Onc pan tum whl gen seq dna — 275 bundling rules
If your bill lists 0297U alongside any of these codes as separate charges, it may be an unbundling error.
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
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 0297U
275 code pairs that have billing restrictions with this procedure.
| Code | Description | Rule |
|---|---|---|
| 0019U | Onc rna tiss predict alg | Never bill together |
| 0029U | Rx metab advrs trgt seq alys | May bill with modifier |
| 0030U | Rx metab warf trgt seq alys | May bill with modifier |
| 0034U | Tpmt nudt15 genes | May bill with modifier |
| 0036U | Xome tum & nml spec seq alys | Never bill together |
| 0046U | Flt3 gene itd variants quan | May bill with modifier |
| 0049U | Npm1 gene analysis quan | May bill with modifier |
| 0070U | Cyp2d6 gen com&slct rar vrnt | May bill with modifier |
| 0086U | Nfct ds bact&fng org id 6+ | May bill with modifier |
| 0111U | Onc colon ca kras&nras alys | May bill with modifier |
| 0133U | Hered prst8 ca rltd do 11 | May bill with modifier |
| 0136U | Atm mrna seq alys | May bill with modifier |
| 0137U | Palb2 mrna seq alys | May bill with modifier |
| 0138U | Brca1 brca2 mrna seq alys | May bill with modifier |
| 0211U | Onc pan-tum dna&rna gnrj seq | May bill with modifier |
| 0229U | Bcat1&ikzf1 prmtr mthyln aly | May bill with modifier |
| 0230U | Ar full sequence analysis | May bill with modifier |
| 0231U | Cacna1a full gene analysis | May bill with modifier |
| 0232U | Cstb full gene analysis | May bill with modifier |
| 0233U | Fxn gene analysis | May bill with modifier |
| 0234U | Mecp2 full gene analysis | May bill with modifier |
| 0235U | Pten full gene analysis | May bill with modifier |
| 0236U | Smn1&smn2 full gene analysis | May bill with modifier |
| 0239U | Trgt gen seq alys pnl 311+ | May bill with modifier |
| 0242U | Trgt gen seq alys pnl 55-74 | May bill with modifier |
| 0244U | Onc solid orgn dna 257 genes | May bill with modifier |
| 0252U | Ftl aneuploidy str alys dna | May bill with modifier |
| 0253U | Rprdtve med rna gen prfl 238 | May bill with modifier |
| 0298U | Onc pan tum whl trns seq rna | May bill with modifier |
| 0299U | Onc pan tum whl gen opt mapg | Never bill together |
| 0300U | Onc pan tum whl gen seq&opt | Never bill together |
| 0409U | Onc sld tum dna 80 & rna 36 | Never bill together |
| 0410U | Onc pncrtc dna whl gn seq 5- | May bill with modifier |
| 0425U | Genom rpd seq alys ea cmprtr | May bill with modifier |
| 0471U | Onc clrc ca 35 vrn kras&nras | May bill with modifier |
| 0481U | Idh1 idh2&tert promoter ngs | May bill with modifier |
| 0507U | Onc ovr dna whole gen w/5hmc | May bill with modifier |
| 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 |
| 81105 | Hpa-1 genotyping | May bill with modifier |
| 81106 | Hpa-2 genotyping | May bill with modifier |
| 81107 | Hpa-3 genotyping | May bill with modifier |
| 81108 | Hpa-4 genotyping | May bill with modifier |
| 81109 | Hpa-5 genotyping | May bill with modifier |
| 81110 | Hpa-6 genotyping | May bill with modifier |
| 81111 | Hpa-9 genotyping | May bill with modifier |
| 81112 | Hpa-15 genotyping | May bill with modifier |
| 81120 | Idh1 common variants | May bill with modifier |
Showing 50 of 275 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.