The term bundling denotes the utilization of a unified CPT code to designate various operations that were carried out throughout a care episode that was provided over a certain length of time. If you use coding software, the software indicates when two or more procedures are incidental to another. The provider you work for is bound by ethics to submit truthful claims. Or, on the other hand, the payer may overlook a CPT modifier and therefore reimburse less than what is due to the provider. They cannot be added solely based on the providers opinion. While there is a CPT code for cauterizing nosebleeds, it should not be used when that procedure is encompassed by the more complex endoscopy. If the physician cauterizes the nosebleed, it is appropriate to bill the endoscopy and the cauterization using separate CPT codes because they were provided at different times. A unified payment is made to healthcare professionals and/or facilities under the bundled payment system for all services rendered to treat a patient during a particular episode of treatment. However, a single code could be subject to bundling might be bundled with dozens of codes. This tactic of. Bundling/Unbundling | Medical Billing and Coding Forum - AAPC Rather, the procedure should be billed using just the CPT code for the endoscopy. Article - Laboratory Panels - Coding and Billing (A56486) Speak to a whistleblower attorney experienced in evaluating claims of upcoding or unbundling.
Jeremy J. Sierra, PhD, is an assistant professor of marketing with a teaching interest in sports marketing and marketing research.
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