tci Medicare Compliance & Reimbursement - 2017 Issue 3

Unbundling? Expect To Be Unpaid

Keep upcoding on your radar, but watch for double-billing errors, too. If you’re on board with MACRA, then you know that the Quality Payment Program (QPP) is all about the bundle. At the core of value-based, affordable care is coordination, and that’s where the bundled payments come in. Risky business. As bundling continues to be the preferred means of payment with many new CMS initiatives, the desire to unbundle payments for financial gain abounds. However, this has been a long-standing problem with Medicare providers, who have tried in the past to use two CPT® codes when one...

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