Final answer:
Unbundling codes to bill separate codes for procedures that should be covered by a single comprehensive code is generally inadvisable and can be considered fraudulent. Accurate reporting should follow NCCI guidelines and CPT bundling rules, with appropriate modifiers used when reporting multiple distinct procedures performed on the same date.
Step-by-step explanation:
The term unbundling codes refers to the practice of using separate codes to bill for procedures that are normally covered by a single comprehensive code. In the context of medicine, this is often inadvisable and can be considered fraudulent if done to increase reimbursement. When two medical procedures are performed on the same date of service, they should be reported accurately according to the National Correct Coding Initiative (NCCI) guidelines and the bundling rules set by the American Medical Association's Current Procedural Terminology (CPT) and other relevant coding standards. These guidelines dictate when it is appropriate to use separate codes or a single comprehensive code.
If two separate and distinct procedures are performed that are not typically bundled, it might be appropriate to use separate codes. However, modifiers should be used to indicate that multiple procedures were performed on the same date, such as modifier 59 or modifier XS, which specify that a procedure or service was distinct or separate from other services performed on the same day. It is essential to comply with payer policies and coding guidelines to ensure that coding is both accurate and ethical.