Bundling and Unbundling

Bundling means combining multiple component services into a single comprehensive code (correct coding). Unbundling is fragmenting a comprehensive service into component parts to bill multiple codes (incorrect, often fraud). NCCI PTP edits enforce correct bundling. Common unbundling violation: billing 99213 + 36415 + 81000 separately when all three are part of an annual physical billed as G0438. OIG Strike Force prosecutes deliberate unbundling.