Anes 2&3 burn ea add 9% tbsa — 53 bundling rules
If your bill lists 01953 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 — 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 01953
53 code pairs that have billing restrictions with this procedure.
| Code | Description | Rule |
|---|---|---|
| 36000 | Place needle in vein | May bill with modifier |
| 36591 | Draw blood off venous device | Never bill together |
| 36592 | Collect blood from picc | Never bill together |
| 43752 | Nasal/orogastric w/tube plmt | May bill with modifier |
| 76998 | Us guide intraop | Never bill together |
| 93050 | Art pressure waveform analys | Never bill together |
| 95700 | Eeg cont rec w/vid eeg tech | Never bill together |
| 95705 | Eeg w/o vid 2-12 hr unmntr | Never bill together |
| 95706 | Eeg wo vid 2-12hr intmt mntr | Never bill together |
| 95707 | Eeg w/o vid 2-12hr cont mntr | Never bill together |
| 95708 | Eeg wo vid ea 12-26hr unmntr | Never bill together |
| 95709 | Eeg w/o vid ea 12-26hr intmt | Never bill together |
| 95710 | Eeg w/o vid ea 12-26hr cont | Never bill together |
| 95711 | Veeg 2-12 hr unmonitored | Never bill together |
| 95712 | Veeg 2-12 hr intmt mntr | Never bill together |
| 95713 | Veeg 2-12 hr cont mntr | Never bill together |
| 95714 | Veeg ea 12-26 hr unmntr | Never bill together |
| 95715 | Veeg ea 12-26hr intmt mntr | Never bill together |
| 95716 | Veeg ea 12-26hr cont mntr | Never bill together |
| 95717 | Eeg phys/qhp 2-12 hr w/o vid | Never bill together |
| 95718 | Eeg phys/qhp 2-12 hr w/veeg | Never bill together |
| 95719 | Eeg phys/qhp ea incr w/o vid | Never bill together |
| 95720 | Eeg phy/qhp ea incr w/veeg | Never bill together |
| 95721 | Eeg phy/qhp>36<60 hr w/o vid | Never bill together |
| 95722 | Eeg phy/qhp>36<60 hr w/veeg | Never bill together |
| 95723 | Eeg phy/qhp>60<84 hr w/o vid | Never bill together |
| 95724 | Eeg phy/qhp>60<84 hr w/veeg | Never bill together |
| 95725 | Eeg phy/qhp>84 hr w/o vid | Never bill together |
| 95726 | Eeg phy/qhp>84 hr w/veeg | Never bill together |
| 95812 | Eeg 41-60 minutes | Never bill together |
| 95813 | Eeg extnd mntr 61-119 min | Never bill together |
| 95816 | Eeg awake and drowsy | Never bill together |
| 95819 | Eeg awake and asleep | Never bill together |
| 95822 | Eeg coma or sleep only | Never bill together |
| 95829 | Surgery electrocorticogram | Never bill together |
| 95957 | Eeg digital analysis | Never bill together |
| 96523 | Irrig drug delivery device | Never bill together |
| 99151 | Mod sed same phys/qhp <5 yrs | Never bill together |
| 99152 | Mod sed same phys/qhp 5/>yrs | Never bill together |
| 99153 | Mod sed same phys/qhp ea | Never bill together |
| 99155 | Mod sed oth phys/qhp <5 yrs | Never bill together |
| 99156 | Mod sed oth phys/qhp 5/>yrs | Never bill together |
| 99157 | Mod sed other phys/qhp ea | Never bill together |
| 99358 | Prolong service w/o contact | Never bill together |
| 99359 | Prolong serv w/o contact add | Never bill together |
| 99418 | Prolng ip/obs e/m ea 15 min | Never bill together |
| 99446 | Ntrprof ph1/ntrnet/ehr 5-10 | Never bill together |
| 99447 | Ntrprof ph1/ntrnet/ehr 11-20 | Never bill together |
| 99448 | Ntrprof ph1/ntrnet/ehr 21-30 | Never bill together |
| 99449 | Ntrprof ph1/ntrnet/ehr 31/> | Never bill together |
Showing 50 of 53 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.