Author Topic: Bundling cpt codes  (Read 2833 times)

EC

  • Newbie
  • *
  • Posts: 12
Bundling cpt codes
« on: July 01, 2010, 01:20:24 AM »
Hi
Can someone advise me how to unbundle a claim that the insurance bundle up?
Megnacare used to pay each CPT code separately. But start from last month they bundle up the most frequent 4 CPT codes that our PT uses, and they pay a lot less after they bundle our claims.
.... What should I do... Please help.....


Michele

  • Administrator
  • Hero Member
  • *****
  • Posts: 5927
    • Solutions Medical Billing
Re: Bundling cpt codes
« Reply #1 on: July 01, 2010, 12:55:09 PM »
First I must point out that it is illegal to 'unbundle' a claim just to increase reimbursement.  However, what you need to do is go back to the provider to see if the claims were coded correctly on the original submission.  For example, some services require modifiers to indicate exactly what was done.  Two modalities can be considered inclusive and therefore bundled, but the provider may have reason to indicate that the modalities were separate for specific reasons and therefore should not be bundled.  In that case, an appropriate modifier can indicate this.  Many providers do not understand the proper use of modifiers and therefore claims are not coded correctly.  You should educate your provider to make sure they are coding their services correctly.

Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

oneround

  • Full Member
  • ***
  • Posts: 226
Re: Bundling cpt codes
« Reply #2 on: July 01, 2010, 01:56:47 PM »
Good advice Michelle
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

EC

  • Newbie
  • *
  • Posts: 12
Re: Bundling cpt codes
« Reply #3 on: July 02, 2010, 06:41:36 PM »
Thank You  :D

Medical Billing Forum

Re: Bundling cpt codes
« Reply #3 on: July 02, 2010, 06:41:36 PM »