Onc colon ca kras&nras alys — 130 bundling rules
If your bill lists 0111U alongside any of these codes as separate charges, it may be an unbundling error.
About the analyst
Elena Vasquez leads hospital billing pattern analysis at BillRazor Research. She focuses on identifying overcharges, markup outliers, and patient advocacy strategies. Expertise: hospital billing patterns, overcharge analysis, patient advocacy.
Common unbundling errors — medical procedures
Unbundling occurs when medical providers bill two separate codes for services that should be combined into a single charge according to National Correct Coding Initiative (NCCI) rules. In other procedures including anesthesia, radiology, pathology, and miscellaneous support services, common unbundling patterns include separately billing diagnostic imaging with its professional interpretation when both should be included in one comprehensive code, and charging for basic monitoring or preparation services alongside the primary procedure when these components are considered integral parts of the main service. Another frequent error involves billing multiple pathology examination codes for what constitutes a single comprehensive analysis. With 809 other codes subject to bundling restrictions in the NCCI database, these errors create charges above the benchmark for patients who receive multiple bills for what should constitute one complete service. The potential difference between unbundled billing and correct coding practices can significantly impact patient financial responsibility, as they may face duplicate charges for components of care that medical coding standards define as a single billable service.
What to check on your bill
When reviewing itemized bills for procedure bundling issues, patients should examine several key areas to identify potential billing irregularities. Look for multiple procedure codes billed on the same date that represent components of a comprehensive service, such as separate charges for incision, repair, and closure when these steps are typically included in one primary procedure code. Watch for code patterns where related procedures share the same first three digits, as these often indicate services that should be bundled together under Medicare's Correct Coding Initiative. Check for appropriate modifier usage, particularly modifier 59 or XS, which legitimately allow separate billing when procedures are performed on different anatomical sites or during distinct sessions. Without proper modifiers, separately billed related procedures may represent charges above the benchmark. Compare your itemized statement against standard bundling practices for your specific procedure type to identify potential differences in billing patterns.
All bundling rules for 0111U
130 code pairs that have billing restrictions with this procedure.
| Code | Description | Rule |
|---|---|---|
| 0009U | Onc brst ca erbb2 amp/nonamp | May bill with modifier |
| 0068U | Candida species pnl amp prb | May bill with modifier |
| 0202U | Nfct ds 22 trgt sars-cov-2 | May bill with modifier |
| 0330U | Iadna vag pthgn panel 27 org | May bill with modifier |
| 0464U | Onc clrct scr qrtsa dna mrk | Never bill together |
| 80503 | Path clin consltj sf 5-20 | May bill with modifier |
| 80504 | Path clin consltj mod 21-40 | May bill with modifier |
| 80505 | Path clin consltj high 41-60 | May bill with modifier |
| 80506 | Path clin consltj prolng svc | May bill with modifier |
| 81513 | Nfct ds bv rna vag flu alg | May bill with modifier |
| 84311 | Spectrophotometry | May bill with modifier |
| 87140 | Culture type immunofluoresc | May bill with modifier |
| 87143 | Culture typing glc/hplc | May bill with modifier |
| 87147 | Culture type immunologic | May bill with modifier |
| 87149 | Dna/rna direct probe | May bill with modifier |
| 87150 | Dna/rna amplified probe | May bill with modifier |
| 87152 | Culture type pulse field gel | May bill with modifier |
| 87153 | Dna/rna sequencing | May bill with modifier |
| 87154 | Cul typ id bld pthgn 6+ trgt | May bill with modifier |
| 87158 | Culture typing added method | May bill with modifier |
| 87468 | Anaplsma phgcytophlm amp prb | May bill with modifier |
| 87469 | Babesia microti amp prb | May bill with modifier |
| 87471 | Bartonella dna amp probe | May bill with modifier |
| 87472 | Bartonella dna quant | May bill with modifier |
| 87475 | Lyme dis dna dir probe | May bill with modifier |
| 87476 | Lyme dis dna amp probe | May bill with modifier |
| 87478 | Borrelia miyamotoi amp prb | May bill with modifier |
| 87480 | Candida dna dir probe | May bill with modifier |
| 87481 | Candida dna amp probe | May bill with modifier |
| 87482 | Candida dna quant | May bill with modifier |
| 87483 | Cns dna amp probe type 12-25 | May bill with modifier |
| 87484 | Ehrlicha chaffeensis amp prb | May bill with modifier |
| 87485 | Chlmyd pneum dna dir probe | May bill with modifier |
| 87486 | Chlmyd pneum dna amp probe | May bill with modifier |
| 87487 | Chlmyd pneum dna quant | May bill with modifier |
| 87490 | Chlmyd trach dna dir probe | May bill with modifier |
| 87491 | Chlmyd trach dna amp probe | May bill with modifier |
| 87492 | Chlmyd trach dna quant | May bill with modifier |
| 87493 | C diff amplified probe | May bill with modifier |
| 87495 | Cytomeg dna dir probe | May bill with modifier |
| 87496 | Cytomeg dna amp probe | May bill with modifier |
| 87497 | Cytomeg dna quant | May bill with modifier |
| 87498 | Enterovirus probe&revrs trns | May bill with modifier |
| 87500 | Vanomycin dna amp probe | May bill with modifier |
| 87501 | Influenza dna amp prob 1+ | May bill with modifier |
| 87502 | Influenza dna amp probe | May bill with modifier |
| 87503 | Influenza dna amp prob addl | May bill with modifier |
| 87505 | Nfct agent detection gi | May bill with modifier |
| 87506 | Iadna-dna/rna probe tq 6-11 | May bill with modifier |
| 87507 | Iadna-dna/rna probe tq 12-25 | May bill with modifier |
Showing 50 of 130 rules. Show all
FAQ — medical procedure bundling
What is NCCI bundling and what does 'bundled' mean on a medical bill?
How can I identify if codes were incorrectly unbundled on my bill?
What should I do if I find unbundled charges on my medical bill?
When is it legitimate 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.