What Is Charge Entry?
Charge entry is the revenue cycle step where rendered services are translated into billable charges in the practice management system, including CPT/HCPCS codes, ICD-10 diagnoses, modifiers, units, and place-of-service codes.
- Track charge lag (days from date of service to charge entry) as a KPI — best practice is under 3 days.
- Charge lag over 5 days correlates with timely-filing risk for short-window payers (Medicaid 30-95 days, workers' comp varies by state).
Charge Entry
Also known as: Charge Capture; Charge Posting
Charge entry is the revenue cycle step where rendered services are translated into billable charges in the practice management system, including CPT/HCPCS codes, ICD-10 diagnoses, modifiers, units, and place-of-service codes.
Definition
Charge entry occurs after the patient encounter, taking the documented and coded services and entering them as charges against the patient's account for claim generation. The process includes selecting the rendering provider, billing provider, place of service (POS), service date, CPT/HCPCS codes with appropriate modifiers, units, and linked ICD-10-CM diagnoses. Charge entry also captures referring/ordering provider NPI when required, prior-auth numbers, and accident/EPSDT indicators. Errors at charge entry propagate downstream — incorrect POS, missing modifiers, or wrong rendering provider NPI all create denials or rejections.
Example
A cardiology echo procedure: charge entry captures CPT 93306 (TTE complete with Doppler), POS 11 (office) or 22 (hospital outpatient), rendering provider's NPI, the technical/professional split (TC/26 modifier if applicable), referring physician NPI for Medicare claims, and the linked ICD-10 (e.g., I50.9 heart failure or R07.9 chest pain).
Common Misconceptions
Charge entry is not just data entry — it is a coding-adjacent step that requires understanding of place-of-service rules, modifier indications, and diagnosis-procedure linkage. Many denials labeled 'coding errors' actually originate at charge entry where a coder's note was mistranscribed.
Practical Application
Track charge lag (days from date of service to charge entry) as a KPI — best practice is under 3 days. Charge lag over 5 days correlates with timely-filing risk for short-window payers (Medicaid 30-95 days, workers' comp varies by state).
Related Terms
Claim Scrubbing
Claim scrubbing is the automated pre-submission process that runs claims through a rule-set of payer-specific and standards-based edits (NCCI, MUE, HIPAA syntax, payer policies) to identify and correct errors before the claim leaves the practice.
Read definition arrow_forwardClean Claim
A clean claim is a properly completed claim that requires no additional information from the provider, contains no errors or defects, and can be processed by the payer without manual intervention or follow-up.
Read definition arrow_forwardCPT (Current Procedural Terminology)
CPT is the five-digit procedural code set developed and maintained by the American Medical Association that describes medical, surgical, and diagnostic services performed by physicians and qualified health professionals; it is HIPAA-named for use in claims.
Read definition arrow_forwardICD-10-CM
ICD-10-CM is the U.S. clinical modification of the WHO's ICD-10 diagnosis code set, maintained by the CDC's National Center for Health Statistics, used to report diagnoses on all HIPAA-covered claims.
Read definition arrow_forwardModifier 25
Modifier 25, defined by the AMA CPT, indicates a significant, separately identifiable evaluation and management (E/M) service performed by the same physician on the same day as another procedure or other service.
Read definition arrow_forwardWhere This Applies on MedPrecision
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