Author Topic: unbundling  (Read 1390 times)

ste

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unbundling
« 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?

PMRNC

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Re: unbundling
« Reply #1 on: May 05, 2011, 03:44:01 PM »
Yes
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
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