Medical Billing Forum

Coding => Coding => Topic started by: ste on May 05, 2011, 03:07:29 PM

Title: unbundling
Post by: ste on May 05, 2011, 03:07:29 PM
An insurance company enforces the following rule:
97811[ additional unit of acupuncture] and 99354 [prolonged office visit] have an unbundled relationship. This means the latter will always get denied when the two codes are used on the same DOS regardless of any dual licensure (where a claim may be submitted in two parts with each part reflecting a specific specialty).
I cannot find any other insurance companies that apply this rule. Do you know of any? Can one insurance company apply rules that the others do not?
Title: Re: unbundling
Post by: PMRNC on May 05, 2011, 03:44:01 PM
Yes