bundling and unbundling

The term “bundling” in medical coding and especially CPT procedure coding refers to the method of coding two or more procedures as a single service or procedure as the smaller of the two procedure is part of the big procedure and so cannot be billed separately along the bigger inclusive procedure. One simple example is when an IV Push injection is given you can only code for IV Push code 96374 and one cannot code CPT intramuscular injection code 96372 for the IV Push service because injection procedure 96372 is inclusive part of IV Push procedure. When two separate services one IV Push and one intramuscular injection on the same day then we can bill for these two services separately provided 59 modifier is used along with IM injection code to indicate the payer that these are two distinct procedures and not a single IV push.

This is termed “unbundling” refers to the practice of reporting the two bundled services separately to double the reimbursement collected from Medicare and other payers. This may lead to liability under the FCA.

1 comment:

HARRIET ARMIJO said...

WHERE CAN I GET TRAINING ON BUNDLING AND UNBUNDLNG, LIVE TRAINING.

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