To diminish such risk, what is often recommended?

To diminish such risk, what is often recommended?

• A. The bundled or excluded codes should not be reported.
• B. Always report both codes.
• C. Only report if the payer approves.
• D. Delay reporting until the next quarter.

Answer: (A)

In medical coding, some services are considered bundled into a single, more comprehensive procedure. To reduce the risk of denial, audit flags, or accusations of unbundling, the usual guidance is not to report codes that are bundled or excluded separately. This keeps claims aligned with payer rules and the documentation, preventing duplicative or inappropriate charges. Reporting both codes, waiting for payer approval, or delaying reporting doesn’t address these bundling rules and can increase risk of denials or audits.

In medical coding, some services are considered bundled into a single, more comprehensive procedure. To reduce the risk of denial, audit flags, or accusations of unbundling, the usual guidance is not to report codes that are bundled or excluded separately. This keeps claims aligned with payer rules and the documentation, preventing duplicative or inappropriate charges. Reporting both codes, waiting for payer approval, or delaying reporting doesn’t address these bundling rules and can increase risk of denials or audits.