

1. Select Admin > Institution > Charge Capture > Custom Charge Capture Screens > CDM Preferences.
2. In the CDM Upload section, click the Export icon The CDM Export dialog is displayed, with criteria fields for Location, CPT code, and CDM code.
3. Determine which mappings you want to export:
   • To export all mappings (including those with a blank facility and/or nursing unit, or a blank billing area), leave all of the selection criteria fields blank, and click the Export button. (It does not matter whether you check or uncheck the Include CDM Entries without Facility and Billing Area mapping box; the application will export wild card entries in both cases.)
   • To export a specific set of mappings, enter data in one or more of the criteria fields below and then click the Export button. Only mappings that meet all of the criteria you define are exported.
     • Location: Click the Select Locations button and then choose one or more locations from the list.

• If you check the box for a facility (causing all of its nursing units to be selected), all CPT codes mapped for that facility are exported, including those that have a blank (wild card) nursing unit.
• If you check the box for one or more specific nursing units in a facility (but not the facility itself), then only the CPT codes mapped specifically to the selected nursing units are exported.
  • Billing Area: Click the Select Billing Areas button and then choose one or more billing areas from the list.
• If you check the box for a department (causing all of its billing areas to be selected), all CPT codes mapped for those billing areas are exported.
• If you check the box for one or more specific billing areas in a department (but not the department itself), then only the CPT codes mapped specifically to the selected billing areas are exported.
  • CPT: Enter a CPT code, click the Search icon to find the code, and then select it to add it to the list. Only the mappings for those CPT codes will be exported.
  • CDM text: Enter a CDM code and then click the Add button to add it to the list. Only CPT codes that are mapped to those CDM codes will be exported.
  • Include CDM Entries without Facility and Billing Area mapping: Check this box if you also want to export wild card CDM entries. If your CDM is location-based, and you entered one or more facilities as criteria, then when you check this box, the application exports those CDM entries that have a blank facility, in addition to those that are mapped to the facilities that you specified using the Location criteria. For example, if you specified CPT = 19061 and Location = City, and you left the Include CDM Entries without Facility and Billing Area mapping box unchecked, you would export the mapping rows for CPT 19061 in the City facility. However, if you checked the Include CDM Entries without Facility and Billing Area mapping box, the export would also include the mapping rows for CPT 19061 where the facility was blank. Similarly, if your CDM is billing area-based, and you entered one or more billing areas as criteria, then when you check this box, the application exports those CDM entries that have a blank billing area, in addition to those that are mapped to the billing areas that you specified using the Billing Area criteria.

4. Click Save to save the export file, or Open to open the file.

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Clearing CDM Mappings in Bulk

The Clear function is used when you want to clear (delete) a large number of CDM mappings in bulk, or when you want to delete all of the CDM mappings so that you can start over with a clean slate. If you want to clear/delete just a few rows, the easiest way to do so is to instead use the Manage CDM option (see When to Use the CDM Preferences Option versus the Manage CDM Option for sample scenarios, or Editing or Deleting a CDM Mapping for instructions). To clear the CDM mappings in bulk:

1. Select Admin > Institution > Charge Capture > Custom Charge Capture Screens > CDM Preferences.
2. In the CDM Upload section, click the Clear CDM button. The Clear CDM dialog is displayed, with criteria fields for Location or Billing Area, and CPT code.
3. Determine whether you want to clear only active mappings, or both active and inactive ones. By default, active mappings are cleared, but you can also clear inactive mappings by checking the Include InActive box prior to performing the next step.
4. Determine which mappings you want to clear:
   • To clear the all CDM mappings (including those with a blank facility and/or nursing unit, or a blank billing area), leave the selection criteria fields blank, and click the Clear All CDM data button. The following message is displayed: “Empty CDM table? CDM table items will be permanently deleted and cannot be recovered. Are you sure?” Click the Clear CDM button. All CDM mapping information is cleared from the database.
   • To clear a specific set of mappings, enter data in one or more of the criteria fields below.
     • Click the Select Locations button and then choose one or more locations from the list.

• If you check the box for a facility (causing all of its nursing units to be selected), all CPT codes mapped for that facility are cleared, except those that have a blank (wild card) nursing unit.
• If you check the box for one or more specific nursing units in a facility (but not the facility itself), then only the CPT codes mapped specifically to the selected nursing units are cleared.
  • Click the Select Billing Area button and then choose one or more billing areas from the list.
• If you check the box for a department (causing all of its billing areas to be selected), all CPT codes mapped to all of the selected billing areas are cleared.
• If you check the box for one or more specific billing areas in a department (but not the department itself), then only the CPT codes mapped specifically to the selected billing areas are cleared.
  • Enter a CPT code in the CPT field, click the Search icon to find the code, and then select it to add it to the list. Only the mappings for those CPT codes will be cleared. Click the Clear CDM by Criteria button. Only mappings that meet all of the criteria you define are cleared.

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Adding, Editing, or Deleting Individual CDM Mappings

Although you can use the Import, Export, and Clear functions in the CDM Preferences option to effectively manage your CDM mappings in bulk, the Manage CDM option offers the easiest approach to CDM management when you are making a small number of changes in order to fine-tune the contents. This option displays the current CDM mappings and allows you to add, edit, or delete individual entries. You can take any of the following actions in this option:

• Viewing the Current List of CDM Mappings
• Adding a New CDM Mapping
• Editing or Deleting a CDM Mapping

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Viewing the Current List of CDM Mappings

1. Select Admin > Institution > Charge Capture > Custom Charge Capture Screens > Manage CDM. The Manage CDM screen is displayed with criteria fields for Location or Billing Area, CPT code, and CDM code listed at the top of the screen.
2. Determine which mappings you want to view:
   • To view all mappings (including those with a blank facility and/or nursing unit), leave the Location or Billing Area, CPT, and CDM text criteria fields blank, and then click the Search button. (It does not matter whether you check or uncheck the Include CDM Entries without Facility and Billing Area mapping box; the application will return wild card entries in both cases.)
   • To view a specific set of mappings, enter data in one or more of the criteria fields below and then click the Search button. Only mappings that meet all of the criteria you define are displayed.
     • Locations: Click the Select Locations button and then choose one or more locations from the list.

• If you check the box for a facility (causing all of its nursing units to be selected), all CPT codes mapped for that facility are displayed, including those that have a blank (wild card) nursing unit.
• If you check the box for one or more specific nursing units in a facility (but not the facility itself), then only the CPT codes mapped specifically to the selected nursing units are displayed.
  • Billing Areas: Click the Select Billing Areas button and then choose one or more billing areas from the list.
• If you check the box for a department (causing all of its billing areas to be selected), all CPT codes mapped for all of the billing areas in the department are displayed.
• If you check the box for one or more specific billing areas in a department (but not the department itself), then only the CPT codes mapped specifically to the selected billing areas are displayed.
  • CPT: Enter a CPT code, click the Search icon to find the code, and then select it to add it to the list. Only the mappings for those CPT codes are displayed.
  • CDM text: Enter a CDM code, which can consist of numbers and/or text, and then click the Add icon to add the CDM code to the list. Only CPT codes that are mapped to this exact CDM code are displayed.
  • Include Entries without Facility and Billing Area mapping: Check this box if you also want to see wild card CDM entries. If your CDM is location-based, and you entered one or more facilities as criteria, then when you check this box, the application retrieves those CDM entries that have a blank facility, in addition to those that are mapped to the facilities units that you specified using the Location criteria. For example, if you specified CPT = 19061 and Location = City, and you left the Include Entries without Facility and Billing Area mapping box unchecked, you would see the mapping rows for CPT 19061 in the City facility. However, if you checked the Include Entries without Facility and Billing Area mapping box, the display would also include the mapping rows for CPT 19061 where the facility was blank. Similarly, if your CDM is billing area-based, and you entered one or more billing areas as criteria, then when you check this box, the application retrieves those CDM entries that have a blank billing area, in addition to those that are mapped to the billing areas that you specified using the Billing Area criteria. After clicking Search, all CDM mappings that meet your criteria are displayed in a table format, including those that are inactive.

The column contents are described below. Any column heading that has arrows indicates that you can click it to sort the list by that item.

• ID: A unique internal ID number for this CDM mapping, automatically assigned by the system.
• CPT: The CPT code that is mapped to a CDM code. This CPT code must exist in the Commure Pro list of charge codes.
• CDM: The CDM code to which the CPT code is mapped.
• Active: An indicator of whether the CDM mapping is active (a green circle) or inactive (a red circle).
• Facility: The facility in which this mapping is applied. An asterisk (*) indicates that the mapping is applied to all facilities (also referred to as a “wild card facility”).
• Nurse Unit: The nursing unit in which this mapping is applied. An asterisk (*) indicates that the mapping is applied to all nursing units within the facility listed in the Facility column (also referred to as a “wild card nursing unit”).
• Billing Area: The billing area in which this mapping is applied. An asterisk (*) indicates that the mapping is applied to all billing areas (also referred to as a “wild card billing area”).
• CDM Type: Indication of whether the mapping is for Technical code (T) or Professional code (P).
• Edit icon : Click the icon open the CDM Detail screen so that you can modify the mapping information, such as the CPT code, CDM code, Facility-Nursing Units or Billing Area, CDM Type, Cost Center, Effective/Expiration dates, or Auxiliary Information.
• Delete icon : Click to delete the CDM Mapping.

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Adding a New CDM Mapping

To add a new CDM mapping, follow the steps below.

1. Select Admin > Institution > Charge Capture > Custom Charge Capture Screens > Manage CDM. The Manage CDM screen is displayed.
2. Use the criteria fields at the top of the screen to view some or all of the mappings (see Viewing the Current List of CDM Mappings for instructions). You should check to make sure that the mapping you are about to add does not already exist.
3. Select the Create CDM button. The CDM Detail screen is displayed.
4. Complete the fields on the CDM Detail screen as follows:
   1. CPT (required): Select a CPT code from the Commure Pro list of charge codes. You can enter the full numeric code if you know it, or search for one. To search, enter any portion of the code or description and then click the Search icon .
   2. Facility-Nursing Units or Billing Area: If your CDM is location-based, use the Facility-Nursing Unit field to select a single facility or nursing unit where the service is provided and this CDM code is used. Or, if your CDM is billing area-based, use the Billing Area field to select a single billing area where the service is provided and this CDM code is used.

To select an item in either of these fields, first click the Search icon to view a list of all facilities and nursing units, or all billing areas. Then select an item as described below:

• If your CDM is location-based:
• If you check the box for a specific nursing unit within a facility (but not the facility itself), then the mapping applies to only that nursing unit in that facility.
• If you check the box for a facility (but not any nursing units within the facility), then the mapping applies to all nursing units within that facility (also referred to as a “wild card nursing unit”).
• If you select nothing and leave the Facility-Nursing Units field blank, then this mapping applies to all facilities and nursing units (also referred to as a “wild card facility”).
  • If your CDM is billing area-based:
• If you check the box for a specific billing area, then the mapping applies to only that billing area.
• If you select nothing and leave the Billing Area field blank, then this mapping applies to all billing areas (also referred to as a “wild card billing area”).

3. CDM (required): Enter the alternate charge code that is used for the selected facility-nursing unit or billing area, in place of the CPT code listed in the CPT field. The format of this code is defined by your organization. For example, it might be a combination of an internally defined Cost Center and Test Code.
4. CDM Type (required): Select whether this mapping is for a professional or technical code.
5. Active (required): Select Yes or No to indicate whether this mapping should be actively used by the application (see also the Effective Date and Expired Date fields below).
6. Cost Center: Enter a number representing the location where the service is provided. This column is for informational purposes only and is not used by the Commure Pro application.
7. Effective Date: Enter the date when this mapping becomes effective.
8. Expired Date: Enter the date when this mapping is no longer in effect.

9. AuxInfo 1 - AuxInfo 20: The CDM contains 20 additional fields purely for informational purposes (these fields are not used by the Commure Pro application, nor are they visible anywhere in the application other than in this option). For example, you might use these fields to record a Description or a Fee.
10. Click the Save button to save the new CDM mapping. The mapping is saved and immediately available for use (as long as the mapping has the Active field set to Yes.

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Editing or Deleting a CDM Mapping

To edit or delete a CDM mapping, follow the steps below.

1. Select Admin > Institution > Charge Capture > Custom Charge Capture Screens > Manage CDM. The Manage CDM screen is displayed.
2. Use the criteria fields at the top of the screen to display the mappings that you want to edit or delete (see Viewing the Current List of CDM Mappings for instructions).
3. Click one of the icons below for the mapping row that you want to edit or delete:
   • Edit icon : Click to open the CDM Detail screen so that you can modify the mapping information, such as the CPT code, CDM code, Facility-Nursing Units, Billing Area, CDM Type, Cost Center, Effective/Expiration dates, or Auxiliary Information. See Adding a New CDM Mapping for a full description of each field. When you are done making changes, click the Save button.
   • Delete icon : Click to delete the CDM mapping.

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Defining the Roles and Locations for the CDM

The CDM maps the CPT codes that are found in the Commure Pro list of charge codes to the CDM codes that are used for each location or billing area. In order to determine the circumstances under which the CDM codes should be retrieved, you must create a table of roles and locations (for a location-based CDM) or roles and billing areas (for a billing area-based CDM). This table is created via the CDM Preferences option, and it is here that you specify the valid combinations of role and location, or role and billing area, that should trigger a CDM code to be retrieved. For example, when a user with a particular role (such as Nurse) enters a charge for a patient in a particular location (such as OP Clinic B) or with a particular billing area (such as Interventional Cardiology), the system will check the table to see if this is a valid combination. If so, it will then check the CDM for the matching charge code(s) that are used for that location or billing area. It will display that CDM code(s) next to the CPT code in the Charges display option and in Holding Bin, Search, and Worklist options. It will also send those CDM code(s) to the billing system that processes the charges for OP Clinic B or Interventional Cardiology. See also How Does the CDM Work? for more information. If a particular combination of role and location, or role and billing area, is not defined in the table, then the system does not retrieve a CDM code; it simply uses the CPT code in displays, and sends only the CPT code to the billing system.

1. Select Admin > Institution > Charge Capture > Custom Charge Capture Screens > CDM Preferences.
2. Select all the user roles for whom you might possibly want to retrieve a CDM code.
   1. Click the Add Role button. A list of roles is displayed.
   2. Select one or more roles, and the click the Ok button. The role is added to the list of selected roles. You can delete any role at any time by clicking the Delete icon next to that item.
3. Select all the locations or billing areas where you might possibly want to retrieve a CDM code by clicking either the Add Location button or the Add Billing Area button. Notice that when you click one button (such as Add Location), the other button (Add Billing Area in this example) becomes disabled. As stated initially, the CDM can only be used for locations or billing areas, and not both.
   • If your CDM is location-based, click the Add Location button and then select one or more facilities and/or nursing units.
     • To select all nursing units in a facility, check the box next to that facility’s name.
     • To select only certain nursing units in a facility, click the Expand arrow next to the facility name, and then check the box next to the specific nursing units that you want. The location is added to the list of selected locations. You can delete any location at any time by clicking the Delete icon next to that item.

• If your CDM is billing area-based, click the Add Billing Area button and then select one or more departments and/or billing areas.
  • To select all billing areas in a department, check the box next to that department’s name.
  • To select only certain billing areas in a department, click the Expand arrow next to the department name, and then check the box next to the specific billing area that you want. The billing area is added to the list of selected billing areas. You can delete any billing area at any time by clicking the Delete icon next to that item. As you select roles and either locations or billing areas, a table is created behind the scenes. The table has roles on the horizontal axis, and either locations or billing areas on the vertical axis. Each time you add a role, a new column is added. Each time you add a location or billing area, a new row is added. Each time you do either, all of the cells within that row or column are checked, indicating that a CDM code should be retrieved when a user with that role enters a charge for that location or billing area. You can review the table and uncheck any cells as desired (see the next step).

4. Click the Edit icon to display the CDM Preferences Table and make adjustments as necessary. Once the CDM Preferences Table is displayed, for each location or billing area in the table, determine which roles should trigger the retrieval of a CDM code. If there are any combinations that should not trigger the retrieval of a CDM code, uncheck the box in that cell.

For example, let’s say your CDM is location-based, so you added OP Clinic A and B as locations, and Nurse and Provider as roles. In the OP Clinic A row, you might leave the cells for Provider and Nurse checked, while in the OP Clinic B row you might uncheck the cell for Provider. This means that in OP Clinic A, any charges entered by either a Provider or a Nurse will retrieve a CDM code. In OP Clinic B, only charges entered by a Nurse will retrieve a CDM code. If you do uncheck any boxes, then once you close the table and return to the CDM Preferences screen, you will notice a red asterisk next to the location or billing area that has an unchecked box. The red asterisk is simply to inform you of the fact that not all roles are selected for that location or billing area. This is certainly an acceptable configuration, but you are notified so that you can quickly scan the list and verify the locations or billing areas that have all roles selected, versus those that do not.

5. Click OK to save your changes to the CDM Preferences Table and close it.
6. On the CDM Preferences screen, click the Save button to save your changes and exit this option. (If you click the X without first clicking Save, your changes will be lost.) Please note that in order for the system to retrieve the CDM codes for the role/location combination or the role/billing area combination that you specified in the CDM Preferences Table above, a CPT to CDM mapping must exist for those locations or billing areas in the CDM (see Mapping CPT Codes to CDM Codes). If a CPT to CDM mapping does not exist in the CDM for a particular location or billing area, then the charge transaction is sent to the Holding Bin with either a Missing Technical CDM or Missing Professional CDM error. Since the typical billing administrator does not have permission to import or add CDM mappings, they may be allowed to send the charges to the Outbox despite these errors, if their user profile is configured appropriately (see Configuring User Settings for a CDM).

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Defining the CPT Exempt Lists

If a user enters a charge that qualifies for a CDM code (see How Does the CDM Work?), then the user’s response to the Supervising MD Present header determines the type of CDM code that is retrieved:

• If the user responds Yes to the Supervising MD Present header, both technical and professional CDMs are retrieved.
• If the user responds No to the Supervising MD Present header, only a technical CDM is retrieved. However, you can define certain CPT codes (or all CPT codes) as exempt from retrieving either technical or professional CDMs, by adding them to the CPT Exempt Lists. There are two CPT Exempt Lists:
• Exempt from Technical CDM: The codes on this list are “exempt” from a technical CDM. You can indicate that all codes are exempt, or that just certain codes are exempt.
  • If you select Exempt All: All CPT codes are exempt from a technical CDM, so a technical CDM is never retrieved no matter what CPT code the user enters or how they respond to the Supervising MD Present header. In addition a Missing Technical CDMerror is never generated. You might select this option if your organization never charges for technical components.
  • If you specify one or more CPT codes in this option:
    • When these CPT codes are entered on a charge transaction, a technical CDM is not retrieved, no matter how the user responds to the Supervising MD Present header for these charges. In addition a Missing Technical CDMerror is not generated.
    • Only a professional CDM could possibly be retrieved (only if the user responds Yes to the Supervising MD Present header).
• Exempt from Professional CDM: The codes on this list are “exempt” from a professional CDM. You can indicate that all codes are exempt, or that just certain codes are exempt.
  • If you select Exempt All: All CPT codes are exempt from a professional CDM, so a professional CDM is never retrieved no matter what CPT code the user enters or how they respond to the Supervising MD Present header. In addition a Missing Professional CDMerror is never generated. You might select this option if your organization never charges for professional components.
  • If you specify one or more CPT codes in this option:
    • When these CPT codes are entered on a charge transaction, a professional CDM is not retrieved, no matter how the user responds to the Supervising MD Present header for these charges. In addition, a Missing Professional CDMerror is not generated.
    • Only a technical CDM is retrieved (it would normally be retrieved in both cases, when the user responds Yes, and also when they respond No, to the Supervising MD Present header). To define the CPT Exempt Lists, follow the instructions below.

1. Select Admin > Institution > Charge Capture > Custom Charge Capture Screens > CDM Preferences. The CDM Preferences screen is displayed. Two headings labeled “Exempt from Technical CDM (n)” and “Exempt from Professional CDM (n)” are displayed on the right side of the screen. The “(n)” represents the number of CPT codes that are currently included on that particular CPT Exempt List.
2. Click on the heading for either CPT Exempt List to expand it and view all of the CPT codes on the list.
3. For a given CPT Exempt List, determine whether all CPT codes should be exempt, or just certain ones:
   • If all codes should be exempt, check the Exempt All checkbox.
   • If only certain codes should be exempt, add them to the list. There are several ways to add codes to these lists:
     • Enter the CPT codes one by one: In the CPT field, enter a partial or full CPT code or description, and then either press the Enter key on your keyboard, or click the Search icon . Select the CPT code you want from the search results. Repeat this step to enter each CPT code that should be exempt.

• Type in a comma separated list of CPT codes: Click the Import icon, type a list of CPT codes separated by commas into the text box, and then click the Import button.
• Import a comma separated list of CPT codes from your clipboard: First, copy a comma separated list of codes onto your clipboard. For example, if you are working from a document that contains the list, highlight the list and copy it (Control-C). Or if you want to copy the exempt list from a different Commure Pro system, go to the CDM Preferences option in that system and click the Export icon located next to the exempt list that you want to copy. This copies the list to your clipboard. Now go to the system where you want to import the codes and click the Import icon. Click your cursor into the text field, paste the list (Control-V), and then click the Import button. The CPT codes are added to the selected CPT Exempt List.

4. On the CDM Preferences screen, click the Save button to save your changes and exit this option. (If you click the X without first clicking Save, your changes will be lost.)

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Configuring User Settings for a CDM

When a charge transaction is sent to the Holding Bin with a either a Missing Technical CDM or Missing Professional CDM error, it means that a CPT-to-CDM mapping does not exist in the CDM for a particular location or billing area, even though the combination of role and location, or role and billing area, for that charge transaction has a checked box on the CDM Preferences Table. A billing administrator can edit a transaction with one of these errors to view the specific charge code(s) that triggered the error. If the provider entered the correct charge codes and the biller does not want to change them, then the only way to correct the error is for a Level 1 administrator to add a new CPT-to-CDM mapping for the charge code(s) in question. Your organization should determine whether they want to allow or prohibit users from sending charge transactions that have these errors to the Outbox. Keep in mind that if you do not allow it, the transaction will remain in the Holding Bin until a Level 1 administrator adds the mapping. Once the mapping is added, a biller can correct the error by opening the charge transaction and submitting it again (this triggers the system to retrieve the appropriate CDM codes). The setting below determines whether a Level 0-2 user can send a transaction to the Outbox even if it has a Missing Technical CDM or Missing Professional CDM error: Admin - User - Charge Capture - Allow User to Override Missing CDM Errors and Send to Outbox (L 0-2)

• When set to Yes (the default), a message displays indicating that the charge transaction has an error. The user may either cancel or proceed with sending it to the Outbox.
  • When set to No, a message displays indicating that the charge transaction has an error, and the user is prevented from sending it to the Outbox. Instead, the charge remains saved as it was before, until the error is resolved (by adding the appropriate CPT-to-CDM mapping and then resubmitting the transaction). In addition, you can opt to either show or hide the Missing Technical CDM or Missing Professional CDM errors from users, on an individual user basis. Typically you would show the errors to Level 0-2 users, who need to address and resolve them, but hide the errors from Level 3 providers, since these users cannot resolve them in any way.

Admin - User - Charge Capture - Show Missing CDM Errors

• When set to Yes (the default), if a transaction has a missing CDM error associated with it, the user will see it when editing a charge transaction or when viewing the charge transaction on any charge report.
  • When set to No, if a transaction has a missing CDM error associated with it, the user will not see it when editing a charge transaction or when viewing the charge transaction on any charge report. When using the Error Type filter on a report, if the user selects the “Missing Professional CDM” or “Missing Technical CDM” options, the report will find the transaction, but the error will be listed as None. If a charge transaction has other errors in addition to the missing CDM errors, only those additional errors are visible.