Anesth abdominal wall surg — 331 bundling rules
If your bill lists 00700 alongside any of these codes as separate charges, it may be an unbundling error.
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
Common unbundling errors — Evaluation/Management procedures
Unbundling occurs when medical providers bill separately for services that should be combined into a single charge according to National Correct Coding Initiative (NCCI) rules. In evaluation and management procedures, the most common unbundling patterns include billing basic office visit codes alongside routine procedures that are already included in the visit, such as vital signs monitoring or standard physical examinations. Another frequent error involves separately charging for brief consultations or follow-up discussions that are components of the primary E/M service. Additionally, providers sometimes incorrectly unbundle diagnostic interpretations or care coordination activities that are integral parts of the evaluation process. With 276 E/M codes subject to NCCI bundling restrictions, these errors create charges above the benchmark for patients who may be billed twice for what should constitute a single comprehensive service. Understanding these bundling rules helps identify potential differences between submitted claims and appropriate coding standards, ensuring patients receive accurate billing for their medical services.
What to check on your bill
When reviewing your medical bill for evaluation and management services, examine these key areas to identify potential bundling issues. First, check for duplicate charges by looking for multiple procedure codes on the same date that should typically be combined, such as separate charges for consultation, examination, and decision-making that occurred during one visit. Second, watch for code patterns where basic services appear alongside comprehensive codes—for example, a simple office visit code billed with a complete physical exam code for the same encounter. Third, verify that separately billed procedures include appropriate modifiers like "25" or "59," which indicate distinct services that justify separate billing. Fourth, compare charges above the benchmark for your area, as unbundled services often result in higher total costs than bundled alternatives. Review itemized statements carefully, as these billing practices can create potential differences in your final charges.
All bundling rules for 00700
331 code pairs that have billing restrictions with this procedure.
| Code | Description | Rule |
|---|---|---|
| 01996 | Hosp manage cont drug admin | May bill with modifier |
| 0213T | Njx paravert w/us cer/thor | May bill with modifier |
| 0216T | Njx paravert w/us lumb/sac | May bill with modifier |
| 0333T | Visual ep scr acuity auto | Never bill together |
| 0464T | Visual ep test for glaucoma | Never bill together |
| 0632T | Perq tcat us abltj nrv p-art | May bill with modifier |
| 0708T | Id ca immntx prep & 1st njx | Never bill together |
| 0709T | Id ca immntx each addl njx | Never bill together |
| 0903T | Ecg alg 12 lead reduced i&r | May bill with modifier |
| 0904T | Ecg alg 12 ld rdcd trcg only | May bill with modifier |
| 0905T | Ecg alg 12 ld rdcd i&r only | May bill with modifier |
| 31505 | Diagnostic laryngoscopy | May bill with modifier |
| 31515 | Laryngoscopy for aspiration | May bill with modifier |
| 31527 | Laryngoscopy for treatment | May bill with modifier |
| 31622 | Dx bronchoscope/wash | May bill with modifier |
| 31634 | Bronch w/balloon occlusion | May bill with modifier |
| 31645 | Brnchsc w/ther aspir 1st | May bill with modifier |
| 31647 | Bronchial valve init insert | May bill with modifier |
| 36000 | Place needle in vein | May bill with modifier |
| 36010 | Place catheter in vein | Never bill together |
| 36011 | Place catheter in vein | May bill with modifier |
| 36012 | Place catheter in vein | May bill with modifier |
| 36013 | Place catheter in artery | May bill with modifier |
| 36014 | Place catheter in artery | May bill with modifier |
| 36015 | Place catheter in artery | May bill with modifier |
| 36400 | Vnpnxr<3yrs phy/qhp fem/jug | May bill with modifier |
| 36405 | Vnpnxr<3yrs phy/qhp scalp vn | May bill with modifier |
| 36406 | Vnpnxr<3yrs phy/qhp other vn | May bill with modifier |
| 36410 | Vnpnxr 3yr/> phy/qhp dx/ther | May bill with modifier |
| 36420 | Venipuncture cutdown < 1 yr | May bill with modifier |
| 36425 | Venipuncture cutdown 1 yr/> | May bill with modifier |
| 36430 | Transfusion bld/bld compnt | May bill with modifier |
| 36440 | Bld push tfuj 2 yr/< | May bill with modifier |
| 36591 | Draw blood off venous device | Never bill together |
| 36592 | Collect blood from picc | Never bill together |
| 36600 | Withdrawal of arterial blood | May bill with modifier |
| 36640 | Insertion catheter artery | May bill with modifier |
| 43752 | Nasal/orogastric w/tube plmt | May bill with modifier |
| 43753 | Tx gastro intub w/asp | May bill with modifier |
| 43754 | Dx gastr intub w/asp spec | May bill with modifier |
| 61026 | Injection into brain canal | May bill with modifier |
| 61055 | Injection into brain canal | May bill with modifier |
| 62280 | Treat spinal cord lesion | May bill with modifier |
| 62281 | Treat spinal cord lesion | May bill with modifier |
| 62282 | Treat spinal canal lesion | May bill with modifier |
| 62284 | Injection for myelogram | May bill with modifier |
| 62320 | Njx interlaminar crv/thrc | May bill with modifier |
| 62321 | Njx interlaminar crv/thrc | May bill with modifier |
| 62322 | Njx interlaminar lmbr/sac | May bill with modifier |
| 62323 | Njx interlaminar lmbr/sac | May bill with modifier |
Showing 50 of 331 rules. Show all
FAQ — Evaluation/Management procedure bundling
What does 'bundled' mean on a medical bill and what is NCCI bundling?
How can I identify if evaluation and management codes were incorrectly unbundled on my bill?
What should I do if I find charges that appear to be incorrectly unbundled?
When is it legitimate for providers to use modifiers to override NCCI bundling rules?
Data source: CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits, updated quarterly. These code pairs are maintained by CMS to prevent improper billing of services that should be billed as a single procedure.
What this means: When two codes are listed as an NCCI edit pair, billing them separately on the same date of service is typically incorrect. "Never bill together" means no modifier can override the rule. "May bill with modifier" means the codes can be billed separately with appropriate documentation.