AHA Coding Clinic® for HCPCS - 2015 Issue 4

Bundling/unbundling caution is essential for accurate coding and reporting

Bundling is defined as the inclusive grouping of codes related to a procedure when reporting and submitting codes to the payer for medical services rendered. Some codes, by nature, are included in other codes that describe a more comprehensive service, which encompasses the lesser procedure. In reimbursement systems the more comprehensive code is valued at a rate that includes the lesser procedure, so it becomes inappropriate to report both codes. Reporting multiple CPT or HCPCS codes when a single comprehensive code describes the service(s) provided is referred to as “unbundling.” The Centers for Medicare & Medicaid Services...

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