Question

Using two separate procedure codes instead of a combination code is known as _____.

A. Unbundling
B. Downcoding
C. Upcoding
D. Sequencing

Answer 1

Unbundling refers to the practice in medical billing where two separate procedure codes are used instead of a single combination code for the entire procedure, which could result in higher costs.

Step-by-step explanation:

Using two separate procedure codes instead of a combination code is known as unbundling. In medical billing and coding, unbundling is the practice of using multiple Current Procedural Terminology (CPT) codes for parts of a procedure when a single combination code is available and appropriate for the entire procedure. This could potentially lead to higher costs as each separate code may be associated with a distinct charge. Therefore, medical practices need to ensure they use the correct coding to represent the health care services provided, to avoid incorrect billing and potential issues with insurance claims.