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CDM - Charge Description Master Segment

The Technical Steward for the CDM segment is Financial Management.

The CDM segment contains the fields for identifying anything which is charged to patient accounts, including procedures, services, supplies. It is intended to be used to maintain a list of valid chargeable utilization items. Its purpose is to keep billing codes synchronized between HIS, Patient Accounting, and other departmental systems. It is not intended to completely support materials management, inventory, or complex pricing structures for which additional complex fields would be required. Given an identifying charge code, the associated fields in the charge description master file will provide basic pricing and billing data. All the additional information necessary for patient accounting systems to do billing and claims is not intended to be included in this segment; those should be part of insurance or billing profile tables.

The CDM segment contains the fields which, for one chargeable item, remain the same across facilities, departments, and patient types. The following PRC segment contains the fields which, for the same chargeable item, vary depending upon facility or department or patient type.

HL7 Attribute Table - CDM - Charge Description Master Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
CDM
1 01306 Primary Key Value - CDM SHALL [1..1] CWE
2 00983 Charge Code Alias [0..*] CWE
3 00984 Charge Description Short SHALL # [1..1] 20 ST
4 00985 Charge Description Long # [0..1] 250 ST
5 00986 Description Override Indicator = [0..1] 1 CWE
6 00987 Exploding Charges [0..*] CWE
7 00393 Procedure Code [0..*] CNE
8 00675 Active/Inactive Flag [0..1] [1..1] ID
9 00990 Inventory Number [0..*] CWE
10 00991 Resource Load = [0..1] 12 NM
11 00992 Contract Number [0..*] CX
12 00993 Contract Organization [0..*] XON
13 00994 Room Fee Indicator [0..1] [1..1] ID

CDM-1: Primary Key Value - CDM (CWE) 01306

(Definition from OM7.24 in Ch. 8)

Definition: Allows the ability to associate a Service/Test/Observation item with a CIM (charge item master). This field contains the corresponding value of CDM-1 for the CIM being linked to. It is possible to allow multiple charge items to a single Service/Test/Observation item.

(Definition from CDM.1 in Ch. 8)

Definition: The key field of the entry. Must match MFE-4 - Primary Key Value - MFE. This field contains the code assigned by the institution for the purpose of uniquely identifying the thing that can be charged. For example, this field would be used to uniquely identify a procedure, item, or test for charging purposes. Probably the same set of values as used in FT1-7- Transaction Code in financial messages (refer to User-defined Table 0132 - Transaction Code in Chapter 2C, Code Tables, for suggested values). See Chapter 7 for discussion of the universal service ID.

CDM-2: Charge Code Alias (CWE) 00983

Definition: This field contains an alternative charge code. For example, points to another charge description master entry in cases where one code supersedes or overrides another code. Repeating field allows for different codes used by different systems which should be handled as if they were the same; for example, the general ledger code may differ from the billing code. Or, in a multi-facility environment which does facility-specific pricing, there may be more than one of these master file entries for one charge description, each with a different facility. Refer to User-defined Table 0132 - Transaction Code in Chapter 2C, Code Tables, for suggested values.

CDM-3: Charge Description Short (ST) 00984

Definition: This field contains the text abbreviations or code that is associated with this CDM entry.

CDM-4: Charge Description Long (ST) 00985

Definition: This field contains the full text description of this CDM entry.

CDM-5: Description Override Indicator (CWE) 00986

Definition: This field indicates whether this CDM entry's description can be overridden. Refer to User-defined Table 0268 - Override in Chapter 2C, Code Tables, for suggested values.

CDM-6: Exploding Charges (CWE) 00987

Definition: This field contains the repeating occurrences for a list of other CDM entry charge codes identifying the other charges which should be generated from this CDM entry. Refer to User-defined Table 0132 - Transaction Code in Chapter 2C, Code Tables, for suggested values. If non-null, posting a charge to this CDM entry should result in posting the charges identified here. These are sometimes called "linked items."

In the case of "chained" charges where the "lead" charge must be included in the exploded charges, the "lead" charge should be included in the list of exploding charges. If the price of this parent charge is included in the message, then it overrides the sum of the exploded charges prices.

CDM-7: Procedure Code (CNE) 00393

(Definition from OBR.44 in Ch. 4)

Definition: This field contains a unique identifier assigned to the procedure, if any, associated with the charge. Refer to Externally-defined table 0088 – Procedure code in Chapter 2C, Code Tables, for suggested values. This field is a coded data type for compatibility with clinical and ancillary systems.

As of version 2.6, applicable external coding systems include those in the referenced table. If the code set used is in the referenced table, then the coding scheme designation in the table shall be used.

(Definition from FT1.25 in Ch. 6)

Definition: This field contains a unique identifier assigned to the procedure, if any, associated with the charge. Refer to Externally-defined Table 0088 - Procedure Code in Chapter 2C, Code Tables, for suggested values. This field is a coded data type for compatibility with clinical and ancillary systems.

As of v 2.6, the known applicable external coding systems include those in the table below. If the code set you are using is in this table, then you must use that designation.

Procedure Code Coding Systems (from HL7 Table 0396)

Code

Description

Comment / Source

C4

CPT-4

American Medical Association, P.O. Box 10946, Chicago IL 60610.

C5

CPT-5

(under development – same contact as above)

HCPCS

CMS (formerly HCFA) Common Procedure Coding System

HCPCS: contains codes for medical equipment, injectable drugs, transportation services, and other services not found in CPT4.

HPC

CMS (formerly HCFA )Procedure Codes (HCPCS)

Health Care Financing Administration (HCFA) Common Procedure Coding System (HCPCS) including modifiers.

I10P

ICD-10 Procedure Codes

Procedure Coding System (ICD-10-PCS.) See http://www/hcfa.gov/stats/icd10.icd10.htm for more information.


(Definition from PR1.3 in Ch. 6)

Definition: This field contains a unique identifier assigned to the procedure. Refer to Externally-defined Table 0088 - Procedure Code in Chapter 2C, Code Tables, for suggested values. This field is a CNE data type for compatibility with clinical and ancillary systems.

(Definition from OBR.44 in Ch. 7)

Definition: This field contains a unique identifier assigned to the procedure, if any, associated with the charge. Refer to Externally-defined table 0088 – Procedure code in Chapter 2C, Code Tables, for suggested values. This field is a coded data type for compatibility with clinical and ancillary systems.

As of version 2.6, applicable external coding systems include those in the referenced table. If the code set used is in the referenced table, then the coding scheme designation in the table shall be used.

(Definition from CDM.7 in Ch. 8)

Definition: This field contains the procedure code for procedure, if any, associated with this charge description. Repeating field allows for different procedure coding systems such as CPT4, ICD9. Coded entry made up of code plus coding schema. Refer to Externally-defined Table 0088 - Procedure Code in Chapter 2C, Code Tables, for suggested values.

(Definition from IIM.14 in Ch. 17)

Definition: This field contains a unique identifier assigned to the service item, if any, associated with the charge. In the United States this is often the HCPCS code. Refer to Externally Defined Table 0088 - Procedure Code in Chapter 2C, Code Tables, for suggested values. This field is a CNE data type for compatibility with clinical and ancillary systems.

As of v2.6, the known applicable external coding systems include those in the table below. If the code set you are using is in this table, then you must use that designation.

Procedure Code Coding Systems

Coding System

Description

Comment

C4

CPT-4

American Medical Association, P.O. Box 10946, Chicago IL 60610.

C5

CPT-5

(under development – same contact as above)

HCPCS

CMS (formerly HCFA) Common Procedure Coding System

HCPCS: contains codes for medical equipment, injectable drugs, transportation services, and other services not found in CPT4.

HPC

CMS (formerly HCFA) Procedure Codes (HCPCS)

Health Care Financing Administration (HCFA) Common Procedure Coding System (HCPCS) including modifiers.


(Definition from ITM.27 in Ch. 17)

Definition: This field contains a unique identifier assigned to the service item, if any, associated with the charge. In the United States this is often the HCPCS code. Refer to Externally defined Table 0088 - Procedure code for suggested values. This field is a CNE data type for compatibility with clinical and ancillary systems. Refer to HL7 Table 0088 – Procedure Coding Systems in Chapter 2C, Code Tables, for valid values.

As of v2.6, the known applicable external coding systems include those in the table below. If the code set you are using is in this table, then you must use that designation.

(Definition from SCD.32 in Ch. 17)

Definition: The unique identifier indicating the type of procedure performed on the patient with the supplies being sterilized.

Refer to HL7 Table 0088 – Procedure Code in Chapter 2C, Code Tables, for suggested values.

As of v2.6, the known applicable external coding systems include those in the referenced table. If the code set you are using is in this table, then you must use that designation.

CDM-8: Active/Inactive Flag (ID) 00675

(Definition from LDP.6 in Ch. 8)

Definition: This field indicates whether the entry for this location is currently an active, that is, valid, usable entry (disregarding whether it's waiting to be maintained by housekeeping). Refer to HL7 Table 0183 - Active/Inactive in Chapter 2C, Code Tables, for valid values.

(Definition from CDM.8 in Ch. 8)

Definition: This field indicates whether this is a usable CDM entry. Refer to HL7 Table 0183 - Active/Inactive in Chapter 2C, Code Tables, for valid values.

(Definition from PRC.16 in Ch. 8)

Definition: This indicates whether this is a usable CDM entry. Refer to HL7 Table 0183 - Active/Inactive in Chapter 2C, Code Tables, for valid values.

(Definition from STF.7 in Ch. 15)

Definition: This field indicates whether person is currently a valid staff member. Refer to HL7 Table 0183 - Active/Inactive in Chapter 2C, Code Tables, for valid values. This table contains values for active or inactive.

CDM-9: Inventory Number (CWE) 00990

Definition: This optional field contains an identifying stock number, if any, which might be used, for example, as a cross reference for materials management. Refer to User-defined Table 0463 - Inventory number in Chapter 2C, Code Tables, for suggested values.

CDM-10: Resource Load (NM) 00991

Definition: This field contains the Relative Value Unit (RVU) minutes and ATS, a factor related to CPT4 coding and to pricing structure for physical billing.

CDM-11: Contract Number (CX) 00992

Definition: This field contains any contract number pertaining to this chargeable item; for example, supplier contract or service contract.

CDM-12: Contract Organization (XON) 00993

Definition: This field contains the organization with which there is a contractual arrangement for providing the service or material used for this chargeable item.

CDM-13: Room Fee Indicator (ID) 00994

Definition: This field contains a room fee indicator. Refer to HL7 Table 0136 - Yes/no Indicator in Chapter 2C, Code Tables, for valid values.