Rx metab genrx ia 16 genes — 380 bundling rules
If your bill lists 0392U 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 — 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 0392U
380 code pairs that have billing restrictions with this procedure.
| Code | Description | Rule |
|---|---|---|
| 0009U | Onc brst ca erbb2 amp/nonamp | May bill with modifier |
| 0016U | Onc hmtlmf neo rna bcr/abl1 | May bill with modifier |
| 0017U | Onc hmtlmf neo jak2 mut dna | May bill with modifier |
| 0027U | Jak2 gene trgt seq alys | May bill with modifier |
| 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 |
| 0040U | Bcr/abl1 gene major bp quan | May bill with modifier |
| 0046U | Flt3 gene itd variants quan | May bill with modifier |
| 0049U | Npm1 gene analysis quan | May bill with modifier |
| 0069U | Onc clrct microrna mir-31-3p | May bill with modifier |
| 0070U | Cyp2d6 gen com&slct rar vrnt | May bill with modifier |
| 0071U | Cyp2d6 full gene sequence | Never bill together |
| 0072U | Cyp2d6 gen cyp2d6-2d7 hybrid | Never bill together |
| 0073U | Cyp2d6 gen cyp2d7-2d6 hybrid | Never bill together |
| 0074U | Cyp2d6 nonduplicated gene | Never bill together |
| 0075U | Cyp2d6 5' gene dup/mlt | Never bill together |
| 0076U | Cyp2d6 3' gene dup/mlt | Never bill together |
| 0086U | Nfct ds bact&fng org id 6+ | May bill with modifier |
| 0111U | Onc colon ca kras&nras alys | May bill with modifier |
| 0112U | Iadi 16s&18s rrna genes | May bill with modifier |
| 0115U | Respir iadna 18 viral&2 bact | 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 |
| 0140U | Nfct ds fungi dna 15 trgt | May bill with modifier |
| 0141U | Nfct ds bact&fng gram pos | May bill with modifier |
| 0142U | Nfct ds bact&fng gram neg | May bill with modifier |
| 0155U | Onc brst ca dna pik3ca gene | May bill with modifier |
| 0156U | Copy number sequence alys | May bill with modifier |
| 0157U | Apc mrna seq alys | May bill with modifier |
| 0158U | Mlh1 mrna seq alys | May bill with modifier |
| 0159U | Msh2 mrna seq alys | May bill with modifier |
| 0160U | Msh6 mrna seq alys | May bill with modifier |
| 0161U | Pms2 mrna seq alys | May bill with modifier |
| 0169U | Nudt15&tpmt gene com vrnt | May bill with modifier |
| 0177U | Onc brst ca dna pik3ca 11 | May bill with modifier |
| 0202U | Nfct ds 22 trgt sars-cov-2 | 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 |
| 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 |
| 0252U | Ftl aneuploidy str alys dna | May bill with modifier |
| 0476U | Rx metab psyc 14gen&cyp2d6 | Never bill together |
| 0477U | Rx metab psy 14&cyp2d6 gn-rx | Never bill together |
| 0500U | Autoinflam ds vexas synd dna | May bill with modifier |
| 0516U | Rx metab rxgenomic gnotyp 40 | Never bill together |
Showing 50 of 380 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.